Dermatomyositis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Dermatomyositis is a term used to describe a disease of the muscles called myopathy (a disorder of muscle tissue). This condition is characterized by chronic muscle inflammation and muscle weakness.
The hallmark of this disease is a skin rash that precedes or accompanies muscle weakness.
Dermatomyositis can be found at any age. However, it is more common in adults in their late 40s to early 60s, or children ages 5–15.
This condition is more common in women than men. This disease cannot be cured, but the symptoms can be controlled.
Symptom
Some of the symptoms that dermatomyositis sufferers may complain of are:
- A blue-purplish rash, often found on the shoulders and back, knuckles (often with changes in the cuticles), palms and fingers, knees and elbows, eye area, and upper chest, and is shaped usually in a ‘V’ shape.
- Calcinosis, calcium deposits that form hard lumps under the skin or in the muscles.
- Weakness in the torso
- Difficulty standing up from a sitting position
- Weakness and pain in the joints
- Difficulty swallowing
- Unexplained weakness
- Tired all the time, even after resting
- In 15-30% of sufferers can be found effects on the lungs and difficulty breathing
- Difficulty swallowing, difficulty speaking
- GERD
- Cardiomyopathy
- Malignancy, in adult patients
Reason
The exact cause of dermatomyositis is not known. However, it is suspected that there is a role for genetic factors, immune system disorders, infections, and environmental factors. Although dermatomyositis rarely affects several members of a family, it is thought that there are genetic factors that make a person more at risk of developing this disease.
In terms of immunity, it is thought that this condition is influenced by the body’s immune system which attacks its own muscle cells and blood vessels by accident. According to the American College of Rheumatology, this theory is the most widely accepted as cause of dermatomyositis.
Several infectious agents are also believed to be triggers for dermatomyositis. These include the coxsackievirus, parvovirus, echovirus, Toxoplasma, Borellia, and several other types of viruses. In addition, several types of drugs are also thought to be a trigger for this disease. For example statins, interferons, BCG vaccines, and several others.
Diagnosis
There are five criteria to help establish the diagnosis of this disorder as proposed by Bohan and Peter in 1975, namely:
- Progressive symmetrical weakness of the proximal limbs
- Increased muscle enzyme levels
- Abnormal findings on electromyography
- Abnormal findings on muscle biopsy
- Appropriate skin complaints
To determine the diagnosis, a complete evaluation is also required which consists of:
- In Anamnesis, the doctor will conduct interviews about the history of the disease, complaints that are felt, and so on
- Physical examination, this direct examination can be known:
- On the skin, there are characteristic and typical symptoms (pathognomic) such as heliotrope, papule l Gottron. Characteristic but not distinctive symptoms include malar erythema (a red, butterfly-shaped rash on the face that appears on the cheeks), violaceous erythema on sun-exposed areas, changes in the area around the nails and cuticles, and several other signs.
- Quadriparesis occurs in the muscles, namely difficulty changing positions from sitting to standing without holding on or weakness of the neck flexor muscles, but the distal area is generally not a problem.
- The necessary supporting examinations are generally in the form of:
- Laboratory and other tests: muscle enzymes (creatine kinase, aminotransferase, etc.), antinuclear antibodies, ECG, malignancy screening (colonoscopy, pap-smear, CA-125, CA-19-9).
- Imaging: ultrasound, MRI, electromyography.
Treatment
This form of treatment for dermatomyositis is not curative but aims to help control symptoms. Several types of treatment that may be recommended:
- Non-pharmacology, treatment in the form of physiotherapy, avoiding sun exposure, using sunscreen, avoiding eating before going to bed, elevating the head position while sleeping, and several other ways
- Pharmacology, administration of corticosteroid-type drugs, immunosuppressive drugs (suppresses the immune system), immunoglobulins, anti-malarial drugs, and several other types of drugs.
Prevention
The cause is not known with certainty, making this dermatomyositis disorder cannot be prevented. Routine monitoring of the condition by a doctor can help prevent this condition from getting worse.