Musc Dis- dermatomyositis

Question 1

risk factors

Answer 1

both are more common in women than in men (2:1 ratio) and usually affect adults older than 20 years, especially those aged 45-60 years

Question 2

what is dermatomyositis

Answer 2

dermatomyositis is clinically similar but also has typical cutaneous manifestations.

Question 3

symptoms (4)

Answer 3

Clinically similar to polymyositis

additional-
V-shaped rash over chest

Gottron’s papules

Heliotrope rash

Question 4

investigation- bloods and antibodies (3)

Answer 4

Inflammatory markers raised.

(CK) level raised, often more than 10 times the normal level.

Autoantibodies include ANA, anti-Jo-1 and anti-SRP.

Question 5

investigation- scans and diagnosis (3)

Answer 5

MRI localize the extent of muscle involvement and show signal intensity abnormalities of muscle due to inflammation, oedema, or scarring.

(EMG) findings are abnormal in almost all patients (90%) with polymyositis.

Muscle biopsy shows muscle fibres in varying stages of inflammation, necrosis, and regeneration.

Question 6

management

Answer 6

same as polymyositis
This consists of prednisolone (initially around 40mg) combined with immunosuppressive drugs such as methotrexate or azathioprine.