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Childhood dermatomyositis

Posted by iskanbasal on July 9, 2007

I posted below on dermatomyositis (DM) and this post reached the 2nd position in google search using the terms dermatomyositis and blogs. My intention was to record some notes on my readings and interests. Many times one reads without planning to write notes, but some writing helps to fix things in memory and is gratifying.

Thanks to a medical publication of the Cleveland foundation where I found out a second interesting case on dermatomyositis (DM). Many of these publications are really very educational, from the Cleveland, the Johns Hopkins, the Mayo, and other great medical centers in USA, I mean their journals of medicine are very instructive and almost free.

This is the case presentation at a cleveland medical journal:

A 64-YEAR-OLD WOMAN has widespread hard subcutaneous nodules which she says developed 18 years ago, about 10 years after the onset of proximal muscle weakness and rash. The nodules are mainly over bony prominences and tendons, but she also has them on her neck, trunk, arms, abdomen, hips and buttocks.

The Fig shows these subcutaneous nodules of calcinosis cutis; it is a characteristic complication of childhood dermatomyositis.calcinosis-cutis.jpg

These nodules are situated in the subcutaneous tissue and also in the muscular tissue itself. They represent a complication of childhood dermatomyositis. In this article they are called Calcinosis cutis, in an another article they are named Calcinosis universalis (image from learningradiology.com) where they appeared as sheet-like calcifications.

What is the source of this calcium in dermatomyositis ?

The authors believe it derives from the process of myositis itself; the necrosis of muscle fibers release calcium which deposits and make these nodules. the aggressive treatment of the inflammatory process of myositis in the child may prevent this complication. The nodules may open over the skin and drainage of material may occur.

There are few other systemic diseases which are associated with this kind of cacification,e.g.; systemic sclerosis is one and some few cases of SLE often of the overlap syndromes.

The article to which I refered above is at the Cleveland clinic journal of medicine Vol 72 Aug 2005, a “clinical picture” by Sheeted Chhaya and Karen Rendt.

So I have learned now for my own interest either this case and the below case on the same condition. There is some difference between the two cases of the same condition : one that occur in the child, the juvenile-type dermatomyositis which is not associated with the risk of malignancy and is not considered to be paraneoplastic and the second is DM of the adult.

(escuse me for my english errors).

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