Dermatomyositis

Dermatomyositis is an uncommon autoimmune disorder that causes inflammation of the skin and muscles. Characteristics of the condition include a distinct rash on the skin, muscle weakness and inflammation, and issues with the tissues near the muscles. Even though a cure has not been found yet, the manifestations can generally be handled through medication, physiotherapy or other forms of treatment.

The exact cause of the condition is unknown, but it belongs to the myositis family of illnesses, which is characterised by inflammation of the muscles.

Dermatomyositis is more prevalent in females than males and can occur in children and adults. It is most commonly seen in children aged 5 to 15 and adults between 40 to 60.

If you suspect you might have dermatomyositis, display signs of a skin rash, or have been experiencing any muscle weakness, it is recommended that you visit your doctor.

Dermatomyositis can cause a rash that appears in a patchy pattern and can be either blue-violet or red. In some cases, the rash develops abruptly; in others, it seems more gradual.

The rash can be seen on various body parts, such as the knees, toes, elbows, chest, back, eyelids, nose, cheeks, knuckles or nail cuticles. It may cause itching and even be painful. Hard tissue and calcium lumps may sometimes form under the skin, especially in children. This is known as calcinosis and can be removed through surgery.

You may not experience muscle weakness until a few weeks or months after the rash appears. It may begin in your hips, thighs, shoulders, arms, and neck and worsen over time.

There are also other symptoms you may experience, including:

• Swallowing problems
  
  
• Sore or painful muscles
  
  
• Swelling around the affected areas
  
  
• Weight loss (more so in adults than children)
  
  
• Tiredness
  
  
• Fever
  
  
• Night sweats

Shortness of breath and aspiration (inhaling food or liquids) are often associated with difficulty swallowing, a common symptom of this condition. Tiny red dots on the fingernails can also indicate this disorder, as can leaky capillaries.

Some individuals may experience no muscle weakness or pain, referred to as amyopathic dermatomyositis, while the severity of the symptoms varies from person to person.

Mild cases may present minimal symptoms, while more severe cases can cause significant impairment.

A trip to the doctor is a must if you have skin rashes and muscle weakness. Unfortunately, there is no cure for this condition; however, you can manage it effectively with proper treatment. Some of the treatments for dermatomyositis may include:

Physiotherapy

Even when symptoms are severe, it is essential to keep your muscles active, as physiotherapy can help to maintain or even enhance muscle strength. It is vital to keep your muscles moving to benefit from physiotherapy.

Corticosteroid medication (steroids)

To manage dermatomyositis, creams can be applied to the rash, tablets can be taken to address muscle weakness, and injections may be administered as needed. This is the typical approach to treating the condition.

Corticosteroids are medications used to reduce inflammation and inhibit the immune system's response, thereby reducing the levels of antibodies in the body. Although these drugs can be effective, they can also cause side effects. Therefore, they should be taken at the lowest possible dose for the shortest amount of time. Doctors usually start with a high dose and then gradually reduce the dosage to minimise the risk of side effects.

Intravenous immunoglobulin therapy

In dermatomyositis, where breathing or swallowing is affected, intravenous immunoglobulin therapy (IVIG) may be an option. This therapy involves injecting healthy antibodies into the body, which block the antibodies attacking the muscles and skin. These antibodies are taken from donated blood and delivered to the patient via IV.

Disease-modifying anti-rheumatic drugs

DMARDs can be used to treat severe muscle weakness due to inflammation. These drugs work by suppressing the activity of the immune system, which reduces inflammation and relieves muscle pain.

Biological therapy

 If immunosuppressants and steroid medications are ineffective in treating your dermatomyositis, biological therapies may be an option. These therapies work by blocking the inflammation in your body, thus helping to reduce the symptoms.

Depending on the severity of dermatomyositis, your doctor may recommend one or more treatments. Generally, the condition responds positively to treatment, and patients may need to remain on a course of medication or treatment for their lives.

After hearing your symptoms, the doctor will evaluate any rash you may have over video consultation to determine if it is related to dermatomyositis. They will refer you for further testing if they believe it is possible.

The doctor might recommend the following tests:

• Muscle biopsy - An examination of muscle tissue to identify inflammation or other issues.
  
  
• Skin biopsy - Analysis of a skin sample to detect disease-related changes.
  
  
• Blood tests - Measuring auto-antibody levels and muscle enzymes to assess muscle damage.
  
  
• Electromyography (EMG) - Recording electrical impulses controlling muscles to detect signs of muscle damage.
  
  
• MRI - Using magnetic resonance imaging to identify muscle abnormalities and inflammation throughout the body.
  
  
• X-ray - A chest X-ray may be conducted to identify potential lung damage associated with the condition.

You can consult with a doctor regarding dermatomyositis at your convenience. Our medical professionals are accessible seven days a week and can provide guidance. They can recommend a specialist for additional evaluation or treatment. Schedule an appointment online now.