23. Dermatomyositis
Definition
Dermatomyositis is a disorder of collagen/connective tissue characterized by nonsuppurative skin inflammation and subcutaneous tissue and muscle fiber necrosis. It may be acute, subacute, or chronic.
Incidence
The most recent estimates indicate that dermatomyositis occurs at the rate of about 5.5:1,000,000. The frequency seems to be increasing. There is a 2:1 predilection toward females, but no apparent preference for a particular race.
Etiology
The cause of dermatomyositis is not fully understood. There are suggestions that it is caused by a complement-mediated vascular inflammation. The immunologic abnormalities may be triggered by a wide variety of agents.
Potential Triggers of Immunologic Abnormalities Related to Dermatomyositis
• Borrelia species
• Collagen injections
• Drug ingestion
• Silicone breast implants
• Toxoplasma species
• Viruses
Signs and Symptoms
• Arthralgia
• Arthritis
• Calcinosis of skin or muscle
• Dysphagia
• Dysphonia
• Dyspnea
• Dysrhythmias
• Facial erythema
• Gottron papules
• Heliotrope rash
• Joint swelling
• Malar erythema
• Muscle tenderness
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