Dermatomyositis: what it is, symptoms and treatment

Dermatomyositis is a rare inflammatory disease that affects mainly muscles and skin, causing muscle weakness and dermatological lesions. It occurs more often in women and is more common in adults, but it can appear in people under the age of 16, being called childhood dermatomyositis.

Sometimes, dermatomyositis is associated with cancer, which can be a sign of the development of some types of cancers such as lung, breast, ovarian, prostate and colon cancer. It can also be associated with other diseases of immunity, such as scleroderma and mixed connective tissue disease, for example. Also understand what scleroderma is.

The causes of this disease are of autoimmune origin, in which the body's own defense cells attack the muscles and cause skin inflammation, and, although the reason for this reaction is not yet fully understood, it is known that it is related to genetic changes, or influenced by the use of some medications or by viral infections. Dermatomyositis has no cure, and is therefore a chronic disease, however, treatment with corticosteroids or immunosuppressive drugs can help control symptoms.

Main symptoms

Symptoms of dermatomyositis can include:

• Muscle weakness, especially in the scapular, pelvic and cervical regions, symmetrically and with gradual worsening;
• Appearance of spots or small reddish lumps on the skin, especially in the joints of the fingers, elbows and knees, called Gottron's sign or papules;
• Violet spots on the upper eyelids, called heliotrope;
• Joint pain and swelling;
• Fever;
• Tiredness;
• Difficulty swallowing;
• Stomach pain;
• Vomiting;
• Weight loss.

Generally, people with this disease may find it difficult to do daily activities such as combing their hair, walking, climbing stairs or getting up from a chair. In addition, skin symptoms may worsen with exposure to the sun.

In the most severe cases, or when dermatomyositis appears in association with other autoimmune diseases, other organs such as the heart, lungs or kidneys may also be affected, affecting its functioning and causing serious complications.

How the diagnosis is made

The diagnosis of dermatomyositis is made through the evaluation of the symptoms of the disease, physical evaluation and tests such as muscle biopsy, electromyography or blood tests to detect the presence of substances that indicate destruction of the muscles, such as the CPK, DHL or AST tests, for example. example.

There may be the production of autoantibodies, such as myositis-specific antibodies (MSAs), anti-RNP or anti MJ, for example. that can be found in high quantities in blood tests.

To confirm the diagnosis, it is also necessary for the doctor to differentiate the symptoms of dermatomyositis from other diseases that cause similar symptoms, such as polymyositis or myositis with inclusion bodies, which are also inflammatory diseases of the muscles. Other diseases that should be considered are myofascitis, necrotizing myositis, polymyalgia rheumatica or inflammations caused by medications, such as clofibrate, simvastatin or amphotericin, for example.

How to treat

The treatment of dermatomyositis is done according to the symptoms presented by the patients, but in most cases it includes the use of:

• Corticosteroids like Prednisone, as they reduce inflammation in the body;
• Immunosuppressants such as Methotrexate, Azathioprine, Mycophenolate or Cyclophosphamide, to decrease the response of the immune system;
• Other remedies, such as Hydroxychloroquine, are useful for relieving dermatological symptoms, such as sensitivity to light, for example.

These remedies are usually taken in high doses and for prolonged periods, and have the effect of decreasing the inflammatory process and reducing the symptoms of the disease. When these drugs do not work, another option is to administer human immunoglobulin.

It is also possible to do physiotherapy sessions, with rehabilitation exercises that help to relieve symptoms and avoid contractures and retractions. Photoprotection is also indicated, with sunscreens, to prevent the worsening of skin lesions.

When dermatomyositis is associated with cancer, the most appropriate treatment is to treat cancer, often causing the signs and symptoms of the disease to be relieved.

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