School of Allied Health & College of Applied Sciences and Arts DERMATOMYOSITIS Sandi Watts, MHA, R.T. (R) School of Allied Health & College of Applied Sciences and Arts A rare inflammatory condition causing rashes on the skin and weakness of the skeletal muscles AGE/GENDER Children aged between 5 and 15 years of age Adults aged 40 to 60 years of age Affects females more than males 2:1 DERMATOMYOSITIS Dermatomyositis can occur in adults between the ages of 40 to 70, but can also develop in children. There is no cure for this disease but there is medications, therapies and self-care that can reduce pain, increase muscle strength and relieve skin rashes. Dermatomyositis invades the muscles and skin through the blood vessels and causes inflammation that will in turn damage the muscles and skin. Symptoms of this disease can include redness of skin in various areas of the body including but not limited to the eyelids, arms, shoulders, hands, chest and back. The area of redness can also vary in size and shape. There is muscle pain and weakness in the areas of skin erythema. Individuals with Dermatomyositis can also experience fatigue and weight loss. Diagnosing this disease include lab testing and imaging procedures. After diagnosis, the patient is informed of how photosensitive their skin is so it is imperative for individuals with Dermatomyositis to stay out of direct sun light, or wear broad-spectrum sunscreens and clothing that is photo protective. Treating the muscle disease of Dermatomyositis includes staying active to keep muscles moving. This disease can have complications, which includes cardiac, and lung destruction. Due to complications arising from Dermatomyositis, patients may be encouraged to have a team of physicians working together. With no cure for Dermatomyositis, the disease is monitored closely including assessment of muscle strength and examination of the skin. http://www.sciencedirect.com/science/article/pii/S0140673699051570#fig4 https://understandingmyositis.org/myositis/dermatomyositis/ HOW IS THIS DIAGNOSED? Blood tests: can indicated muscle damage and autoantibodies Chest X-ray: can show lung damage Electromyography: measures electrical activity in muscles MRI: provides cross sectional images of muscles, can assess inflammation. SYMPTOMS Skin changes. Rash develops on: chest back knees elbows face eyelids Muscle weakness in the areas of: hips thighs shoulders upper arms neck. Muscle pain Joint inflammation Fatigue Weight loss Lung problems http://www.physicianspractice.com/lupus/rash-questions-rheumatologists/page/0/4 TREATMENT/MEDICATIONS Corticosteroids such as Prednisone: controls symptoms quickly Corticosteroid-sparing agents: used to decrease dose and side effects of corticosteroids Rituxan: used if initial medications do not work Sunscreens: to protect rash on skin http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)05157-0/fulltext?rss=yes https://understandingmyositis.org/myositis-complications/interstitial-lung-disease Muscles typically affected by PM/DM. Image courtesy of the Muscular Dystrophy Association. REFERENCES Femia, Alisa N., Callen, Jeffrey P., Vleugels, Ruth Ann (2017) Dermatomyositis Treatment & Management. Medscape, Retrieved from https://emedicine.medscape.com/article/332783-treatment#showall Harmon, Angela (2017) Dermatomyositis. Salem Press Encyclopedia of Health, Item: 87321782 Shiel, William c. Jr. (Reviewed 2016) Polymyositis and Dermatomyositis. Medicinenet.com, Retrieved from https://www.medicinenet.com/polymyositis/article.htm Mayo Clinic Staff (1998-2017) Dermatomyositis. Mayo Foundation for Medical Education and Research, Retrieved from https://www.mayoclinic.org/diseases-conditions/dermatomyositis/symptoms-causes/syc-20353188?p=1 What is Dermatomyositis? Myositis Support and Understanding, Retrieved from https://understandingmyositis.org/myositis/dermatomyositis/ Case courtesy of Radswiki, Radiopaedia.org, rID: 11355   http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)05157-0/fulltext?rss=yes http://www.physicianspractice.com/lupus/rash-questions-rheumatologists/page/0/4 https://understandingmyositis.org/myositis-complications/interstitial-lung-disease http://www.svuhradiology.ie/case-study/dermatomyositis-mri MANAGEMENT - PROGNOSIS Well balanced diet Stay active with exercise Take protective measures when in the sun Continue medications when needed May have remission periods Annual physical exams May need to incorporate a “team” of physicians to help manage disease Case courtesy of Radswiki, Radiopaedia.org, rID: 11355 COMPLICATIONS Calcium deposits in muscles, skin, connective tissue (Calcinosis) Increased risk of falling Bumps over knuckles, elbows, knees (Gottron’ s Sign) Increased risk of infection Interstitial lung disease Cardiovascular disease http://www.svuhradiology.ie/case-study/dermatomyositis-mri THERE IS NO CURE AT THIS TIME