There's no cure for dermatomyositis, but treatment can improve your skin and your muscle strength and function. The earlier treatment is started in the course of dermatomyositis, the more effective it is — leading to fewer complications.
However, as with many conditions, no single approach is best; your doctor will tailor your treatment strategy based on your symptoms and how well they respond to therapy.
The most commonly used medications to treat dermatomyositis include:
- Corticosteroids. Drugs such as prednisone can be very effective in controlling dermatomyositis symptoms. But prolonged use of these drugs can have serious and wide-ranging side effects, which is why your doctor may gradually taper the dose of medication down to lower levels.
- Corticosteroid-sparing agents. When used in combination with a corticosteroid, these drugs can decrease the dose and potential side effects of the corticosteroid. The two most common medications used for dermatomyositis are azathioprine (Azasan, Imuran) and methotrexate (Trexall).
- Rituximab (Rituxan). More commonly used to treat rheumatoid arthritis, rituximab is an option if initial therapies don't adequately control your dermatomyositis symptoms.
- Antimalarial medications. For a persistent rash, your doctor may prescribe an antimalarial medication, such as hydroxychloroquine (Plaquenil).
Depending on the severity of your symptoms, your doctor might suggest:
- Physical therapy. A physical therapist can show you exercises to maintain and improve your strength and flexibility and advise an appropriate level of activity.
- Speech therapy. If your swallowing muscles are weakened by dermatomyositis, speech therapy can help you learn how to compensate for those changes.
- Dietetic assessment. Later in the course of dermatomyositis, chewing and swallowing can become more difficult. A registered dietitian can teach you how to prepare easy-to-eat foods.
Surgical and other procedures
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- Intravenous immunoglobulin (IVIg). IVIg is a purified blood product that contains healthy antibodies from thousands of blood donors. These healthy antibodies can block the damaging antibodies that attack muscle and skin in dermatomyositis. Given as an infusion through a vein, IVIg treatments are expensive and may need to be repeated regularly for the effects to continue.
- Surgery. Surgery may be an option to remove painful calcium deposits and prevent recurrent skin infections.
- NINDS dermatomyositis information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dermatomyositis/dermatomyositis.htm. Accessed March 25, 2014.
- Goldman L, et al. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed March 25, 2014.
- Imboden JB, et al. Current Rheumatology Diagnosis & Treatment. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=809. Accessed March 25, 2014.
- Oddis CV, et al. Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: A randomized, placebo-phase trial. Arthritis and Rheumatology. 2013;65:314.
- Miller ML. Diagnosis and differential diagnosis of dermatomyositis and polymyositis in adults. http://www.uptodate.com/home. Accessed March 25, 2014.
- Miller ML, et al. Malignancy in dermatomyositis and polymyositis. http://www.uptodate.com/home. Accessed March 27, 2014.
- Miller ML, et al. Initial treatment of dermatomyositis and polymyositis in adults. http://www.uptodate.com/home. Accessed March 27, 2014.
- Miller ML, et al. Treatment of recurrent and resistant dermatomyositis and polymyositis in adults. http://www.uptodate.com/home. Accessed March 27, 2014.
- Vleugels RA. Management of refractory cutaneous dermatomyositis. http://www.uptodate.com/home. Accessed April 11, 2014.