Dermatomyositis (DM)

A rash usually accompanies or precedes the muscle weakness in DM. 

in 1975 a set of five criteria were established to aid in the diagnosis of the disease: progressive proximal symmetrical muscle weakness, elevated muscle enzymes, abnormality on an electromyogram (EMG), abnormal muscle biopsy, and cutaneous skin disease.

 

Symptoms:

  • dusky red or violet coloured rash on face, neck, shoulders, upper chest, elbows, knees, knuckles, and back
  • distinct heliotrope rash generally around the eyes
  • progressive muscle weakness  particularly in the muscles closest to the trunk -  hips, thighs, shoulders, upper arms and neck.

 

       

       

       

      High magnification micrograph of dermatomyositis from a  H&E stain of a muscle biopsy.

      Image by Nephron

       Gottron's papules in dermatomyositis. Discrete erythematous papules.

      Photos above & below from E. M. Dugan, A. M. Huber, F. W. Miller, L. G. Rider

      Heliotrope. Confluent macular erythema confined to the upper eyelid, with associated periorbital edema. 

      Heliotrope. Confluent macular erythema - upper & lower eyelid, with associated periorbital edema. 
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