Contact us:
040 4016 5703 099 6344 0404
Follow us:

What People Over 50 Should Know About Dermatomyositis

Whether the first sign was a purple-red rash on your face or struggling to raise your arms to wash your hair, getting a diagnosis of dermatomyositis can affect your life in many ways, big and small. And while it’s true that you can develop this condition at any age, including childhood, it’s people ages 50 to 70 who are affected the most, according to Johns Hopkins Medicine.

Here’s what you need to know about having dermatomyositis during these years of your life, including why age may increase your risk in the first place, how cancer and dermatomyositis may be linked, and the best treatment options to get you feeling as healthy as possible.

What Are the Risk Factors for Dermatomyositis?

We still don’t fully understand what the underlying cause of dermatomyositis is, so figuring out whether you have risk factors for developing the disease can be tough. In general, it’s likely a combination of a genetic predisposition, immune system factors, and environmental triggers, says Anthony Fernandez, M.D., Ph.D., a dermatologist at Cleveland Clinic in Cleveland, OH. “Triggers may be viral infections, bacterial infections, life stressors, or environmental exposures—things we are all exposed to,” he says. “So there aren’t clear risk factors that we have identified for dermatomyositis.”

Still, there are some truths scientists know about dermatomyositis. For one, women are more commonly affected than men, says Dr. A. Fernandez: “This isn’t really a surprise, because we have known in general for decades that women are more likely to develop autoimmune diseases than men,” and dermatomyositis is considered to be an autoimmune disease. That means that the body’s immune system mistakenly attacks itself, causing the symptoms of the disease, like muscle weakness and skin rashes in this case. The gender disparity is likely due to many factors, including hormonal differences between men and women and how hormones interact with the immune system, he says.

Also true: People within the 50 to 70 age range are the most likely to get dermatomyositis. But why?

Age and Dermatomyositis: What’s the Connection?

While it’s not 100% clear why people between the ages of 50 and 70 develop dermatomyositis the most, specialists in the disease have educated guesses. “It probably has to do with the fact that an aging immune system has more of a propensity for dysregulation than a young, healthy immune system,” says Dr. A. Fernandez. “Like most of the other organs and cells in anyone’s body, over time with age, you have more risk of things not functioning properly, and so perhaps it’s more inherent in an aging immune system to go off in pathways it shouldn’t.”

Is it a Symptom of Aging or Dermatomyositis?

For the most part, the symptoms you have with dermatomyositis are similar regardless of your age, Dr. A. Fernandez says. They include the following:

  1. A reddish-purple skin rash, most commonly around the eyes and parts of the face most exposed to the sun, the neck, the shoulders, the upper chest, the hands, and the back
  2. Muscle weakness, particularly in muscles close to the trunk like the shoulders and hips, which can cause difficulties with things like lifting your arms above your head or standing up from low chairs
  3. “Mechanic’s hands,” a colloquial term for cracked, splitting lines that appear along the side of the fingers and nails
  4. Difficulty swallowing
  5. Shortness of breath and cough due to lung inflammation or interstitial lung disease, in a subset of cases

But here’s the thing: Some of the symptoms above may be similar to signs of natural aging, like a decrease in muscle strength over time. So it may be harder to decipher what’s a symptom of natural aging versus a symptom of dermatomyositis when you’re over 50. The danger of this? You might be more likely to ignore symptoms and delay getting treatment you need.

“It’s possible that the older patients are, the more they tend to write off symptoms,” Dr. A. Fernandez says. “So if you are feeling a bit more weak or you are having achy muscles, don’t just immediately attribute it to age.” This is especially important if you also have a rash along with new muscle weakness, since this is a red flag for dermatomyositis. “That should hopefully prompt you to seek medical advice from a physician,” he says.

The Dermatomyositis and Cancer Connection

Another common concern for those with dermatomyositis in the 50+ age group is the link to cancer risk: About 15% to 20% of cases of dermatomyositis are associated with cancer, according to a 2023 study published in Frontiers particularly cancers of the ovaries, lungs, pancreas, gastrointestinal tract, and blood. Naturally, this fact can be alarming, especially if you have just been diagnosed and you are over 50, since cancer risk increases with age the median age of cancer diagnosis is 66 years old, according to the National Cancer Institute.

“In some of those cases [of patients whose dermatomyositis is associated with cancer], those patients have a known cancer one day and develop a rash and weakness afterward, and in other cases, it’s patients who develop the rash and weakness first, and then if you go looking with screening and tests, you can sometimes find a cancer that is yet to be diagnosed,” explains David R. Fernandez, M.D., a rheumatologist at the Hospital for Special Surgery in New York City. “In those instances, we believe the dermatomyositis basically represents collateral damage in the body’s effort to eradicate the cancer.” In other words, dermatomyositis is sort of like a symptom of the cancer, not a cause. This might occur because cancer shares features of skin and muscle tissues, he says, and as the immune system attacks the cancer, it can also have impacts on these other areas of the body.

With all of this in mind, your doctor may evaluate you for possible associated cancer when you first get diagnosed with dermatomyositis, especially if you are older, according to a study in the Annals of Translational Medicine. While there is no official guideline for cancer screening for dermatomyositis patients, the study authors recommend a shared decision-making approach with your doctor about which cancer screenings you should undergo, weighing the risks and benefits of screening. Possible steps your doctor may take to screen you for cancer include the following:

  1. Asking you questions to collect a thorough health and family history
  2. Performing a physical exam
  3. Making sure you are up to date on routine cancer screenings based on your age and other risk factors, like Pap smears for cervical cancer, colonoscopy for colorectal cancer, and mammograms for breast cancer, per the American Cancer Society
  4. Based on your specific symptoms and background, your doctor may recommend further cancer screening tests, too.

While the reality is that most people with dermatomyositis don’t have an associated cancer, discussing concerns and any new symptoms with your doctor can help rule out any other health problems.

Treatment Options for Dermatomyositis

There’s no cure for dermatomyositis, so if you’re in the over-50 crowd and you develop it, it’s something you’ll likely be treated for throughout the rest of your life, per Johns Hopkins Medicine. The good news is that most people who undergo treatment for dermatomyositis eventually get back to feeling better with good quality of life through the use of effective therapies, says Dr. A. Fernandez. To get there, it’s important to get treated soon after symptoms begin and stick to your treatment plan. In general, treatment options include:

Steroids

Topical and oral steroids are the first-line treatment to help get dermatomyositis under control as quickly as possible. They work by calming the inflammation throughout your body, which reduces symptoms like muscle weakness and skin rashes, according to Cleveland Clinic.

Physical Therapy

“Exercise and physical therapy have been studied pretty extensively in dermatomyositis,” says Dr. D. Fernandez. “It’s a little counterintuitive because when you exercise, you cause microscopic injury to your muscles that your body has to repair to build strength and recover, so it’s weird that you are doing something to theoretically add to the damage happening already in the muscle—but it seems that the natural repair and restorative processes that occur after exercise actually provide benefit and help to restore strength overall.” While physical therapy can be helpful at any stage of the disease, make sure to work with a professional and listen to your body to avoid injury.

Immunosuppressant Drugs

These medications work by tamping down on your immune system’s ability to send inflammation throughout your body, per Cleveland Clinic, thereby reducing damage to your muscles, skin, and other affected areas.

Speech Therapy

For people whose dermatomyositis is causing muscle weakness that impacts swallowing, working with a speech-language pathologist may be helpful, according to Cleveland Clinic. These therapists can teach you techniques to strengthen the muscles involved in swallowing and help make mealtimes more manageable.

Intravenous Immunoglobulin (IVIG)

“I think most of us who treat dermatomyositis believe the best medication we have at the moment may be IVIG, which works very well to control the skin and the muscles, and it can even work for the interstitial lung disease if that is present,” Dr. A. Fernandez says. “It’s a great medicine, but one reason we don’t use it first line in most patients is because it is quite expensive, and it’s an infusion that requires people to sit for seven hours usually two to three days in a row every month.” Ask your doctor about this treatment if other approaches are not helping, he says, or if your symptoms are particularly severe at diagnosis.

Your healthcare team will consider things like your specific symptoms, age, and other factors when determining the best treatment plan for you—often, treatment is a combination of the above options used consistently over time.

Takeaways

While anyone can get dermatomyositis, research shows that people ages 50 to 70 are diagnosed most frequently. It’s possible that an aging immune system is partially to blame for this, although we don’t yet fully understand what exactly increases someone’s risk of developing this autoimmune condition. We also know that a subset of people with dermatomyositis also have an underlying cancer, so it’s wise to discuss any with your doctor and make sure you are up to date on routine cancer screenings for your age group, particularly because cancer risk rises with age.

People in the 50 to 70 age group typically have similar symptoms to anyone else living with dermatomyositis, and likely will benefit from the same treatments, too. Working with your healthcare team—which may include specialists like a rheumatologist, dermatologist, physical therapist, and speech therapist—can help you begin a therapy regimen that works to get your dermatomyositis under control so you can start feeling better ASAP.

“In the majority of cases, this isn’t a condition that we think should change your quality of life in a significantly negative way over a long period of time,” he says. “Initially, when we are trying to get it under control, you may not feel your best, but with the treatment weapons we have available today and others that are emerging, we can get almost all of these patients essentially back to their baseline.”


https://www.healthcentral.com/condition/dermatomyositis/what-people-over-50-should-know-about-dermatomyositis

No Comments Yet.

Leave a reply