Childhood dermatomyositis

Childhood dermatomyositis

Childhood dermatomyositis is an inflammatory process characterized by proximal muscle weakness and skin lesions. At the onset of the disease, the child will begin to complain of difficulty performing various daily activities or movements, e.g. B. climb stairs, get dressed and even play games.

What is childhood dermatomyositis?

According to a study by the Vicente López Municipal Hospital in Argentina, the incidence of dermatomyositis in pediatrics is between 1 and 3.2 per million, between 5 and 14 years of age, which is considered a low percentage and a rare pathology.

Childhood dermatomyositis is a disease characterized by inflammation of the muscles and the appearance of a rash. Since it is a rare disease, its cause is unknown, which is why it is currently linked to autoimmune pathogenesis or a genetic predisposition.

Symptoms of childhood dermatomyositis

The symptoms of infantile dermatomyositis usually appear progressively. It starts with a muscular proximal weakness that prevents various types of activity. Then skin lesions appear, which are crucial for the diagnosis. We explain the symptoms in detail:

Muscle injuries

Muscle weakness begins slowly and prevents simple activities such as climbing stairs or getting dressed. Little by little the child begins to say that it is difficult to carry out its daily tasks. In some cases, painful muscle pounding can occur. Although this pain can occur in any part of the body, it is more common in proximal peripheral muscle groups.

Skin lesions

It is characterized by a violet color of the upper eyelids, which is called heliotrope erythema. Photo-localized erythema can also occur on both cheeks. The so-called “Schalzeichen” or “Erythema capelina” can be seen in the cervicodorsal region.Childhood dermatomyositis

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They can also be seen in hands like lesions like plaques or purple papules. In addition, they are often accompanied by desquamative processes that are reminiscent of psoriasis. “Gottron papules” can be seen in the fingers, although they can also appear on the elbows and knees.

Other symptoms

Although muscle pain and skin lesions are usually the most common complaints, other symptoms such as fever, fatigue, and weight loss also occur. Among others, less often we find:

stomach pain
Digestive bleeding
pneumonia
Pericarditis
Myocarditis
Symmetrical arthritis
Microhematuria.
Behavioral disorders.
hypertension
Reynaud phenomenon.

diagnosis

The diagnosis of this disease is determined by analyzing skin lesions along with the findings of this process, as is the case with muscle inflammation. During the blood test you can see the increase in certain substances such as CPK, LDH or GOT. We explain some of the tests in detail:

Blood test It is used to measure whether the child has high levels of muscle enzymes such as creatine kinase and aldolase. A high level can cause muscle damage.
Electromyography The doctor inserts a thin needle electrode through the skin into the muscle to be tested. Changes in the pattern of electrical activity confirm whether there is a muscle disorder.
Skin or muscle biopsy. A piece of skin or muscle is removed for laboratory tests. This helps identify muscle problems.

treatment

In childhood it is important to strike a balance between rest, rehabilitation and physiotherapy combined with pharmacological treatment. This consists in the administration of corticosteroids, which generally have to be maintained for long periods; Sometimes even life.

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If the response to treatment is not as expected or the improvement is not seen, immunosuppressants (methotrexate and cyclosporin A) are used. Rehabilitation and physiotherapy are essential in this phase.Childhood dermatomyositis

“Dermatomyositis treatment is usually prolonged; It usually takes at least two years. In some cases, it can get even longer. “

Diseases such as childhood dermatomyositis can be complicated if proper treatment and rehabilitation is not done. It is most recommended that the parents go to the pediatrician the moment they discover that the child has difficulty performing various tasks and the appearance of skin changes that are characteristic of this pathology.

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