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  Dermatomyositis  
 
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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations

 

Dermatomyositis is one of a group of acquired muscle diseases called inflammatory myopathies. Symptoms in children and adults are similar, the only distinction being that childhood onset is more likely to be very acute, and adult onset more gradual. Females are more often affected than males. An acute infection may precede or incite the initial symptoms. Dermatomyositis is characterized by a rash accompanying, or more often, preceding muscle weakness. The rash is described as patchy, bluish-purple discolorations on the face, neck, shoulders, upper chest, elbows, knees, knuckles, and back. Some patients may also develop hardened bumps of calcium deposits under the skin.

The most common symptom is muscle weakness, usually affecting those muscles that are closest to the trunk of the body (proximal). Eventually, patients have difficulty rising from a sitting position, climbing stairs, lifting objects, or reaching overhead. In some cases, distal muscles (those not close to the trunk of the body) may be affected later in the course of the disease. Trouble with swallowing (dysphagia) may occur. Occasionally, the muscles ache and are tender to touch. Patients may also feel fatigue and discomfort and have weight loss or a low-grade fever.

Conventional treatment for dermatomyositis generally consists of a steroid drug called prednisone. For patients in whom prednisone is not effective, other immunosuppressants such as azathioprine and methotrexate may be prescribed. Recently, a drug called intravenous immunoglobulin was shown to be effective and safe in the treatment of the disease. Physical therapy is usually recommended to preserve muscle function and avoid muscle atrophy.
 

 
 

Signs, symptoms & indicators of Dermatomyositis:
 
 
Symptoms - Gas-Int - General  Difficulty swallowing

Counter-indicators:
  No difficulty swallowing

Symptoms - General

  Constant fatigue

Symptoms - Head - Mouth/Oral

  Voice change

Symptoms - Metabolic

  Mild/moderate unexplained fevers or unexplained fevers that hit hard or unexplained high fevers
  Occasional/frequent unexplained fevers

Symptoms - Muscular

  Individual weak muscles
 The muscle weakness may appear suddenly and progress over weeks to months. Patients may have difficulty raising the arms above the shoulders, climbing steps, or arising from a sitting position, and be unable to raise the head from the pillow. Patients may become wheelchair bound or bedridden because of weakness of pelvic and shoulder girdle muscle groups. The flexors of the neck may be severely affected. The muscles of the hands, feet, and face escape involvement.

  Tender muscles

Symptoms - Skeletal

  Joint pain/swelling/stiffness

Symptoms - Skin - Conditions

  Rashes
 
 

Conditions that suggest Dermatomyositis:
 
 
Circulation  Raynaud's Phenomenon

Symptoms - Muscular

  (Possible) dermatomyositis

Counter-indicators:
  Absence of dermatomyositis
 
 

Risk factors for Dermatomyositis:
 
 
Autoimmune  Autoimmune Tendency

Environment / Toxicity

  General Detoxification Requirement
 Chronic exposure to a variety of chemicals can result in autoimmune disease in animal and human models. Systemic lupus erythematosus, scleroderma, eosinophilia myalgia syndrome, Raynaud's syndrome and dermatomyositis are some of the autoimmune illnesses related to xenobiotics. [ Toxicology, 1997; pp.119:1-21] As with all autoimmune disorders, detoxification is usually helpful.

Symptoms - Metabolic

  Recent unexplained weight loss
 
 

Dermatomyositis suggests the following may be present:
 
 
Allergy  Allergy / Intolerance to Foods (Hidden)
 As with all autoimmune conditions, food allergies/intolerances and environemental triggers may be contributing factors.

Autoimmune

  Autoimmune Tendency

Environment / Toxicity

  General Detoxification Requirement
 Chronic exposure to a variety of chemicals can result in autoimmune disease in animal and human models. Systemic lupus erythematosus, scleroderma, eosinophilia myalgia syndrome, Raynaud's syndrome and dermatomyositis are some of the autoimmune illnesses related to xenobiotics. [ Toxicology, 1997; pp.119:1-21] As with all autoimmune disorders, detoxification is usually helpful.
 
 

Recommendations for Dermatomyositis:
 
 
Drug  Antibiotics
 Dr. Thomas McPherson Brown pioneered the use of low dose antibiotics in the treatment of rheumatologic diseases. He also saw improvement in cases of mixed connective tissue disease, ankylosing spondylitis, dermatomyositis and polymyositis. Minocin (minocycline) is currently the antibiotic of choice.

Vitamins

  Vitamin Paba
 There have been several cases where paba, taken as "Potaba", caused significant and lasting improvement in those with dermatomyositis. Suppression and reversal of autoimmunity seemed to occur. Doses taken ranged up to 20 grams per day. [N Y State J Med 63: pp.140-4, 1963]
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Weakly counter-indicative
Very strongly or absolutely counter-indicative
May do some good
Likely to help







GLOSSARY

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Allergy:  Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Autoimmune Disease:  One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.

Calcium:  The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Dermatomyositis:  A diffuse connective tissue disease.

Distal:  Anatomically located further away from a point of reference, such as an origin or a point of attachment.

Dysphagia:  Difficulty in swallowing.

Flexor:  A muscle that closes a joint.

Myalgia:  Diffuse muscle pain.

Proximal:  Nearer to a point of reference such as an origin, a point of attachment, or the midline of the body.

Raynaud's Phenomenon:  Raynaud's disease or syndrome is a disorder of blood circulation, mainly in the fingers and toes. It is of unknown cause and characterized by changes of the skin that are aggravated by exposure to cold: first, becoming white with numbness and pain as a result of inadequate oxygenation of the blood, then red/purple with a burning sensation. The sudden constriction of blood vessels causes decreased blood flow to the extremities and can, in extreme cases, lead to gangrene. Also called "white finger", "wax finger" or "dead finger".

Steroid:  Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.