What is dermatomyositis?
Dermatomyositis is a rare inflammatory disease. Common symptoms of dermatomyositis include a distinctive skin rash, muscle weakness, and inflammatory myopathy, or inflamed muscles. It’s one of only three known inflammatory myopathies.
How common is dermatomyositis?
The condition can affect adults and children. In adults, dermatomyositis usually occurs from the late 40s to early 60s. In children, it most often appears between 5 and 15 years of age. Dermatomyositis affects more females than males. Please discuss with your doctor for further information.
What are the symptoms of dermatomyositis?
The common symptoms of dermatomyositis are:
- Skin changes. A violet-colored or dusky red rash develops, most commonly on your face and eyelids and on knuckles, elbows, knees, chest and back. The rash, which can be itchy and painful, is often the first sign of dermatomyositis.
- Muscle weakness. Progressive muscle weakness involves the muscles closest to the trunk, such as those in your hips, thighs, shoulders, upper arms and neck. The weakness affects both the left and right sides of your body, and tends to gradually worsen.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- Muscle weakness
- Unexplained rash.
What causes dermatomyositis?
The exact cause of dermatomyositis isn’t known. However, it has many similarities to an autoimmune disease. An autoimmune disease occurs when your body’s disease-fighting cells, called antibodies, attack your healthy cells. Having a compromised immune system may also contribute to getting the disease. For example, having a viral infection or cancer may compromise your immune system and lead to the development of dermatomyositis.
What increases my risk for dermatomyositis?
Anyone can develop dermatomyositis. However, it’s most common in adults between the ages of 40 and 60 and children between the ages of 5 and 15. The disease affects women more often than men.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is dermatomyositis diagnosed?
If your doctor suspects you have dermatomyositis, he or she might suggest some of the following tests:
- Blood analysis. A blood test will let your doctor know if you have elevated levels of muscle enzymes, such as creatine kinase (CK) and aldolase. Increased CK and aldolase levels can indicate muscle damage. A blood test can also detect autoantibodies associated with different symptoms of dermatomyositis, which can help in determining the best medication and treatment.
- Chest X-ray. This simple test can check for signs of the type of lung damage that sometimes occurs with dermatomyositis.
- A doctor with specialized training inserts a thin needle electrode through the skin into the muscle to be tested. Electrical activity is measured as you relax or tighten the muscle, and changes in the pattern of electrical activity can confirm a muscle disease. The doctor can determine which muscles are affected.
- A scanner creates cross-sectional images of your muscles from data generated by a powerful magnetic field and radio waves. Unlike a muscle biopsy, an MRI can assess inflammation over a large area of muscle.
- Skin or muscle biopsy. A small piece of skin or muscle is removed for laboratory analysis. A skin sample can help confirm the diagnosis of dermatomyositis. A muscle biopsy might reveal inflammation in your muscles or other problems, such as damage or infection. If the skin biopsy confirms the diagnosis, a muscle biopsy might not be necessary.
How is dermatomyositis treated?
For most people, there’s no cure for dermatomyositis. Treatment can improve the condition of your skin and muscle weakness. Available treatments include medication, physical therapy, and surgery.
Corticosteroid medications, such as prednisone, are the preferred method of treatment in most cases. You can take them by mouth or apply them to your skin. Corticosteroids lower the response of your immune system, which reduces the number of inflammation-causing antibodies.
For some people, especially children, symptoms may resolve completely after a treatment course with corticosteroids. This is called remission. Remission may be long-lasting, and sometimes even permanent.
Corticosteroids, especially in high doses, shouldn’t be used for extended periods of time because of their potential side effects. Your doctor will most likely start you on a high dose and then gradually lower it. Some people can eventually stop taking corticosteroids completely if their symptoms go away and stay away after stopping the medication.
If corticosteroids alone don’t improve your symptoms, your doctor might prescribe other medications to suppress your immune system.
Corticosteroid-sparing medications are used to reduce the side effects of corticosteroids. Drugs such as azathioprine and methotrexate may be used if your case is advanced or if you have any complications from corticosteroids.
Intravenous immunoglobulin (IVIG)
If you have dermatomyositis, your body is producing antibodies that target your skin and muscles. Intravenous immunoglobulin (IVIG) uses healthy antibodies to block these antibodies. IVIG consists of a mixture of antibodies that have been collected from thousands of healthy people who have donated their blood. These antibodies are given to you through an IV.
Your doctor might suggest additional treatments, such as:
- Physical therapy that improves and preserves your muscle strength, along with preventing loss of muscle tissue
- An antimalarial medication, hydroxychloroquine, for a persistent rash
- Surgery to remove calcium deposits
- Medications to help with pain
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage dermatomyositis?
The following lifestyles and home remedies might help you cope with dermatomyositis:
- Know your illness. Read all you can about dermatomyositis and other muscle and autoimmune disorders. Talk to people who have a similar condition. Don’t be afraid to ask your doctor questions concerning your illness, diagnosis or treatment plan.
- Be a part of your medical team. Consider yourself, your doctor and other medical experts involved in your care as a united front in the fight against your disease. Following the treatment plan you agreed to is vital. Keep your doctor updated on any new signs or symptoms you develop.
- Get active. A regular exercise routine can help you maintain and build your muscle strength. Be sure to get a detailed plan and recommendations from your doctor or physical therapist before starting an exercise program.
- Rest when you’re tired. Don’t wait until you’re exhausted. This will only set you back further as your body tries to recuperate. Learning to pace yourself can help you maintain a consistent level of energy, accomplish just as much and feel better emotionally.
- Acknowledge your emotions. Denial, anger and frustration are normal when dealing with an illness. Things don’t seem normal or fair and likely seem out of your control. Feelings of fear and isolation are common, so stay close to your family and friends. Try to maintain your daily routine as best you can and don’t neglect doing things you enjoy. Many people find support groups helpful.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Dermatomyositis. http://www.mayoclinic.org/diseases-conditions/dermatomyositis/symptoms-causes/syc-20353188. Accessed October 5, 2017.
Dermatomyositis: What Is It? https://www.healthline.com/health/dermatomyositis#overview1. Accessed October 5, 2017.
Review Date: October 5, 2017 | Last Modified: October 5, 2017