Dermatomyositis: Causes, Symptoms, Treatment and Cost

Dermatomyositis is a condition that affects the muscles, skin, and blood vessels, and it is both inflammatory and degenerative. Inflammatory myopathies are a category of disorders that cause the body's immune system to target healthy muscle tissue. This condition is a member of that group of diseases.

There are two main types of dermatomyositis: Juvenile dermatomyositis (JDM) and Adult dermatomyositis (ADM).

• Juvenile Dermatomyositis (JDM): JDM is the most common form of dermatomyositis and typically affects children between the ages of 5 to 15 years old. Symptoms of JDM include a rash on the face, neck, chest, and upper arms, muscle weakness in the hips and shoulders, shortness of breath, fatigue, fever and joint pain.
• Adult Dermatomyositis (ADM): ADM is less common than JDM but typically affects adults between 30 to 50 years old. Symptoms of ADM include a rash on the face, neck and chest; muscle weakness in the thighs or hips; difficulty climbing stairs; difficulty swallowing; shortness of breath; fatigue; fever and joint pain.

• The exact cause of dermatomyositis is unknown, but it likely involves a combination of genetic and environmental factors.
• Certain inherited genes may increase the risk for developing dermatomyositis, as well as exposure to certain medications or infections that trigger an autoimmune response.
• Additionally, some individuals with other autoimmune disorders are more likely to develop dermatomyositis than others.

Common symptoms of Dermatomyositis are:

• Muscle weakness, typically in the proximal muscles of the arms and legs.
• Symmetrical skin rash, most commonly on the face, neck, chest, elbows, knees, and knuckles
• Joint pain/inflammation
• Difficulty swallowing (dysphagia)
• Shortness of breath
• Fever and fatigue
• Calcinosis cutis (deposits of calcium under the skin)

• Avoid coming into contact with environmental poisons like pesticides and herbicides as much as you can.
• Maintaining proper hygiene includes routinely washing your hands and avoiding close contact with persons who are sick with the common cold or any other sickness.
• Exercise regularly to help strengthen muscles and reduce the risk of developing muscle weakness or joint pain from the condition.
• Get regular medical checkups to monitor for signs of Dermatomyositis early on, allowing for early treatment if needed.
• Ensure you are getting adequate nutrition by eating a balanced diet with plenty of fresh fruits and vegetables for essential vitamins and minerals needed for muscle health.

• Physical examination: A physician will look for signs of muscle weakness and inflammation such as muscle tenderness or atrophy, as well as the characteristic rash associated with the disorder.
• Blood tests: Blood tests may also be used to look for elevated levels of certain antibodies that are associated with dermatomyositis. These antibodies include anti-Mi-2, anti-Jo-1, and anti-signal recognition particle (SRP).
• MRI: Magnetic Resonance Imaging (MRI) is often used to diagnose the condition, as it can help to detect muscle inflammation and damage.
• CT scans: CT scans can help to identify inflammation and swelling of the muscles, as well as any other underlying medical conditions that may be contributing to the symptoms. CT scans can also reveal any calcifications or changes in the structure of the muscles that may be associated with dermatomyositis.
• Electromyography (EMG): Electromyography is a diagnostic procedure that detects problems with muscle by measuring the electrical activity of the muscle being examined. It is able to identify muscular weakness, inflammation, and damage brought on by the illness, therefore it may be utilised in the process of diagnosing dermatomyositis.

• Muscle weakness: Can lead to difficulty in performing daily activities, such as dressing and walking.
• Cardiac complications: Heart muscle inflammation and damage, leading to heart failure or arrhythmia.
• Lung complications: Can cause shortness of breath and coughing due to inflammation of the lungs.
• Skin complications: Ulcers of the skin, calcinosis (calcium deposits in the skin), and Raynaud's phenomenon are all symptoms of this illness (a condition that causes blood vessels in the fingers and toes to spasm).
• Gastrointestinal problems: Difficulty swallowing, abdominal pain, nausea, vomiting and weight loss due to inflammation of the digestive tract.Joint pain and stiffness due to inflammation of the joints.

• Turmeric: Because it is a potent anti-inflammatory agent, turmeric may be able to assist in reducing the inflammation brought on by dermatomyositis. Consume a mixture consisting of one teaspoon of turmeric powder combined with one glass of warm milk on a daily basis.
• Ginger: Ginger is another powerful anti-inflammatory agent that can help reduce inflammation caused by dermatomyositis. Cut fresh ginger into small pieces and add them to boiling water. Let the mixture steep for 10 minutes, strain, and drink it twice daily to get relief from the symptoms of dermatomyositis.
• Licorice Root: Licorice root has natural anti-inflammatory properties that can help reduce inflammation caused by dermatomyositis. Mix one teaspoon of licorice root powder in a glass of warm milk and drink it twice daily to get relief from the symptoms of dermatomyositis.
• Coconut Oil: Coconut oil is known for its moisturizing properties that can help soothe dry, irritated skin caused by dermatomyositis. Massage some coconut oil onto the affected area twice daily to get relief from the symptoms of dermatomyositis.

• A balanced diet rich in fruits, vegetables, and whole grains is recommended for people with dermatomyositis.
• Include lean proteins (such as fish, poultry, eggs and legumes) in your diet.
• Eat antioxidant-rich foods such as berries and citrus fruits to reduce inflammation in the body.

• Avoid foods that are high in saturated fats, trans fats, and cholesterol: red meat, full-fat dairy products, processed meats, fried foods, and junk foods.
• Limit your intake of salt and sodium: canned and processed foods can be high in sodium.

Treatment for dermatomyositis typically includes:

• Medications: Treatment of dermatomyositis typically includes medications to reduce inflammation and control the underlying condition.
• Physical therapy: Physical therapy may include exercises to stretch and strengthen muscles, range-of-motion exercises, and activities to improve coordination.
• Occupational therapy: Occupational therapy can be an important part of a successful treatment plan for individuals with dermatomyositis. Occupational therapists can provide interventions to improve the individual’s ability to participate in daily activities, increase their independence, and promote their overall health and wellbeing.
• Sun protection and topical medications: It is important to wear protective clothing such as long-sleeved shirts and wide-brimmed hats when outdoors, and to use sunscreen with a high SPF rating. In addition to sun protection, topical medications may be prescribed by a doctor to help treat the symptoms of dermatomyositis.
• Surgery: In some cases, surgery may be necessary to treat complications related to the disorder such as joint contractures or skin ulcers.

It is important to consult with a doctor who specializes in autoimmune disorders, such as an immunologist, rheumatologist, or dermatologist.

These doctors can diagnose and treat the condition through medications and lifestyle changes, and will work with other specialists such as physical therapists to provide comprehensive care for the patient.

• Corticosteroids: Corticosteroids are the main treatment for dermatomyositis. They can reduce inflammation and help control symptoms.
• Immunosuppressive drugs: These medications work to suppress the immune system and reduce inflammation. Some commonly used drugs include methotrexate, azathioprine, and mycophenolate mofetil.
• Antioxidants: Vitamin E, selenium, and Coenzyme Q10 may be beneficial in reducing inflammation associated with dermatomyositis.
• Antivirals: In some cases, antiviral drugs such as acyclovir may be prescribed to treat any underlying virus that may be causing the symptoms.
• Muscle relaxants: Muscle relaxants are often used to help ease muscle pain, stiffness, and spasms associated with the condition. Common muscle relaxants used for dermatomyositis include cyclobenzaprine, carisoprodol, tizanidine, and baclofen.

Recovery from Dermatomyositis can vary greatly depending on the severity and duration of the condition. Generally, mild cases may resolve within weeks to months with treatment, while more severe conditions will require ongoing management over several years. With proper care and support, many individuals with Dermatomyositis can achieve a full recovery.

The effectiveness of therapy for dermatomyositis varies from patient to patient and is proportional to the degree to which the illness has progressed. In some cases, treatment can lead to long-term remission and even a cure. However, in other cases, symptoms may recur after treatment is stopped or may become chronic.

• Post-treatment care should focus on reducing inflammation and managing pain. Nonsteroidal anti-inflammatory medicines, often known as NSAIDs, might be of assistance in reducing discomfort and swelling in the afflicted regions.
• Physical therapy should be done to maintain muscle flexibility and strength, as well as to help improve range of motion of joints that may have been affected by the condition.
• Careful monitoring for signs of infection or recurrence is important, as this condition can flare up again after surgery or other treatments.
• Good sleep hygiene, stress management techniques, healthy eating habits, and avoiding exposure to environmental triggers such as sunlight or cold temperatures can also help keep symptoms at bay.

The cost of Dermatomyositis treatments in India can vary greatly depending on the type and severity of the condition. The cost of medications can range from a few hundred rupees per month to several thousand rupees for high-end drugs.

Physical therapy and occupational therapy can also be expensive; fees may range from a few thousand rupees to several lakhs depending on the duration and type of treatment required. In some cases, surgery may be necessary, which can cost anywhere from tens of thousands to several lakhs rupees.

• Fatigue: Long-term fatigue is a common side effect of Dermatomyositis treatments due to the body needing to adjust to medications.
• Nausea and vomiting: Nausea and vomiting are potential side effects of certain medications used for Dermatomyositis treatment, such as corticosteroids or immunosuppressants.
• Hair loss: Hair loss is a common side effect of some medications used for Dermatomyositis treatment, such as corticosteroids or chemotherapy drugs.
• Weight gain: Weight gain is a possible side effect of corticosteroid treatments for Dermatomyositis, as well as other medications used to treat the condition.
• Infection: Immunosuppressive therapies can increase the risk of infection in patients with Dermatomyositis, especially those taking high doses of medication over long periods of time

If you are suffering from any complications relating to dermatomyositis then you should consult a doctor nearby as they can cause complications like muscle weakness, cardiac and skin complications etc. in which treatment course can range from a few months to years depending on the severity of the situation.