amyopathic dermatomyositis
Introduction
Introduction to myopathy-free dermatomyositis Myositis dermatomyositis is a new type of dermatomyositis. It has characteristic dermatomyositis with skin changes without myositis for 24 months. It has the same high incidence of malignant tumors as dermatomyositis. The rate is associated with neoplastic connective tissue disease. basic knowledge The proportion of illness: 0.003%-0.004% Susceptible people: more common in women aged 20-40 Mode of infection: non-infectious Complications: malignant tumor
Cause
No cause of myopathy dermatomyositis
It may be that the susceptible system is infected with certain viruses, and the immune system of the body is disordered, leading to inflammation of connective tissue mainly composed of skeletal muscle lesions.
Prevention
No myopathy dermatomyositis prevention
1. Remove possible incentives, such as cold, damp heat and other adverse factors on the human body. 2. Strengthen the law of physical exercise and pay attention to work and rest. 3. Strengthen nutrition and prevent infection. 4. Adjust your emotions and keep your mood happy.
Complication
No myopathy dermatomyositis complications Complications malignant tumor
Mainly involving the limb muscles, neck muscles, throat muscles, such as at the same time involving the skin, called dermatomyositis. More common in women aged 20-40, some patients may have a history of infection before the disease, with symmetrical limb proximal muscle weakness, pain and tenderness. Can involve the pharyngeal muscles, respiratory muscles and neck muscles. In the advanced stage, there may be muscle atrophy. Some have skin or visceral damage, or have malignant tumors.
Symptom
No myopathy dermatitis symptoms Common symptoms Eyelid edema Eyelids are purple-red erythematous rash red or purple, slightly... telangiecta dermatomyositis Gott... Skin atrophy and pigmentation
1. There are edematous purple-red spots (violet) around the eyelids (especially the upper eyelids have purple-red spots, edema around the eyelids, also known as positive skin lesions), and symmetric distribution. There are ectopic erythema in the neck, shoulders, upper chest, forearm, and upper arm (the skin lesions have telangiectasia, mild atrophy. Both pigmentation and hypopigmentation).
2, Gottron papules and Gottron sign: on the back of the knuckles, the metacarpophalangeal joints, the elbows, knee joints have a symmetric distribution of purple red papules, called Gottron papules, these pimples have purple spots, atrophy or fusion It is a plaque (with telangiectasia, flushing and scaling) called the Gottron sign.
3, there is telangiectasia at the nail fold (there is telangiectasia around the nail).
4, the exposed part of the skin erythema: the exposed part of the exposed area of the edematous erythema. The most typical is found in the chest V-shaped area or the round neck outer skin of the round neck, which is caused by photosensitivity. (The V-shaped area has atrophic dermatitis, erythema, telangiectasia, and cigar paper-like shrinkage). The realm is clear.
5, clinical no muscle inflammation, no muscle weakness, creatine and myalgia.
6, muscle zymogram, EMG, muscle biopsy, myositis specific antibodies are normal. Muscle imaging examination ( scan, CT, MRI, muscle ultrasound examination were normal.
Examine
Examination of no myopathy dermatomyositis
Muscle zymogram, electromyography, muscle biopsy, and myositis-specific antibodies were normal. Muscle imaging examination ( scan, CT, MRI, muscle ultrasound examination, serum CK level was mildly elevated. Muscle histology showed abnormal inflammatory changes in muscle fiber structure, CD8 T cell infiltration. Confirmation of denaturation using immunohistochemistry The cytoplasm and nucleus of the muscle fibers are formed, and the -amyloid protein is positively stained.
Diagnosis
Diagnosis and differentiation of myopathy-free dermatomyositis
diagnosis
1. Diagnostic skin damage (lasting more than 6 months), there are 4 main items:
(1) There are edematous purple-red spots around the upper and lower eyelids and symmetrical distribution.
(2) The knuckles, the back of the palm joint, the Gottron papules and the Gottron sign on the elbow and knee extension.
(3) There is flushing and telangiectasia in nail folds.
(4) Skin erythema at the exposed site: The exposed area is exposed to sunlight and the edematous erythema is obvious. The most typical is found in the chest V-shaped area or the round neck outer skin of the round neck, which is caused by photosensitivity. (The V-shaped area has atrophic dermatitis, erythema, telangiectasia, and cigar paper-like shrinkage).
2, there are characteristic DM skin damage, skin biopsy in line with DM histopathological changes, that is, can exclude other skin diseases.
3. 24 months after the appearance of skin lesions, there are no symptoms of inflammation in the skeletal muscles of the shoulders and hips, such as muscle weakness, creatine, and myalgia.
4. The laboratory muscle enzyme test is within the normal range within 24 months after the onset of skin lesions, especially creatine kinase (CK) and aldolase (ALD).
Differential diagnosis
Different from other skin diseases.
