There are a variety of skin conditions that might affect you throughout your life, and some of them can be very rare. One of the many rare skin conditions you might become inflicted with is dermatomyositis, and it will show very distinctive symptoms.
Dermatomyositis is a rare inflammatory disease of the skin which can occur at any age. Adults between age 40 and age 60 are the most likely group to get the skin condition as well as children between ages of 5 and 15. Dermatomyositis can occur in men or women but it does appear most often in women. The symptoms of dermatomyositis will occur over a period of time, which might be weeks or months. Some of the most common symptoms of dermatomyositis include a violet-colored rash and progressive muscle weakness. The violet-colored rash will most commonly affect your eyelids, face, nails, knuckles, knees, chest, back and elbows. The rash can appear sporadic in nature, often showing up as small patches throughout the body. Usually this is the first sign of dermatomyositis, but it can also be a symptom of other skin conditions. Progressive muscle weakness is also common and will occur in muscles closest to the trunk of your body such as your shoulders, arms, neck and thighs. The muscle weakness will affect both your left and right side and since it is progressive, it will worsen over time. You might also show other symptoms of the condition such as fatigue, fever, weight loss and muscle pain or tenderness. Someone with dermatomyositis might also have a difficult time swallowing, which can be painful. Lung problems, calcium deposits under the skin, intestinal perforations and gastrointestinal ulcers are also likely symptoms. The calcium deposits and gastrointestinal ulcers are most commonly seen in children, but an adult with dermatomyositis could be affected with them as well.
Dermatomyositis is classified with other diseases of the muscles called inflammatory myopathies. Most of the time diseases within this category have unknown causes and dermatomyositis is one of these conditions. Usually conditions like these are infections caused by parasites, viruses or bacteria, but it might be hard to determine in someone with dermatomyositis. Some doctors believe that there is a predisposition which might cause dermatomyositis to occur, such as a genetic susceptibility. Autoimmune disorders and inflammatory myopathies often have a lot of the same characteristics, such as the immune system attacking normal cells. Someone who has dermatomyositis might have an unknown trigger in their immune system which is causing their body to attack healthy tissues.
Although there might not be an exact cause for dermatomyositis, the diagnosis of the condition is rather easy. The easy diagnosis is due to the fact that dermatomyositis has a specific rash associated with it, which will be obvious to any doctor. A doctor might even diagnose dermatomyositis without knowing any other facts of your condition, just based on the characteristic rash alone. In order to confirm the diagnosis, the doctor will ask you about all of your signs and symptoms and will give you a thorough physical examination. Magnetic resonance imaging might also be used to diagnose dermatomyositis, because it can detect a lot of inflammatory myopathies. The images will be able to detect calcium deposits, fibrosis and inflammation within the muscles. The images are also good to use for a diagnosis because it can look at larger amounts of muscles, which can help the doctor detect a pattern of muscle weakness. A skin biopsy could also be performed which is where a small piece of skin is removed for further laboratory analysis. The small piece of skin can either confirm the diagnosis of dermatomyositis or it could confirm other conditions. The skin biopsy could be used first to confirm the diagnosis before a muscle biopsy is performed. A muscle biopsy is where a small piece of muscle is surgically removed. The piece of muscle will be sent to a laboratory for further analysis of dermatomyositis. They will look for inflammatory cells surrounding capillary blood vessels in the muscle, which would show damage. The biopsy would reveal any inflammation in the muscle and can also show an infection. Once you have a confirmed diagnosis of dermatomyositis, then you will be able to move onto finding appropriate treatment.
There is no cure for dermatomyositis but treatment will help improve your muscle strength and overall skin appearance. Starting treatment as quickly as possible will help promote a better outcome and will also lessen the possibility of complications. Corticosteroids might be given which will help suppress the immune system. This will also reduce the skin inflammation and muscle inflammation, which will improve your muscle strength and overall function. Usually corticosteroids are the first treatment option used for inflammatory myopathies including dermatomyositis. Immunosuppressant medication might be used as well, which can improve the overall symptoms of the disease. Since people who have dermatomyositis often develop a rash, antimalarial medication might be used to help combat the symptoms associated with the rash. Over-the-counter pain medications might be given, which can help decrease pain and inflammation. Intravenous immunoglobulin can also help treat someone with dermatomyositis, because it contains healthy antibodies from various blood donors. These healthy antibodies will help block the damaged antibodies you are producing, which are what attacks your muscle and skin. Physical, speech and dietary therapies are also common treatment options for someone suffering from dermatomyositis. Physical therapy can be used to help maintain your strength or improve muscle function. Speech therapy is given to people who have weakened swallowing muscles. The speech therapist can also advise you on how to cope with changes in your muscles and learn new ways to eat and communicate. Someone who has advanced dermatomyositis will often find chewing and swallowing is difficult, which can affect your dietary habits. A dietetic assessment and consultation can help you learn how to prepare easier meals to swallow. Surgery might also be performed if there are painful calcium deposits in the skin and it can also help prevent the skin infections from reoccurring.
Although there is no cure for dermatomyositis, through treatment you can go on to live a fairly normal life. The essential aspect of dermatomyositis is seeking treatment as soon as symptoms develop, so treatment can combat long-term complications. Someone who has dermatomyositis can go on to live a normal and healthy life as long as treatment options are followed correctly.
Mayo Clinic Staff, “Dermatomyositis”, Mayo Clinic
