dermatomyositis

Question 1

causes for Dermatomyositis

Answer 1

paraneoplastic condition seen in the context of a range of solid and haematological malignancies, including breast cancer

Question 2

x

Question 3

x

Question 4

x

Question 5

x

Question 6

clinical features of the skin in dermatomyositis ?

Answer 6

heliotrope’ rash around eyelids
symmetrical

photosensitive

macular rash over back and shoulder

‘mechanic’s hands’: extremely dry and scaly hands with linear ‘cracks’ on the palmar and lateral aspects of the fingers

nail fold capillary dilatation

violaceous papules over the dorsal aspect of her proximal and distal interphalangeal joints.

Gottron papules are red or violet bumps that form on the outside joints of the hand or knees

Question 7

other features of dermatomyositis ?

Answer 7

proximal muscle weakness +/- tenderness

Raynaud’s

respiratory muscle weakness
interstitial lung disease: e.g. Fibrosing alveolitis or organising pneumonia

dysphagia, dysphonia

Question 8

x

Question 9

diagnosis of dermatomyositis ?

Answer 9

ANA positive in 80 percent !

around 30% of patients have antibodies to aminoacyl-tRNA synthetases (anti-synthetase antibodies), including:

antibodies against histidine-tRNA ligase (also called Jo-1)

antibodies to signal recognition particle (SRP)

Elevated CK

========

EMG
muscle biopsy

Question 10

management of dermatomyositis ?

Answer 10

prednisolone