- 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)
- 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'
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