polymyositis dermatomyositis

Systemic diseases of the skeletal and smooth muscles, and skin. Estimated cause of the disease - viral (Coxsackie B2 virus). Provoke disease cooling, prolonged sun exposure, pregnancy, drug intolerance. In 20-30% of cases dermatomyositis observed in patients with various tumors. The mechanism of the disease - disorders in the immune status. Women suffer in 2 times more often than men, with two peaks of age (puberty, menopause). Family genetic predisposition.
The disease begins more or less acute with the defeat of the musculoskeletal system (muscle weakness, muscle pain), pain in the joints, fever, skin lesions (various rashes, itching, patchy redness, excessive actinic reinforced or dramatically reduced pigmentation, calcium deposition in thicker skin or subcutaneous fat), dense widespread edema. In the future, the disease gets relapsing course. Progressive destruction of skeletal muscle - they are painful on motion and at rest, pain increases when pressing on them, increases muscle weakness. The muscles of the shoulder and pelvic girdle are sealed, increase in volume, violated their active movements, patients can not sit on their own, to raise his head from the pillow. The defeat of the facial muscles leads to maskoobraznosgi face, pharyngeal and respiratory - to violations of swallowing and breathing, which also complicated by frequent pneumonia. If the eye muscles are affected, the developing double vision, strabismus, bilateral ptosis (drooping of the upper eyelid). Involvement in the process of the heart muscle (myocarditis or miokardidistrofiya) appears resistant increased heart rate, decrease in pressure, systolic appearance of noise can lead to heart failure. One third of patients - Raynaud's Syndrome (whitening cooling blue fingers). Reduced or no appetite, there are abdominal pain, may develop gastrointestinal bleeding, intestinal obstruction. There are 3 forms of dermatomyositis flow: acute with the rapid development of symptoms (may end in death within 36 months due to severe damage to the lungs and cardiovascular system.), Sub-acute and chronic. Changes in blood tests are nonspecific: moderate leukocytosis with a marked increase in the number of eosinophils (up to 25-70%), persistent elevated levels of gamma globulin in the blood and ESR.
Detection is carried out on the basis of biochemical analysis of blood and urine tests (creatine kinase enzyme levels), but the main role is played by the detection of specific changes in muscle biopsies.
In the presence of a malignant tumor of its removal leads to permanent improvement. It is necessary to use high doses of glucocorticoid hormones for a long time (prednisone, methylprednisolone). You can receive delagila, Plaquenil, indomethacin, Brufen, butadiona; important are B vitamins, ascorbic acid. In severe muscle weakness Neostigmine used, anabolic steroids (nerabol, retabolil). After calming down inflammation - physiotherapy, massage.