$Unique_ID{BRK01630}
$Pretitle{Skin and Subcutaneous Tissue, Ill Defined Symptoms and Rare
Diseases}
$Title{Information About Dermatomyositis}
$Subject{dermatomyositis diagnosis}
$Volume{L-18, N-18}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Information About Dermatomyositis


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QUESTION:  After a long search for answers, my condition has been identified
as dermatomyositis.  What can you tell me about this weird disease?  I would
be most grateful for any information you can provide.

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ANSWER:  Dermatomyositis is a disorder characterized by pain, redness, heat,
and swelling of deep muscle tissue accompanied by a surface rash.  And in a
way you're right to label it a "weird" disease because its symptoms are often
dramatic and its cause is as yet unknown.  Research indicates a strong link
between its occurrence and immune reactions such as antigen/antibody activity
present during infection, as well as a possible defect in the immune system
itself.  However, dermatomyositis often develops in conjunction with latent
malignancies and other connective tissue diseases such as Lupus and sclerosis
(a hardening and scarring of tissue), and its particular symptoms are hard to
isolate.
     Clinically, five features tend to characterize the disorder:  weakness in
the muscles of the arms, legs, neck and respiratory system (with or without
difficulty in swallowing), serum elevation of skeletal muscle enzymes,
muscular degeneration identified by inserting electrodes confirmed by biopsy,
and a severe surface rash.  The rule of thumb is to label the diagnosis
definite when three or four of these criteria and the rash are present, and
probable when two criteria plus a rash are present.
     When only a probability of dermatomyositis exists, your physician will be
alert to signs of other conditions which carry similar symptoms, such as other
collagen vascular diseases, hyperthyroidism, trichinosis, drug reactions, and
muscular dystrophy.  (Although rash and muscle weakness in the joints are
usually present in every case of confirmed dermatomyositis)
     Once an accurate diagnosis is made, prompt treatment can begin, since
left untreated the disorder can injure the lungs, heart, esophagus, eyes,
kidneys, and joints, (though the incidence of these complications is somewhat
rare.)
     Initially most patients are treated with corticosteroids, with prednisone
the corticosteroid of choice because prednisone is not only inexpensive but
less likely to cause further skin irritation.  In fact, it can be injected
directly into the joints or applied in creams, lotions, and ointments to
relieve the various types of rashes and papules which erupt.  Adult dosage is
usually started at 50 to 100 mg a day and increased or decreased depending on
degeneration or improvement of muscle strength, but we'll let your physician
work out the best dosage schedule for your situation.  The condition itself
can last for as long as two to three years.
     If the initial course of treatment is unsuccessful, plasmapheresis is
usually attempted.  This is a method of removing a quantity of plasma from the
blood to filter out possible immune complexes or autoantibodies which might be
interfering with the healing process.
     With this unusual disease, as with many other disorders where the cause
is still unclear, remaining under the care of your physician is a must.  That
is the best way to get the benefit of any new developments in both diagnosis
and treatment which result from the constant research efforts that are always
underway.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
