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Dermatomyositis
Dermatomyositis is a muscle disease that involves inflammation and a skin rash. It is a type of inflammatory myopathy.
Causes
The cause of dermatomyositis is unknown. Experts think it may be due to a viral infection of the muscles or a problem with the body's immune system. It may also occur in people who have cancer in the abdomen, lung, or other parts of the body.
Anyone can develop dermatomyositis. It most often occurs in children age 5 to 15 and adults age 40 to 60. Women develop this condition more often than men.
Polymyositis is a similar condition, but the symptoms do not include a skin rash.
Polymyositis
Polymyositis is a rare inflammatory disease. It leads to muscle weakness, swelling tenderness, and tissue damage. It is part of a larger group of d...
Symptoms
Symptoms may include:
-
Muscle weakness
, stiffness, or soreness
Muscle weakness
Weakness is reduced strength in one or more muscles.
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- Purple color to the upper eyelids
- Purple-red skin rash
-
Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
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The muscle weakness may come on suddenly or develop slowly over weeks or months. You may have trouble raising your arms over your head, getting up from a sitting position, and climbing stairs.
The rash may appear on your face, knuckles, neck, shoulders, upper chest, and back.
Exams and Tests
The health care provider will do a physical exam. Tests may include:
-
Bloods test to check levels of muscle enzymes called creatine phosphokinase and
aldolase
Aldolase
Aldolase is a protein (called an enzyme) that helps break down certain sugars to produce energy. It is found in high amount in muscle tissue. A test...
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-
ECG
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Electromyography
Electromyography
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
ImageRead Article Now Book Mark Article - Magnetic resonance imaging (MRI)
-
Muscle biopsy
Muscle biopsy
A muscle biopsy is the removal of a small piece of muscle tissue for examination.
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Skin biopsy
Skin biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
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Treatment
The disease is treated with anti-inflammatory medicines called corticosteroids. You may also take drugs to suppress the immune system such as methotrexate, azathioprine, and hydroxychloroquine to treat the skin rash.
If the condition does not respond to these medicines, other drugs that suppress the immune system may be tried.
When your muscles get stronger, your doctor may tell you to slowly cut back on your doses. Most people with this condition must take a medicine called prednisone for the rest of their lives.
If a cancer is causing the condition, the muscle weakness and rash may get better when the tumor is removed.
Outlook (Prognosis)
Symptoms may go away completely in some people, such as children.
The condition may be fatal in adults due to severe muscle weakness, malnutrition, pneumonia , or lung failure. The major causes of death with this condition are cancer and lung disease.
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
Possible Complications
Complications may include:
-
Acute renal failure
Acute renal failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
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Cancer (
malignancy
)
Malignancy
The term "malignancy" refers to the presence of cancerous cells that have the ability to spread to other sites in the body (metastasize) or to invade...
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Inflammation of the heart
Inflammation of the heart
Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
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- Lung disease
When to Contact a Medical Professional
Call your health care provider if you have muscle weakness or other symptoms of this condition.
References
Jorizzo JL, Vleugels RA. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology . 3rd ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 42.
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Dermatomyositis, Gottron's papule - illustration
Red, thickened, scaly skin over the knuckles (Gottron's sign) associated with dermatomyositis, an autoimmune disease of the skin and muscles.
Dermatomyositis, Gottron's papule
illustration
-
Dermatomyositis, Gottron's papules on the hand - illustration
This violet-colored inflammation (erythema) over the knuckles is caused by Dermatomyositis. Other skin conditions produce more redness, while the color of this lesion is violet. There may also be inflammation in the muscle tissue.
Dermatomyositis, Gottron's papules on the hand
illustration
-
Dermatomyositis, heliotrope eyelids - illustration
This photograph demonstrates the sign "heliotrope eyelids" in which the eyelids develop a brown (violaceous - rather than red) color. Heliotrope eyelids and Gottron's papules on the knuckles are characteristic findings in dermatomyositis.
Dermatomyositis, heliotrope eyelids
illustration
-
Dermatomyositis on the legs - illustration
The appearance of purple (violaceous) plaques on the knees may be associated with dermatomyositis. Typically, most lesions associated with other diseases are red (erythematous).
Dermatomyositis on the legs
illustration
-
Dermatomyositis, Gottron's papule - illustration
This is Gottron's sign, seen in dermatomyositis (an inflammatory disease of the muscles and skin). Violet-colored inflammation over the knuckles is an important diagnostic finding in dermatomyositis, since other skin conditions produce more redness.
Dermatomyositis, Gottron's papule
illustration
-
Paronychia, candidial - illustration
Candida paronychia produced periungual erythema, edema and nail fold maceration.
Paronychia, candidial
illustration
-
Dermatomyositis, heliotrope rash on the face - illustration
Dermatomyositis, a connective tissue disease, typically produces a reddish-purple (violaceous) rash. The rash is named after the tendency of plants to grow toward the sun (heliotropic) and is characteristic of dermatomyositis.
Dermatomyositis, heliotrope rash on the face
illustration
-
Dermatomyositis, Gottron's papule - illustration
Red, thickened, scaly skin over the knuckles (Gottron's sign) associated with dermatomyositis, an autoimmune disease of the skin and muscles.
Dermatomyositis, Gottron's papule
illustration
-
Dermatomyositis, Gottron's papules on the hand - illustration
This violet-colored inflammation (erythema) over the knuckles is caused by Dermatomyositis. Other skin conditions produce more redness, while the color of this lesion is violet. There may also be inflammation in the muscle tissue.
Dermatomyositis, Gottron's papules on the hand
illustration
-
Dermatomyositis, heliotrope eyelids - illustration
This photograph demonstrates the sign "heliotrope eyelids" in which the eyelids develop a brown (violaceous - rather than red) color. Heliotrope eyelids and Gottron's papules on the knuckles are characteristic findings in dermatomyositis.
Dermatomyositis, heliotrope eyelids
illustration
-
Dermatomyositis on the legs - illustration
The appearance of purple (violaceous) plaques on the knees may be associated with dermatomyositis. Typically, most lesions associated with other diseases are red (erythematous).
Dermatomyositis on the legs
illustration
-
Dermatomyositis, Gottron's papule - illustration
This is Gottron's sign, seen in dermatomyositis (an inflammatory disease of the muscles and skin). Violet-colored inflammation over the knuckles is an important diagnostic finding in dermatomyositis, since other skin conditions produce more redness.
Dermatomyositis, Gottron's papule
illustration
-
Paronychia, candidial - illustration
Candida paronychia produced periungual erythema, edema and nail fold maceration.
Paronychia, candidial
illustration
-
Dermatomyositis, heliotrope rash on the face - illustration
Dermatomyositis, a connective tissue disease, typically produces a reddish-purple (violaceous) rash. The rash is named after the tendency of plants to grow toward the sun (heliotropic) and is characteristic of dermatomyositis.
Dermatomyositis, heliotrope rash on the face
illustration
Review Date: 1/20/2015
Reviewed By: Gordon A. Starkebaum, MD, professor of medicine, division of rheumatology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
