Dermatomyositis is a disease of the connective-tissue which is defined by swelling of the skin and muscles. This condition affects adults and children however it is more common in females than males. It mostly affects the skin and muscles, but it may also affect the lungs and oesophagus.
Paraneoplastic is a phenomenon that develops in the presence of cancer, usually pre-existent ones. In such cases, the removal of the cancerous growth results in dermatomyositis. The condition, on diagnosis, discloses dystrophic calcification of muscles and sometimes calcium deposits under the skin. The accompanying rash appears and disappears with topical applications, but the Gottron's papules, pink knuckle patches, and priapism are unmistakable symptoms. This malady is studied in relation to polymyositis and body myositis. When the condition strikes children, it is referred to as juvenile dermatomyositis (JDM).
What are the causes of Dermatomyositis
The cause of dermatomyositis is not known yet however, research reveals that it could be associated with a viral infection or some autoimmune reaction. There have been a number of cases in which the condition has developed in the presence of autoimmune diseases such as scleroderma, lupus or vasculitis. The link between dermatomyositis and autoimmune disease has been established beyond doubt and is the main reason for the preference of antinuclear antibody tests for proper diagnosis.
- Muscle fascicles, surrounded by shrunken polygonal muscle fibres
- Mature lymphocytes, with scant cytoplasm and dark nuclei
- B- and T-cells in equal numbers
- Damaged microscopic vessels and lymphocytic inflammation
- Tissue ischemia
- Dominant lymphocyte myopathies, inflammatory in nature
This condition can be treated with the help of prednisone
, plasmapheresis, IVIG (intravenous immunoglobulin), and chemotherapy
. Today, there are a number of immune-modulating drugs available to address the onset of this condition. Before the treatment, a thorough diagnosis of the condition with the help of EMG (electromyography), muscle biopsy
, and a number of other prescribed blood tests
is done. The muscle biopsy results usually highlight either mixed B and T-cell perivascular infiltrate or perifascicular muscle atrophy. The condition is commonly associated with auto-antibodies like anti-Jo1. Dermatomyositis is also treated with the help of orthotic devices. Options like intravenous immunoglobulin, immunosuppressants, and topical corticosteroids are a part of the treatment.
Corticosteroids help to suppress the immune system and limit antibody production. This helps in reducing the painful muscle and skin inflammation. However, prolonged corticosteroid usage results in osteoporosis, weight gain, and diabetes. The immunosuppressant treatment option includes the administration of drugs such as azathioprine
and methotrexate. Anti-malarial medication like hydroxychloroquine and chloroquine phosphate also helps to ease the inflammation. Physiotherapy
is also an important part of treatment. The exercises are designed around the need to improve muscle strength and flexibility. Surgery
is a treatment option resorted only to remove the painful calcium deposits. Doctors may also prescribe pain relievers and radiation therapy.