Can dermatomyositis be cured
Polymyositis and dermatomyositis
Polymyositis (PM): Inflammatory autoimmune disease of the muscles with symmetrical muscle inflammation, mainly affects the thigh and upper arm muscles.
Dermatomyositis (DM): Polymyositis with skin involvement in areas of the body exposed to light.
Both diseases tend to occur between the ages of 45 and 60 years and affect 70% women. The disease has a different course, but it usually progresses slowly and in stages. Several years of cortisone therapy can cure about half of the patients.
- Sore muscles
- Fatigue, exhaustion, fever, weight loss
- Difficulty getting up, sitting down and climbing stairs
- Problems lifting arms, combing, brushing teeth
- Difficulty swallowing.
In addition, for dermatomyositis:
- Swelling of the upper eyelids, tearful expression
- Scaly, inflammatory reddening of the skin, typically purple in color, on the face or neckline
- Scaly reddening of the skin over the extensor surfaces of the metacarpophalangeal and median joints, elbows, knees and ankles
- Hardened skin, pigmentation disorders and inflammation of the mucous membranes.
33-year-old male patient with dermatomyositis with typical reddening of the skin v. a. around the eyes. Sometimes the reddish-blue skin changes are also accompanied by edema around the eyes.
Georg Thieme Verlag, Stuttgart
Both diseases lead to extensive inflammation and then to the breakdown of muscle fibers. The cause of these autoimmune diseases is unknown. A genetic predisposition and various viruses are discussed. In 20% of those affected, a completely different mechanism, namely cancer (as paraneoplastic symptoms), triggers the disease. If it can be completely removed, the myositis will also disappear.
The doctor does that
With a symmetrical weakness of the shoulder and pelvic muscles, an experienced doctor immediately thinks of the correct diagnosis. If laboratory tests show typical muscle inflammation (increased CK), the suspicion is confirmed. Sometimes is a EMG (Electromyography) or a biopsy to confirm the diagnosis makes sense. In any case, the doctor must look for a malignant tumor.
The disease usually responds well to treatment with cortisone (e.g., prednisolone). If the symptoms improve, the cortisone dose is gradually reduced under the control of laboratory values. However, even with optimal therapy, the symptoms only recede slowly.
If the clinical symptoms are severe, a basic therapeutic agent such as azathioprine is recommended. High-dose immunoglobulins (IVIG) are also effective. The damage to the muscles can be alleviated through regular physiotherapy.
AuthorsDr. rer. nat. Katharina Munk, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 15:39
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