The dermatomiositis It is an autoimmune disease that mainly affects the skin and muscle tissue of the striated type., found throughout the body and is responsible for moving bones and joint structures. It is a disease that is included within the myopathyíinflammatory, and although in a 60-70% of the cases, affectation coexistón cutánea y muscular, it doesn't always happen this way, and there are even occasions in which the affectationón is exclusively cutánea.
This is a disease that is distributed universally, although it is a bitás prevalent in the Caucasian breedáphysical and less frequent in the black race. Además, spaghettién occurs to a greater extent among women than among men. Although it can occur in youth, the manifestations of the disease are más frequent among 30 and the 50 años.
Dermatomyositis is considered a rare disease., with an annual incidence of about 4-6 cases per thousandóNo. of inhabitants.
Index
Causes of dermatomyositis
Dermatomyositis is unknown, but the disease has much in commonún with autoimmune disorders, in which the immune system mistakenly attacks body tissues. Gene factorséethical and environmental tooécan'tístill performedñplay an important role. Environmental factors include medications, smoking and viral infections.
Sísymptoms of dermatomyositis
The dermatomiositis has two great manifestations, the muscular and the cutánea. Among the first it is worth highlighting weakness and pain and they can present themselves in the prápractical whole body, although they are máfrequent s in peripheral muscle groupsérich proximal.
The símuscle symptoms need noté be the first to show up, but it is rarelyán absent at the time of diagnosisóstico. The intensity of weakness may be mild, but alsoén severe, although it is usual for the weakness to be moderate. Although other muscle groups may be affected, to the torso musclesácica or abdominal is infrequent or when it occurs, It is already in advanced stages of the disease.
With regard to the manifestations cutádenies, on the face you can identify a rashóno purple skináfrowning around the eyes and which is called heliotrope. in the regionóIn the cervico-dorsal area, the so-called capelin erythema can be seen, which consists of the presence of reddening of the skin from the occipital area to the base of the neck..
on the hands, plaque-type lesions or p can be identifiedápurple tone pulesáceo accompaniesñadas desquamative processes, and that tend to accumulate on large surfaces.ón of joints such as elbows, fingers and knees.
Although dermatomyositis can have visceral manifestations, probably the most relevant is the respiratory, which is presented as a picture of respiratory failure, who can cause a sensationóNo choking at intermediate and minor efforts.
It can cause different difficulties, as they are:
- dysphagia (difficulty to swallow)
- pneumoniaíby aspirationón
- Lung disease
- Cáncer
- Respiratory problems
- Calcinosis (depócalcium sites)
- cardiovascular disease
- Other connective tissue diseases
Diagnóstic of dermatomyositis
As with many other rheumatic diseasesátics, the diagnosisóclassification standardón is established based on different clinical criteriaíunique, resorting to the use of:
- Anáblood lysis. Un anáblood lysis allows detecting elevated levels of muscle enzymes, that can indicate a dayñthe muscular, además to detect antibodies.
- Electromiografía. It is a test that can confirm whether or not there is a muscle disease, and which consists of inserting a fine needle electrode throughés skin in the múcentury.
- magn resonanceética. Imaging tests can assess inflammationón in a certain muscle group.
- tissue biopsy. If you extractúrigidly a sample of cut tissueáneo the muscle for su análysis in the laboratory. Thanks to this test, the diagnosis can be confirmed.óstic of dermatomyositis.
- Radiographeríto of tórax. Indications of the type of damage can be identifiedñor lung.
- Manometería esofágica. Used to rule out involvementón esofágica to verify that there is no risk of dysphagia.
Treatment of dermatomyositis
As with other low-incidence diseases, the therapeutic experienceéutica is limited, así as the existence of clinical studiesíonly controlled. Although there is no cure, can improve skin lesionsálines and helps restore strength and functionón muscular.
In this way we can talk about:
drug treatmentógico
- Corticosteroids. They reduce inflammationón shaped ráask, but prolonged use can have serious side effects. The dose should be gradually reduced.
- Fácorticosteroid-sparing drugs. They are drugs to suppress the immune system and replace corticosteroids. Among the medicinesás used to treat dermatomyositis are methotrexate, azathioprine and mycophenolate mofetil.
- Rituximab. Biological treatment can be usedólogical if initial therapies cannot adequately control the symptomsísymptoms of dermatomyositis.
- Antipalm drugsútips. In the case of injuryón cutápersistent snow, an antipal medication can be prescribedúI say, like hydroxychloroquine.
- Intravenous immunoglobulin (IgIV). It is a blood productípurified neo containing healthy antibodies from thousands of blood donors. They can block antibodiesñines that attack the múdermatomyositis sculi.
non-pharmacological treatmentógico
- Physiotherapy. Exercises to maintain and improve strength and flexibility are beneficial, so that it does not seek to lose autonomyíto of movement.
- Sunscreens. It is important to protect the skin from exposureón sun by applying sunscreen and wearing clothing and hats.
- Talk therapy. weakens the múmuscles involved in the actionóno to swallow, speech therapy to help learn cóhow to cope with changes.
- Evaluationón of the nutrición. As dermatomyositis progresses, should be chewed and swallowed may be máit's complicated. A varied diet will helpá when it comes to controlling and maintaining both weight and nutritionón proper.
Cirugía
A third optionón of treatment for dermatomyositis is the cirugía, what can be an optionón to remove the painful depócalcium sites and to prevent recurrent skin infections.
arrow shaped, there are different possibilities, having to drink for one or the other depending onón of each particular case, And beá the professional who has to determine the treatment.
