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Dermatomyositis
Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) with characteristic cutaneous findings.
Classification :
- 1ry idiopathic PM
- 1ry idiopathic DM ( PM + Skin lesion )
- PM or DM + Malignancy
- Juvenile DM
- PM or DM associated with other CT disorders ( Mixed CT diseases )
"The onset of a rash in patients with pre-existing myositis requires investigation of the neoplastic possibility"
C/p :
1- Muscle :
- bilateral proximal " weakness, wasting but not tender " , facal and distal muscles are not affected .
" DD >> -MG : occular and face affection , increase with use and nocturnal
-Guan Barre : Distal affection > proximal . "
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1Zgq7O8RcuRZREQDW6FY8J7PABbUQyl0X0n6I9QJ0UleFT48qmC2ZwZPJw5K3I6xdC8BRB3Ei-qNZFchtoTkedwQxO3LHQtMxNvKR3Gp8ej1s3TUo9vhQ7sDv_QB-1xV3vL8UTqVYj8FP/s320/Gottron's+papules.+Characteristic+raised+erythematous+papule+overlying+the+proximal+interphalangeal+joint+in+a+patient+with+dermatomyositis..jpg)
- Dysphagia
- Cardiomyopathy >> HF , arrhythmia
2- Skin :
3- Malignancy
4- Raynaud's phenomenon
5- ISP fibrosis
6- Arthralgia
Investigations :
1- EMG
2- Muscle biopsy , after MRI .. ??
3- CK level
4- ANA
5- Anti-jo-1 .. it is a myositis specific antibody (30%)
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Treament :
1- Please search for neoplasms anywhere .
2- Steroids with the usual regimen .
3- Immunosuppressive therapy .
4- Pulse steroid ... ???
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhf6te26Ftl5iY-lRqEJYNo4ur1_L7V2GJp9fmbc0teh-kI0LdWXiJ1rtmZ5RpT1EA6d4NFMix1cgeiNPl2xOEEIACQIHx3EDqnteSb1p0Cr2GrYjS114SeOHHtcu9FGkTWBo_T3KbC0A9_/s320/Gottron's+papule.jpg)
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