Eyelids are purple
Introduction
Introduction The eyelid is purple-red is the second section of dermatomyositis skin symptoms, the initial facial edema erythema, especially in the eyelids are purple-red, the cheeks may have seborrheic dermatitis-like diffuse erythema.
Cause
Cause
The cause of the eyelids is purple-red:
Cause: The cause is unknown. In recent years, the disease has been attributed to autoimmune diseases. In addition, such as viral infection, allergic reactions to tumors.
Examine
an examination
Related inspection
Eyelid examination, ophthalmologic examination, slit lamp, and CT examination of the temporal region
The examination of the eyelids is purple-red:
Clinical manifestations: The initial symptoms of the disease are symptoms such as general fatigue, fatigue, headache, joint pain, and low muscle strength. The main lesions are skin and muscle. There is no skin lesion called polymysitis. Good middle-aged women.
Skin symptoms: Initially, edematous erythema appears on the face, especially in the eyelids, which is purplish red, and the cheeks may have diffuse erythema like seborrheic dermatitis. There is telangiectasia, much like SLE. The trunk, dry skin of the limbs, diffuse erythema, can appear pigmentation, punctate keratinization, mild skin atrophy, telangiectasia and other skin color changes, called heterochromic dermatomyositis.
The skin on the back of the finger joints often has obvious edematous erythema, hyperpigmentation, and sometimes dark purple flat papules. A erythema appears around the nail.
30% of patients have Raynaud, which can be an early symptom of the disease.
20% of pediatric dermatomyositis has calcium deposition in the muscle or under the skin.
Muscle symptoms: muscle weakness, swelling, spontaneous pain or tenderness due to muscle inflammation, degeneration, etc. in the acute phase. Generally, the proximal muscle is involved first, and movement disorders such as raising hands, lifting the foot, squatting, swallowing, and vocalization are difficult. Depending on the damaged muscle, it can also cause different symptoms. Chronic phase can show muscle atrophy, or hard due to fibrosis, resulting in complete loss of motor function.
Other organ involvement can lead to interstitial pneumonia, myocarditis, arthritis, glomerulitis and extensive vasculitis.
About 5-40% of patients have malignant tumors, often with lung cancer, esophageal cancer, gastric cancer, malignant lymphoma and so on. Malignant tumors can occur before, at the same time or after dermatomyositis. Pediatric dermatomyositis is rarely associated with malignant tumors.
Laboratory inspection:
1.24 hours of increased creatinine excretion, up to 1000 mg or more (normal 0-200 mg).
2. Serum enzyme chemistry: aspartate aminotransferase (GOT), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), creatine kinase (CK), aldolase (Aldoiase) increased significantly, CPK and Aldoiase often and muscle The lesions are parallel.
3. Immunological examination: the immunoglobulin is increased, the erythrocyte sedimentation rate is accelerated, and the RA reaction is positive. The anti-nuclear antibody was lower than the SLE positive rate, the anti-Pm-1 antibody was 61% specific to the disease, and the anti-J0-1 antibody was approximately 24% positive, among which the lung disease was higher.
4. Electromyography: mostly myogenic, atrophic phase EMG. Generally, at low voltages, the visible amplitude is reduced, the unit is reduced, and most of the polyphase units appear, and the unit duration is shortened.
Diagnosis
Differential diagnosis
Eyelids are purple-red and easy to confuse symptoms:
It should be differentiated from the edematous purple-red spot on the upper eyelid. The edematous purple-red spot on the upper eyelid is a typical skin lesion of dermatomyositis. The edematous purple-red spot on the upper eyelid spread to the periorbital area and gradually spread to the V-shaped area of the face, neck and upper chest. The elbow and elbow, especially the metacarpophalangeal joint and the metatarsophalangeal joint, appear purple-red papules with telangiectasia, hypopigmentation, overlying fine scales, called Gottron (Gordon) sign or Grottron papules.
Clinical manifestations: The initial symptoms of the disease are symptoms such as general fatigue, fatigue, headache, joint pain, and low muscle strength. The main lesions are skin and muscle. There is no skin lesion called polymysitis. Good middle-aged women.
Skin symptoms: Initially, edematous erythema appears on the face, especially in the eyelids, which is purplish red, and the cheeks may have diffuse erythema like seborrheic dermatitis. There is telangiectasia, much like SLE. The trunk, dry skin of the limbs, diffuse erythema, can appear pigmentation, punctate keratinization, mild skin atrophy, telangiectasia and other skin color changes, called heterochromic dermatomyositis.
The skin on the back of the finger joints often has obvious edematous erythema, hyperpigmentation, and sometimes dark purple flat papules. A erythema appears around the nail.
30% of patients have Raynaud, which can be an early symptom of the disease.
20% of pediatric dermatomyositis has calcium deposition in the muscle or under the skin.
Muscle symptoms: muscle weakness, swelling, spontaneous pain or tenderness due to muscle inflammation, degeneration, etc. in the acute phase. Generally, the proximal muscle is involved first, and movement disorders such as raising hands, lifting the foot, squatting, swallowing, and vocalization are difficult. Depending on the damaged muscle, it can also cause different symptoms. Chronic phase can show muscle atrophy, or hard due to fibrosis, resulting in complete loss of motor function.
Other organ involvement can lead to interstitial pneumonia, myocarditis, arthritis, glomerulitis and extensive vasculitis.
About 5-40% of patients have malignant tumors, often with lung cancer, esophageal cancer, gastric cancer, malignant lymphoma and so on. Malignant tumors can occur before, at the same time or after dermatomyositis. Pediatric dermatomyositis is rarely associated with malignant tumors.
Laboratory inspection:
1.24 hours of increased creatinine excretion, up to 1000 mg or more (normal 0-200 mg).
2. Serum enzyme chemistry: aspartate aminotransferase (GOT), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), creatine kinase (CK), aldolase (Aldoiase) increased significantly, CPK and Aldoiase often and muscle The lesions are parallel.
3. Immunological examination: the immunoglobulin is increased, the erythrocyte sedimentation rate is accelerated, and the RA reaction is positive. The anti-nuclear antibody was lower than the SLE positive rate, the anti-Pm-1 antibody was 61% specific to the disease, and the anti-J0-1 antibody was approximately 24% positive, among which the lung disease was higher.
4. Electromyography: mostly myogenic, atrophic phase EMG. Generally, at low voltages, the visible amplitude is reduced, the unit is reduced, and most of the polyphase units appear, and the unit duration is shortened.
