-
Facial Rash
- Dermatomyositis- Usually involves nasolabial fold
- SLE - Usually spares the nasolabial fold
Posted 08/03/16 09:33:35 AM by Adam Faye
-
When evaluating a patient with weakness, also check core strength and neck strength. Extremities may be 5/5 but may find that patient is unable to lift head off the bed.
Posted 08/03/16 09:35:02 AM by Adam Faye
-
Dermatomyositis: Skin Findings
- Gottron's Papules (found over bony prominences - usually MCPs, PIPs, DIPs)
- Heliotrope Rash (violaceous rash without edema in a symmetrical distribution on the face
- Pokilodermia (atrophy, dyspigmentation, and telangiectasia) can occur on extensor surfaces, V-neck area, upper back (shawl sign), or upper-lateral thighs (holster sign)
Tissue Diagnosis:
- Biopsy where there is weakness and MRI/EMG evidence of inflammation
- if you biopsied the skin in dermatomyositis- would show "Interfaced Dermatitis" which is non-specific (can also see this in SLE as well).
Association between Malignancy and Dermatomyositis:
- New diagnosis of dermatomyositis - eval for malignancy with CT Chest/A-P.
- High association with ovarian Ca
- Usually increased association with malignancy in first 5 years- as time goes on the association weakens.
Posted 08/03/16 09:40:04 AM by Adam Faye
-
- Usually Dermatomyositis and Polymyositis are without myalgias
- Check medication list- statins can cause autoimmune necrotizing myopathy
- If patient has distal weakness + proximal weakness - think about Inclusion Body Myositis
- If ANA generally > 1:40 or 1:80 start to think of underlying autoimmune process
Posted 08/03/16 09:50:00 AM by Adam Faye
-
For further reading...
Posted 08/03/16 09:33:51 AM by Adam Faye
Created by Christopher Kelly
Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.