Dermatomyositis: diagnosis, evaluation and management

Dermatomyositis (DM) is a condition primarily of the skin and muscles, but other systemic features may occur. DM in adults is associated with malignancy and thus a careful evaluation of each patient should be part of their initial and follow-up assessments. Patients should also be evaluated for the presence of esophageal, pulmonary and cardiac disease. Corticosteroids, immunosuppressives, biologic agents and/or immune globulin are effective therapies for the myopathy of DM, whereas the skin disease is best managed with sunprotection, topical corticosteroids, antimalarials, methotrexate and/or immune globulin. The prognosis is good except for patients with malignancy, those with severe weakness and those with cardiopulmonary dysfunction. However, many patients are left with residual weakness even after control of the disease.