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Clinical symptoms of polymyositis and dermatomyositis

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Updated: Tuesday, Feb 09,2010, 3:08:17 PM
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(1) muscle lesions

Symmetry of the upper and lower limbs showed proximal muscle weakness gradually aggravated. Pelvic muscles with lower limb involvement, the patients upstairs is often difficult to take the escalator and the line, after standing or squatting to standing position from sitting, the need to rely on the strength of arms to help, gait slow, swing instability and even duck-step was and so on. Upper shoulder girdle muscles involved, appeared Arm Lift, clothing and hair problems. Cervical muscle involvement, the patient could not lift his head from the supine pillow or sit on their own from a supine serious cases, can not stand up, sit immediately head can not be vertical. When the throat muscles and esophagus when the muscle involved, there Shengya, nasal, pronunciation ambiguities and difficulty swallowing. Respiratory muscle involvement, the shortness of breath, superficial and weakness. But the face and eye muscles almost never involved, and this is different from myasthenia gravis.
Myalgia appears only in a small number of patients early. Muscle tenderness during physical examination more common. Muscular atrophy often seen in advanced patients, and was accompanied by lower tendon reflexes.
Strength generally based on six classification. 0: complete paralysis; one: You can have muscle contraction, but can not produce mobile movements; 2: Physically able to move in the plane, but not anti-gravity can not be carried away from the plane; 3: Physically you can carry away from the plane, but not against resistance; 4: physical resistance to the resistance, but the strength weak; 5: normal muscle strength. Inspection and grading muscle strength can be used as observation of disease progression and treatment effects of important clinical indicator.

(2) skin lesions

Skin lesions may appear before or after the lesions in the muscle, or muscle lesions simultaneously. Dermatomyositis rash include:

① to the positive rash: the emergence in the bilateral upper eyelids, often accompanied by edema. Lesions can be extended around the eyes, or even involving the whole face. Was light purple or dark purple, is the characteristic rash of this disease.

② "Gaucher," maculopapular rash: The metacarpophalangeal joints and proximal joints purple skin, red magic papules, top flat, with a little scaling, long after the skin atrophy, decreased pigment, is another characteristic of dermatomyositis rash.

③ poikiloderma Disease: In the shoulder department, anterior Department, chest V-shaped area diffuse dark purple-red rash, the skin may flake was shrinking, and accompanied by telangiectasia, pigmentation, and diminished the formation of pigment spots .

④ Mechanic Hand: finger extensor side or both sides of the alternating dark black or dirty after the rash, it seems a long period of oil operations by the hand.

⑤ Others: There is that edge of the skin hyperemia, scaling, rough, a bed thickness, erythema and scar, etc. A week.

In addition, there can be bright red or dark red facial edema, erythema, like drunk-like appearance; with dark brown pigment spots and telangiectasia, often prompted to merge malignancy. Raynaud's phenomenon, fingertip ulcers, necrosis, and subcutaneous calcinosis can also be seen. Special parts of the calcinosis can affect motor function.

(3) The joint disease of 40% a 60% of patients with polymyositis and dermatomyositis, there may be joint pain or arthritis, accompanied by morning stiffness. Involvement of the joints are fingers, wrist, knee, ankle, shoulder. Occasional joint deformity occurs; due to muscle spasm caused by, X ray did not arise bone and joint damage.

(4) lung lesions ① interstitial lung disease: patients have fever, dry cough, dyspnea, pulmonary rales, and a little X-ray examination with interstitial lung disease. ② inhalant pneumonia: Due to respiratory muscle paralysis and pharyngeal muscle weakness caused. ③ pleurisy: often appear a small amount of pleural effusion. Other pulmonary diseases, including secondary infection, atelectasis, and emphysema.

(5), half of heart attack patients have palpitations, precordial discomfort and breathing difficulties. May have arrhythmias, conduction disturbances, mitral valve prolapse, heart disease and pericardial effusions.

(6) The digestive tract lesions, there may be difficulty in swallowing, esophageal reflux and regurgitation through the nose and so on, more common in critically ill patients. Small number of patients, there may be gastrointestinal ulcers and bleeding. In addition, there may be diarrhea, constipation and other intestinal malabsorption.

(7) kidney, kidney damage are rare. In the disease activity, may occur proteinuria, disappeared with the remission. A sustained myoglobinuria persons with renal insufficiency can occur.

(8) and malignant tumors of the relevance of 10% -30% of the disease, patients with malignant tumors, particularly in the age of 40 or more. More common with dermatomyositis.

(9) and other connective tissue disease in the patients with other connective tissue disease with complications such as rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma, or polyarteritis artery Yandeng.

Tags: polymyositis dermatomyosi

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