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What should be the treatment for dermatomyositis?

Q: I am a 31 years old housewife having nodular swelling in my biceps muscle for more than a year now. The end of the biceps muscle has become hard and pains when touched. I am suffering form dermatomyositis and taking steroid treatment. The doctor told me that it is calcification but after doing sonography and X-ray the results have not shown any signs of calcification. I have been advised to do a FNAC. The swelling has reduced but is spreading towards my forearm muscles. Please advise.

A:Dermatomyositis is a rare diagnosis that can affect young people also. Swellings beneath the skin are common in this and often these may get calcified that is why your physician told you about the swelling being a calcified nodule. Skin rash however is possible. Lab tests to confirm this may show elevation of enzymes (CK – creatine kinase). However, in some patients this may be normal.

Diagnosis is based on muscle biopsy. Treatment is usually with steroids but immune suppressive drugs (drugs that reduce the body immunity like Azathioprine, Methotrexate) may be needed. Intravenous immunoglobulin and in some cases additional drugs like Cyclophosphamide may also help.

These cases are best handled by physicians trained in immunological problems of body.

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