Brimonidine for treatment of telangiectasia of dermatomyositis (original) (raw)
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Dermatomyositis. Diagnostic and therapeutic recommendations of the Polish Dermatological Society
Dermatology Review, 2021
Dermatomyositis is an autoimmune disease characterized by skin lesions and/or symptoms of myositis. In addition to the so-called classic dermatomyositis the following forms of dermatomyositis are distinguished based on the clinical presentation: pediatric, paraneoplastic, drug-induced and amyopathic. A number of disease-specific autoantibodies are identified in dermatomyositis (including anti-Mi2, anti-TIF1, anti-NXP2, anti-SAE or anti-MDA5), presence of which may be associated with a specific clinical phenotype. The diagnosis of the severity of muscle involvement is currently based mainly on physical examination, deviations in results of laboratory investigations, electromyographic examination and imaging examination, mainly with the use of magnetic resonance imaging. Systemic glucocorticosteroids administered as monotherapy or in combination with other immunosuppressants remain the mainstay of dermatomyositis treatment, and in the absence of satisfactory improvement, intravenous immunoglobulins are used. In addition, in case of interstitial lung disease, the use of cyclophosphamide may be necessary. The choice of a therapy, as well as the rate of dose reduction, depend on the dynamics of the disease, symptoms, diagnosed immunological disorders, as well as comorbidities and the drugs used. Each diagnostic and therapeutic decision must take into account the individual clinical data of the patient and current scientific reports.
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.6\_June2021/IJRR-Abstract038.html, 2021
Dermatomyositis (DM) is an autoimmune idiopathic inflammatory myopathy characterized by distinctive skin lesions, specific autoantibodies, and, most importantly, subacute symmetrical proximal muscle weakness and inflammation. Clinically amyopathic DM is a type of DM that presents with only characteristic skin lesions and no muscle disease. Heliotrope rash, erythematous rash over the face, erythematous scaly papules over the interphalangeal and metacarpophalangeal joints (Gottron's papules), erythema over the same joints (Gottron's sign), photosensitive pruritic erythema over the anterior chest and neck (Vsign), erythema extending to the shoulders and malignancy, respiratory disease, and cardiac disease are all causes of mortality and morbidity in dermatomyositis. Depending on the patient's parameters, management may include photoprotection and medications such as systemic corticosteroids, antimalarials, mycophenolate mofetil, biologicals, and IV immunoglobulins.
Dermatomyositis: A dermatology-based case series
Journal of the American Academy of Dermatology, 1998
Dermatomyositis is associated with significant morbidity and occasional mortality. Currently there is no consensus on treatment for patients with dermatomyositis. Our purpose was to review the clinical features and response to therapy of patients with dermatomyositis and compare these data with previous series of patients with dermatomyositis/polymyositis. Clinical characteristics of 65 patients seen during a 10-year period were reviewed retrospectively. Twenty-one of these patients were enrolled in a prospective, uncontrolled study of treatment with high-dose prednisone followed by slow tapering. Clinical features were similar to those previously described; however, muscle strength at diagnosis was on average greater in patients in this series than in patients previously reported. Malignancy was present in 5 of 43 adult patients (12%), but was not found in patients with juvenile dermatomyositis. Another connective tissue disease was present in 19% of patients. Twelve patients had dermatomyositis sine myositis. Eighteen of 21 patients (85%) in the prednisone study group had resolution of myositis. Patients with dermatomyositis in this series had less active myositis at presentation, but were otherwise similar to patients with dermatomyositis/polymyositis previously reported. Treatment with high-dose daily prednisone followed by slow tapering was effective.
Rituximab for the treatment of the skin manifestations of dermatomyositis: A report of 3 cases
Journal of the American Academy of Dermatology, 2007
Three patients suffering from classic dermatomyositis (juvenile and adult-onset) with prominent recalcitrant skin manifestations are described. All patients demonstrated good control of muscle symptoms on immunosuppressive medications, but their cutaneous disease persisted despite treatment with at least 4 different systemic treatments and topical agents. They were given rituximab, a monoclonal anti-CD20 antibody, achieving a response with minimal side effects. We document our experience with this medication for the cutaneous lesions of dermatomyositis. ( J Am Acad Dermatol
A Patient with Dermatomyositis Developing Steroid Induced Myopathy: A Case Report
Journal of Dhaka Medical College, 2016
Dermatomyositis is not a very uncommon disease affecting skin and muscles. Some varieties have atypical presentations and early diagnosis is pivotal to the effective management as it has significant morbidity and mortality including malignancy. Corticosteroids and other immunosuppressive is the mainstay of treatment; however, it should also be aimed to reduce the complications of steroid therapy as there is a possibility of steroid induced myopathy where withdrawal of steroid with introduction of other immunosuppressive drug is promptly warranted. Here, we presented a 60 year old lady with dermatomyositis who developed steroid induced myopathy.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 156-159
Dermatomyositis: An Acute Flare and Current Treatments
Clinical Medicine Insights: Case Reports
The purpose of this case report is to assess and review the literature to determine the frequency of occurrence of dermatomyositis (DM). Dermatomyositis is a rare autoimmune condition that disproportionately affects adolescence and pediatric patients. The symptomatology experienced in this condition includes but not limited to fatigue, reduced mobility, and dysphagia. Symptoms of dysphonia and dyspnea have been reported due to weakened esophageal and respiratory muscle. Another major complication seen in DM is calcinosis. Calcinosis is a calcium deposit on soft tissue. This is mostly been attributed to late diagnosis or use of ineffective treatment regimen. Systemic corticosteroid is the first-line treatment for DM; however, other agents such as anti-malaria, IVIG, and immunosuppressive therapies have been used successfully.
Case Report: Anti-MDA-5 dermatomyositis in a resource-limited setting
Wellcome Open Research
Anti-Melanoma Differentiation-Associated gene 5 (Anti-MDA-5) dermatomyositis is a rare subtype of inflammatory myopathy characterized by unique skin lesions, rapidly progressive interstitial lung disease, and skeletal muscle inflammation. It has a high mortality rate in the absence of early treatment. However, diagnosis of this entity is challenging in a country like Nepal because of various constraints such as lack of expert rheumatologists and resource limitations. Here we describe a case of one patient who had presented to us with generalized weakness, cough and shortness of breath who was finally diagnosed as anti-MDA-5 dermatomyositis. He responded to combination of immunosuppressives and is currently doing well. This case highlights the diagnostic and therapeutic challenges in managing such cases in a resource-limited setting.