DERMATOMYOSITIS

Dermatomyositis is an inflammatory disease marked by muscle weakness and a distinctive skin rash, which sets it apart from other muscle diseases. Some people with dermatomyositis also have a connective tissue disorder, such as lupus or rheumatoid arthritis.

While rare in general, dermatomyositis affects adults (usually ages 50-70) and children (usually ages 5-15) alike. Women are twice as likely as men to be diagnosed with the disease.

Symptoms

The most common signs and symptoms of dermatomyositis include:

• Skin changes. A violet or dusky red rash, most commonly on the face and eyelids, and around the nails, knuckles, elbows, knees, chest and back. The rash, which can be patchy with bluish-purple discolorations, is often the first sign of dermatomyositis.
• Muscle weakness. Progressive muscle weakness involves the muscles closest to the trunk, such as those in the hips, thighs, shoulders, upper arms and neck. This affects both the left and right sides of the body, and tends to worsen gradually.

Treatment Options

There is no cure, but periods of remission, when symptoms improve spontaneously, may occur. Treatment can clear the skin rash and help regain muscle strength and function. The earlier treatment is started in the course of dermatomyositis, the more effective it is, resulting in fewer complications.

Treatment methods include:

• Physical therapy: To help stretch and strengthen the muscles. Orthotics or assistive devices may also be used.
• Skin treatment: You may need to avoid sun exposure and wear sunscreen to help prevent skin rashes. Itchy rashes can be treated with antihistamine drugs or with anti-inflammatory steroid creams.
• Anti-inflammatory medications: Steroid drugs or corticosteroids that ease inflammation in the body. They may be given by mouth or through an IV.
• Immunosuppressive drugs: Drugs that block or slow down the immune system.
• Immunoglobulin:Donated blood products that may boost the immune system. Put directly into the bloodstream through an IV. Generally an option only if other treatments have failed.
• Surgery: May be necessary to remove calcium deposits (calcinosis) under the skin if they become painful or infected.