Dermatomyositis

GENERAL INFORMATION:

What is dermatomyositis? Dermatomyositis (der-MAH-to-mi-o-SI-tis) is a disease that affects the muscles. This disease causes muscle inflammation (swelling), and skin rashes. Dermatomyositis may get worse over time. Women get this disease more often than men.

What causes dermatomyositis? Caregivers do not know what causes dermatomyositis. Problems with your body's immune system may cause this disease. Normally, the immune system helps fight infection in your body. With dermatomyositis, your body's immune system attacks muscle tissue instead. Germs, called viruses, may also cause dermatomyositis.

What are the signs and symptoms of dermatomyositis? The most common symptoms of dermatomyositis are muscle weakness and skin rashes. The muscles of your upper arms, thighs, and hips often grow weak. This can affect your normal activities. It may be hard to stand up after sitting in a chair. You may also have trouble climbing stairs, lifting objects, and combing your hair. Skin rashes on your upper eyelids may look bluish-purple in color. You may have a flat, red rash on your face and chest. Your knuckles, elbows, and knees may also have a rash. These skin rashes often get worse after exposure to the sun. Other signs and symptoms may include:

• Contractures (painful shortening of the muscles) that prevent movement of the joints.
  
  
• Feeling more tired than usual and weight loss without trying.
  
  
• Fever.
  
  
• Hard bumps under the skin.
  
  
• Lung problems, such as infection and trouble breathing.
  
  
• Trouble swallowing or talking.

How is dermatomyositis diagnosed? You may need one or more of the following tests:

• Biopsy: Your caregiver will collect samples of your muscles and skin, which is sent to the lab for tests.
  
  
• Blood tests: Creatine kinase is a substance made by injured muscles. Blood tests check for this substance.
  
  
• Electromyography (EMG): Electromyography is a test that measures the electrical activity of your muscles. Your muscles are tested at rest and while you are using them. An EMG test may also check the nerves that control your muscles.
  
  
• Magnetic resonance imaging: This test is also called MRI. An MRI shows caregivers areas inside your body. During the MRI, pictures are taken of your muscles and skin. Caregivers use these pictures to look for muscle and skin changes.

How is dermatomyositis treated? You may have one or more of the following:

• Medicine:
  
  
  • Anti-itching medicine: Caregivers may give you medicine to help keep your skin from itching. This medicine may be given in an IV, as a shot, by mouth, or as a skin lotion. Sometimes this medicine can make you sleepy.
    
    
  • Antimalarial medicine: These medicines may help to decrease your symptoms, such as skin rashes.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.
    
    
  • Immunosuppressives: This medicine may slow down the attack on muscle cells by the immune system. Do not stop taking these medicines without your caregivers OK. Stopping on your own can cause problems.
    
    
  • Pain medicine: This medicine may take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.
  
  
• Therapy: You may have the following:
  
  
  • Hydrotherapy: This is a gentle water exercise program. It may strengthen muscles that are not damaged by dermatomyositis.
    
    
  • Massage and stretching: Gentle body massages and stretching may help keep you from getting contractures.
    
    
  • Therapy: A physical therapist and an occupational therapist may exercise your arms, legs, and hands. They may also teach you new ways to do things around the house. A speech therapist may work with you to help you talk or swallow.

How should I protect my skin?

• Wear sunscreen that has sun protectant factor 15 (SPF15) or higher. The sunscreen should also have UVA and UVB protection. Follow the directions on the label when using sunscreen. Put on more sunscreen if you are in the sun for more than an hour. Reapply sunscreen often if you go swimming or are sweating a lot.
  
  
• Stay out of the sun between 10 AM and 4 PM. The sun is strongest and most harmful to your skin between these times.
  
  
• Avoid being in the sun at high altitude and around the snow, sand, and water.
  
  
• Protect your lips by using lipsticks and lip balms that have sunscreen in them.
  
  
• Wear long-sleeved shirts and pants to protect your arms and legs when you are out in the sun. Wear a hat with a wide brim to protect both your face and neck.
  
  
• Do not use tanning booths. These can damage your skin as much as the sun.

Where can I find support and more information? Dermatomyositis is a life-changing disease for you and your family. Accepting that you have it is hard. You and those close to you may feel angry, sad, or scared. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group. This is a group of people who also have a skin disease. Contact the following for more information.

• The Myositis Association
  1233 20th St. NW, Ste 402
  Washington, DC, 20036
  Phone: 1-202-887-0088
  Web Address: http://www.myositis.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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