Dermatomyositis Flashcards
What is Dermatomyositis?
Dermatomyositis is a connective tissue diseases characterised by inflammation of muscles.
It is part of a group of Idiopathic inflammatory myopathies . Which are chronic, autoimmune conditions affecting primarily the proximal muscles. The most common types are dermatomyositis and polymyositis
What will you find on a history taking of Dermatomyositis?
Symptoms:
Same as polymyositis - Diffuse Proximal muscle weakness and dysphagia (Pharyngeal weakness)
Rash - exacerbated by sunlight.
There is muscle pain and tenderness
Systemic Features - Fever, Arthraliga, Malasie, Weight loss
Cardiac features - Arrhythmias, dilated cardiomyopathy
GI ulcer and infection
Interstitial lung disease
Risk Factors:
Affects children and adults
Specific Questions to ask:
What will you find on examination of Dermatomyositis?
End of the bed:
Skin lesions may produce scaling, pigmentation or depigmentation of the skin and a shiny appearance.
Hands:
Dilated capillary loops at the fingernail base
cuticles may be irregular and thickened
palmar and lateral surfaces of the fingers may become rough and cracked.
Raised purple-red scaly patches over the extensor surfaces of joints and fingers
Neck:
Face:
Blue-purple discolouration on the upper eyelids with periorbital oedema
A flat red rash involving the face and upper trunk
Chest:
Raised purple-red scaly patches over shoulders, back and upper chest
Abdomen:
Legs:
Raised purple-red scaly patches over the extensor surfaces of joints and fingers
What investigations will you order in Dermatomyositis?
Bloods:
Creatinine Kinase - Can be rasied
Special tests:
SGOT, SGPT, LDH, Aldolase can be raised
Autoantibodies - ANA, Anti-Mi-2
Electromyography and muscle biopsy is diagnostic
What is the treatment of Dermatomyositis?
Lifestlye:
Sun block - Reduces rash
Encourage exercise to maintain strength
Medical:
Steroids - Systemic or topical
Second line - azathioprine
