The following symptoms and complaints may indicate dermatomyositis (muscle inflammation with skin involvement): Main symptoms Skin involvement: Head/face Alopecia (hair loss) Scaling in sun-exposed areas (forehead, auricles, walls and neck (shawl sign). Erythema (skin redness), slightly purple in color – this extends to the parts of the body exposed to sunlight (scalp, face, neck, neckline, … Dermatomyositis: Symptoms, Complaints, Signs
Pathogenesis (disease development) The exact causes of dermatomyositis have not yet been determined. Genetic factors (HLA associations) and pathologic autoimmunologic processes have been demonstrated to date. This is supported by the fact that autoantibodies or immune complex deposits in the vessels can be detected in some of the affected individuals. Etiology (Causes) Biographic Causes Genetic … Dermatomyositis: Causes
General measures Acute phase of illness: bed rest or physical rest. Pay attention to adequate sun protection! UV radiation can aggravate the skin symptoms. Review of permanent medication due topossible effect on the existing disease. Regular check-ups Regular medical checkups Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according to a mixed diet … Dermatomyositis: Therapy
Medical history (history of illness) represents an important component in the diagnosis of dermatomyositis (muscle inflammation with skin involvement). Family history Are there frequent skin diseases, muscle diseases, autoimmune diseases in your family? Are there any hereditary diseases in your family? Social history What is your profession? Is there any evidence of psychosocial stress or … Dermatomyositis: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Hypothyroidism (underactive thyroid gland); rare. Skin and subcutaneous (L00-L99). Allergic contact dermatitis of the face Musculoskeletal system and connective tissue (M00-M99). Inclusion body myositis – neuromuscular disease; weakness near the trunk, fewer atrophies. Muscular dystrophies (muscle atrophy). Myositides (muscle inflammation), infectious origin (Coxsackie viruses, trichinae). Polymyalgia rheumatica – inflammatory … Dermatomyositis: Or something else? Differential Diagnosis
Dermatomyositis (DM) (synonyms: Dermatomucomyositis; Dermatomucosomyositis; Dermatomyositis; Purple disease; Petges-Cléjat-Jacobi syndrome; Poikilodermatomyositis; Pseudotrichinosis; Pseudotrichinosis; Wagner disease; Wagner polymyositis; Wagner-Unverricht syndrome; White-spotted purple disease; ICD-10-GM M33. 1: Other dermatomyositis) is an inflammatory muscle disease (myositis/muscle inflammation) that also affects the skin (dermatitis/inflammation of the skin). Involvement of internal organs such as the heart, lungs, gastrointestinal tract is … Dermatomyositis: Symptoms, Causes, Treatment
The following are the most important diseases or complications that can be caused by dermatomyositis (muscle inflammation with skin involvement): Respiratory system (J00-J99) Aspiration pneumonia (pneumonia caused by inhalation of foreign material (often stomach contents)) – due to weakness of the esophageal muscles (muscles of the esophagus). Pulmonary fibrosis (connective tissue remodeling of the lungs). … Dermatomyositis: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing) of the skin [Face: erythema (redness of the skin), slightly purplish; tearful facial expression; edema of the periorbital region (swelling at the side and below the … Dermatomyositis: Examination
1st order laboratory parameters – obligatory laboratory tests. Blood count Eosinophilia (increase in the number of eosinophilic granulocytes) [frequently expressed]. Leukocytosis with left shift [may occur]. Lymphopenia (decrease in lymphocytes). Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Muscle enzymes Creatine kinase (CK) [↑] Aldolase [↑] GOT [↑] Lactate dehydrogenase (LDH) [↑] … Dermatomyositis: Test and Diagnosis
Therapy goals Symptom relief Immunosuppression (drug suppression of the immune system). Therapy recommendations Local treatment Symptomatic local corticosteroids (as ointment). Removal of calcinosis lesions Systemic treatment Central treatment with glucocorticoids: Prednisolone; possibly higher initial dose in the first 4 weeks. Cave: fluorinated glucocorticoids such as dexamethasone and triamcinolone can cause myopathies (muscle pain) and should … Dermatomyositis: Drug Therapy
Obligatory medical device diagnostics. Electromyography (EMG; measurement of electrical muscle activity). Capillary microscopy of the nail fold Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging method (using magnetic fields, i.e., without X-rays); particularly well suited for visualizing soft tissue lesions) – to find the right sampling site for biopsy, because the changes are detectable only in … Dermatomyositis: Diagnostic Tests
For prevention of dermatomyositis (muscle inflammation with skin involvement), attention must be paid to reducing individual risk factors. If autoimmune disposition is present, the following provoking factors (triggers) may be considered: Muscle strain Viral infections (coxsackie, picorna viruses). Medications (rare): Allopurinol (urostatic drug/for treatment of elevated uric acid levels). Antimalarials such as chloroquine D-penicillamine (antibiotic) … Dermatomyositis: Prevention
