Dermatomyositis (synonym polymyositis) is a systemic disease of the skin, muscles with various lesions of the internal organs. Etiology and pathogenesis - see Collagen diseases.
The onset of the disease can be acute, but more often gradual. The skin is affected ( erythema , rashes, thick edema over the affected muscles), striated muscles ( myalgia , progressive myasthenia gravis - to complete immobility), especially the muscles of the neck, back, shoulder and pelvic girdles. The defeat of the pharyngeal muscles causes dysphagia (see). In addition, there are arthralgia, myocarditis, sometimes with heart failure. If dermatomyositis in the skin atrophy is present in the picture, the term “poikilodermatomyositis” is used. More rarely are involved in the pathological process of the gastrointestinal tract (gastroenterocolitis), kidneys , liver , eyes ( retinitis , hemorrhage).
The diagnosis of dermatomyositis is based on the clinical picture. An increase in the level of transaminases in the blood and creatinuria is also characteristic.
The prognosis for the acute course is unfavorable, death occurs after 3-6 months, for chronic it is a long-term survival.
Treatment . In acute and subacute currents, steroid hormones are used in large doses (as prescribed by a physician), preferably prednisone 40–60 (up to 100) mg per day, followed by a gradual decrease in dose after a distinct improvement (2 months on average); aminoquinoline preparation - hingamin (delagil, rezokhin, chloroquine) 0.25 g 1 time per day after dinner for 1-1.5 years; vitamins (groups B and C); ATP 1 ml of 1% solution intramuscularly, for a course of 15-20 injections, etc. Hormone therapy lasts at least 1 year. In the chronic course, treatment is the same, but corticosteroids are used at a lower dose (20–30 mg of prednisone per day) and for a shorter time.