Dermatomyositis Rash - Pictures, Prognosis, Causes, Treatment

Dermatomyositis is a rare inflammatory condition characterized by formation of prominent skin rashes and weakness of the muscles. Medical experts categorize the condition as a ‘chronic inflammatory myopathy’; there are three disorders that fall under this group and dermatomyositis is considered as one of them.

Also called heliotrope rash, dermatomyositis can occur in adults as well as children. However, adults aged between 45 and 65 years as well as children aged between 5 and 15 years are more prone to developing the inflammatory condition than people of other age groups. Women are also at greater risk than men.

Occasionally, the symptoms associated with dermatomyositis may stop suddenly. However, such episodes of remission last for only a very short period. Doctors make use of varied treatment options to get rid of the abnormal rashes on the skin, as well as to alleviate muscular function and strength.

Dermatomyositis rash symptoms

A few prevalent signs and symptoms of dermatomyositis are as follows:

Patients may experience the formation of skin rashes that are violet, brown, or reddish hued. These rashes are unique and often the first sign of the disease. Such rashes typically occur on the eyelids and face and may occasionally affect the knuckles, nails, knees, elbows, back and chest. The skin abnormalities usually develop in patches and elicit blue-purplish blemishes.
Another prominent symptom of dermatomyositis is progressive weakness of muscles; the muscles near the torso, such as those occurring on the shoulders, upper arms, neck, hips, and thighs are typically affected by the weakness. The anomaly develops symmetrically, slowly worsens, and can occur on the left or the right part of the body.
The affected muscles may be tender and painful.
The condition may be accompanied by fever, fatigue, and loss of weight.
Affected children are prone to developing solid deposits of calcium under the skin. Children are also at greater risk to suffering from gastrointestinal ulcers and intestinal perforations.
Complications of the lungs as well as swallowing problems may be noticed.

Dermatomyositis prognosis

Dermatomyositis can result in a variety of health complications as listed below:

1. Complications arising due to defects of the skin

As dermatomyositis worsens with the passage of time, patients may experience the buildup of calcium in the skin, muscles, and connective tissues. Such hardened calcium particles are more widespread and develop more rapidly in children.
The skin rashes often tend to develop secondary infections. The digestive and respiratory tracts are most vulnerable to such infections.

2. Complications arising due to muscle defects:

Swallowing problems can increase the risk to development of aspiration pneumonia. Subsequently, patients may aspirate saliva, liquids, and/or food particles into the lungs, thereby causing respiratory conditions.
Weak esophageal muscles can also cause swallowing difficulties as well as dysphagia. Dermatomyositis patients may thus be prone to malnutrition and subsequent weight loss.
Weakness of the chest muscles may result in breathing problems such as breathlessness.
When weakness of different muscles adjacent to the torso occurs in the elderly, then severe instances of aging disturbances such as ulceration, bleeding, and other gastrointestinal problems may also be observed.

3. Increased susceptibility to developing diverse diseases

Increased risk to varied cancers, especially cancer of the lungs, cervix, ovaries, breasts, and the bowels.
Dermatomyositis in pregnant women can result in pregnancy complications, including stillbirth and premature childbirth. It may however be noted that if the condition is in remission, then such complications usually do not arise.
Increased risk to developing varied cardiovascular diseases, including cardiac muscle inflammation or myocarditis. Some individuals with dermatomyositis may also experience cardiac arrhythmia and/or congestive heart failure.
Increased risk to disorders of the connective tissues, including conditions like rheumatoid arthritis, lupus, Sjogren’s syndrome, and scleroderma.
Dermatomyositis patients are at increased risk to development of interstitial lung disease, a group of conditions characterized by fibrosis or lung tissue scarring. Affected people may suffer from lowered lung elasticity or pulmonary stiffness, which in turn can result in shortness of breath, dry cough, and other respiratory problems.
Increased risk to the occurrence of Raynaud’s phenomenon. It is a syndrome marked by discoloration of the extremities of the body after exposure to cold weather; patients may experience numbness and discoloration of fingers, cheeks, toes, ears, and nose, etc.

Causes

Medical experts regard dermatomyositis as an autoimmune disease; they are however unaware about the main cause of the condition.
Just like in autoimmune diseases, the immune system in dermatomyositis patients creates antibodies which incorrectly identify the healthy body tissues as invaders and attacks it leading to widespread inflammation of the muscles, elevated levels of inflamed cells in blood vessels, and eventual degradation of muscle fibers.

Dermatomyositis rash treatment

Currently, there is no cure for dermatomyositis. Treatment involves management, alleviation, and control of the adverse symptoms as well as treatment and prevention of health complications.

Corticosteroid drugs are prescribed to inhibit the abnormal actions of the immune system. If these drugs are inadequate, then doctors may opt for intravenous immunoglobulin and other such immunosuppressive therapies.
Rituximab, TNF inhibitors, or other such biological medicines can help treat the skin rashes associated with dermatomyositis.
Physical therapy can help regain muscle strength and elasticity.
Pain killers are prescribed to overcome pain.