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Dermatomyositis

Causes and symptoms of dermatomyositis


What is dermatomyositis?

Dermatomyositis, or Wagner's disease is a systemic disease in which the pathological process involved the skeletal and smooth muscle muscles and also the skin.


Causes of dermatomyositis

Causes of dermatomyositis currently has not been fully established. Considered the disease to multifactorial. To provoke disease in most cases are viral diseases: influenza, parainfluenza, hepatitis b, picornaviruses, parvoviruses, are also common etiological factors include some protozoa and a number of infectious diseases caused by bacterial infection (Lyme disease).

In addition, dermatomyositis can develop after vaccination against typhoid, cholera, measles, rubella, mumps, and after parenteral administration of certain medications. The disease can be triggered by hypothermia, insolation, trauma, allergies to medicines, pregnancy. Approximately 30% of patients with dermatomyositis occurs in the background of malignant diseases.

The disease is accompanied by various disorders of the immune system. It is known that most often this disease affects women, who are most susceptible to the disease in the transitional and menopausal age. There is a view of the genetic predisposition to dermatomyositis, and a value of neuroendocrine reactivity in the development of the disease.


The symptoms of dermatomyositis

Symptoms of dermatomyositis at the initial stage of the disease is manifested acute or subacute. In the first days of the disease marked myasthenia gravis, muscle pain, joint pain, swelling, rise of body temperature, a lose skin. Over time, the pathology becomes chronic and is accompanied by relapses. Constant aggravation cause destruction of skeletal muscle, patients reported muscle pain during motion, at rest and when depressed, patients also suffer from muscle weakness, which over time increases.

On the background of pathological process thickens and increases in volume the muscle tissue of the shoulder and pelvic girdle, which causes the violation of the amplitude of motion. The patient can not sit without assistance, to lift and hold the head, raise the arms and legs. In some cases, there is complete immobility, and even a state of prostration. For muscle weakness in dermatomyositis, the characteristic ineffectiveness of neostigmine and similar medicines.

If the pathological process affects facial muscles, the patient's face like a mask. Can be affected also muscle fibers that are responsible for swallowing, leading to dysphagia. Distribution of dermatomyositis on intercostals and diaphragmatic muscles leads to disruption of the process of breathing: the patient is reduced lung capacity and develops pneumonia on the background of hyperventilation. The involvement in the pathological process of the eye muscles leads to the development of diplopia, strabismus and ptosis of bilateral eyelids.

Early in the disease the muscles are painful and swollen. The gradual development of degenerative phenomena in the fibers of the tissue starts the process of myolysis, which appears miofibroz, there is atrophy and contracture of the muscle fibers, in rare cases, calcification is observed. The phenomenon of calcification may spread to the subcutaneous tissue, which is typical for young patients. Such changes are detected, usually under x-ray examination.

For accurate diagnosis is of great importance in the biochemical study of blood, urine and biopsy of muscle fibers, especially if we are talking about chronic and subacute pathological process.

Acute dermatomyositis accompanied by rapidly increasing generalized lesion of striated muscle that often causes complete immobility, and also leads to the development of dysphagia and dysarthria. The disease occurs with symptoms of intoxication, high body temperature, skin rashes. The lack of treatment leads to the patient's death from aspiration pneumonia or cardiopulmonary failure a few months after the onset of the disease.

Subacute dermatomyositis cyclically recurs, accompanied by increasing weakness, lesions of the skin and internal organs. The most favorable outcome is the chronic course of the pathological process, in this case, the operation of only individual groups of muscle fibers, and even in the case of a significant number of exacerbations the General condition of patients can be considered satisfactory, which helps patients to stay a long time working.

At the same time with the young people of chronic dermatomyositis can occur with calcification of the subcutaneous tissue, the skin and muscles that becomes the reason of occurrence of persistent contractures and complete immobility.

Treatment of dermatomyositis

Treatment of dermatomyositis is carried out mainly by glucocorticoids, in some cases, cytostatics, anddrugs that promote elimination of disorders caused by decreased blood supply to the muscle fibers.

Can be recommended drugs that enhance the metabolic processes affecting the functioning of internal organs, reducing risk of complications.