dermatomyositis dermatomyositis dermatomyositis (dm) is a long-term inflammatory disorder which affects skin and the muscles. its symptoms are generally a skin rash and worsening muscle weakness over time. these may occur suddenly or develop over months. other symptoms may include weight loss, fever, lung inflammation, or light sensitivity. complications may include calcium deposits in muscles or skin. dermatomyositisdiscrete red areas overlying the knuckles in a person with juvenile dermatomyositis. these are known as gottron's papules.specialtyrheumatologysymptomsrash, muscle weakness, weight loss, fevercomplicationscalcinosis, lung inflammation, heart diseaseusual onset40s to 50sdurationlong termcausesunknowndiagnostic methodbased on symptoms, blood tests, electromyography, muscle biopsiesdifferential diagnosispolymyositis, inclusion body myositis, sclerodermatreatmentmedication, physical therapy, exercise, heat therapy, orthotics, assistive devices, restmedicationcorticosteroids, methotrexate, azathioprinefrequency~ 1 per 100,000 people per year the cause is unknown. theories include that it is an autoimmune disease or a result of a viral infection. dermatomyositis may develop as a paraneoplastic syndrome associated with several forms of malignancy. it is a type of inflammatory myopathy. diagnosis is typically based on some combination of symptoms, blood tests, electromyography, and muscle biopsies. while no cure for the condition is known, treatments generally improve symptoms. treatments may include medication, physical therapy, exercise, heat therapy, orthotics and assistive devices, and rest. medications in the corticosteroids family are typically used with other agents such as methotrexate or azathioprine recommended if steroids are not working well. intravenous immunoglobulin may also improve outcomes. most people improve with treatment and in some, the condition resolves completely. about one per 100,000 people per year are newly affected. the condition usually occurs in those in their 40s and 50s with women being affected more often than men. people of any age, however, may be affected. the condition was first described in the 1800s. signs and symptoms the main symptoms include several kinds of skin rash along with muscle weakness in both upper arms or thighs. skin one form the rashes take is called "heliotrope" (a purplish color) or lilac, but may also be red. it can occur around the eyes along with swelling, but also occurs on the upper chest or back what is called the "shawl" (around the neck) or "v-sign" above the breasts and may also occur on the face, upper arms, thighs, or hands. another form the rash takes is called gottron's sign which are red or violet, sometimes scaly, slightly raised papules that erupt on any of the finger joints (the metacarpophalangeal joints or the interphalangeal joints). gottron's papules may also be found over other bony prominences including the elbows, knees, or feet. all these rashes are made worse by exposure to sunlight, and are often very itchy, painful, and may bleed. if a person exhibits only skin findings characteristic of dm, without weakness or abnormal muscle enzymes, then he or she may be experiencing amyopathic dermatomyositis (adm), formerly known as "dermatomyositis sine myositis". muscles people with dm experience progressively worsening muscle weakness in the proximal muscles (for example, the shoulders and thighs). tasks that use these muscles: standing from sitting, lifting, and climbing stairs, can become increasingly difficult for people with dermatomyositis. other around 30% of people have swollen, painful joints, but this is generally mild. in some people, the condition affects the lungs, and they may have a cough or difficulty breathing. if the disease affects the heart, arrhythmias may occur. if it affects the blood vessels in the stomach or intestines, which is more common in juvenile dm, the people might vomit blood, have black tarry bowel movements, or may develop a hole somewhere in their gi tract. there are further complications possible with dermatomyositis. these complications include difficulty swallowing due to the muscles in the esophagus being affected which can result in malnutrition and can cause the breathing of food or liquids, into the lungs. examples of dermatomyositis gottron's papules on finger joints gottron's papules on the elbows of a person with juvenile dm gottron's papules gottron's bumps on a person with juvenile dm gottron's papules in a severe case of juvenile dermatomyositis heliotrope with swelling around the eyes heliotrope facial rash severe rash on the hands, extending up the forearm forearm rash causes