Dermatomyositis Symptoms: How to Spot This Rare Rash and Muscle Disorder

If you experience persistent muscle weakness, fatigue and skin changes that don’t seem to fade, it could be more than just everyday exhaustion. These lingering issues may be symptoms of dermatomyositis, a rare inflammatory disease that impacts the body inside and out. Understanding the warning signs is essential for proper treatment and early intervention. Keep reading to learn more about this condition, including its causes, how it’s diagnosed and effective self-care remedies to alleviate discomfort. 

Dermatomyositis symptoms: Understanding the disease

While dermatomyositis isn’t super common, the inflammatory condition greatly affects the muscles and skin. It typically occurs in women rather than men, especially those between their late 40s and early 60s, explains Melanie Palm, MD, MBA, board-certified dermatologist at Art of Skin MD. 

How can you tell if you have it? Dr. Palm says the most common dermatomyositis symptoms include: 

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• An itchy, violet-colored or dark red rash around the face, upper eyelids, chest and back
• Red scaly bumps on the knuckles, elbows and knees 
• Muscle weakness in the hips, thighs, shoulders, upper arms or neck or that worsens over time
• Joint pain, stiffness and fatigue (which can make climbing stairs or lifting objects overhead more difficult)

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Dermatomyositis symptoms may differ in women

Women are more likely to present with a skin-predominant form of the inflammatory muscle disease, sometimes without significant muscle involvement—a condition called amyopathic dermatomyositis, says Hannah Kopelman, DO, a dermatologist at Kopelman Aesthetic Surgery. Muscle weakness is more common in men, but if women experience it, it will mainly affect the proximal muscles (those closest to the center of the body).

What causes dermatomyositis? 

Currently, the root cause of dermatomyositis isn’t fully understood. Dr. Kopelman says, “It’s an autoimmune response where the immune system mistakenly attacks healthy skin and muscle tissue.” 

Your genetic history may contribute to the development of the disease, while certain infections or environmental factors can act as triggers. However, the exact cause remains unclear and continues to be a focus of ongoing research, explains Dr. Kopelman. 

If you notice any dermatomyositis symptoms, it’s important to see your doctor for a proper diagnosis. This involves a clinical evaluation, blood tests, imaging and sometimes biopsies. Dr. Kopelman said she starts with a thorough skin exam and history, then orders blood tests to check for elevated muscle enzymes like creatine kinase (CK) and autoantibodies specific to dermatomyositis.

MRIs can also show muscle inflammation, while skin and muscle biopsies can help provide more substantial evidence of the condition. 

Dermatomyositis self-care strategies

While Dr. Palm says prescription immunosuppressants and corticosteroids are often the first line of defense to alleviate dermatomyositis discomfort, it’s also important to practice self-care at home. Some effective remedies include: 

Use sunscreen daily 

Too much UV exposure can cause or exacerbate skin rashes, which is why sun protection is key. “This includes limiting peak sun hours, applying a broad-spectrum sunscreen of SPF 30 or higher daily when outdoors and wearing UPF clothing when appropriate,” says Dr. Palm.

Make time for gentle physical activity

“Physical therapy and low-impact exercises like swimming or walking can help maintain muscle strength and function and can delay muscle weakness as the disease progresses,” says Dr. Kopelman.

Soothe irritated skin 

Using products that help your skin rather than hurt it is always beneficial, but it is especially important with dermatomyositis. To soothe irritated skin, Dr. Kopelman suggests using gentle, fragrance-free moisturizers and avoiding harsh soaps. Cold compresses can also help calm inflammation during flare-ups.

Complications of dermatomyositis 

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In some cases, people with severe dermatomyositis may experience difficulty swallowing, aspiration pneumonia and breathing problems. Dr. Palm explains that this is caused by a weakening of the muscles in the esophagus. 

Since dermatomyositis results in the weakening of muscles, Dr. Palm adds that it can also put you at a higher risk of developing other complications, including connective tissue diseases like rheumatoid arthritis, a cardiovascular disease resulting in congestive heart failure, interstitial lung disease, and some cases, ovarian cancer.

With any diagnosis, you must see your doctor regularly and address any changes you notice in your body, no matter how small. Treating dermatomyositis early on can help prevent symptoms from worsening.