Clinical polymyositis and dermatomyositis which performance

The disease onset hide. Most developing slowly, but there are also a sudden onset, rapidly deteriorating, quickly life can not take care of themselves. Onset is usually myasthenia gravis, a small number of patients because of muscle pain and treatment. General performance moderately low heat or fever; fatigue, malaise and weight loss. (1) symmetry myopathy manifested as the upper and lower extremities gradually add to the proximal muscle weakness. Pelvic with lower limb muscle involvement, the patient often public housing difficulties, and take the escalator to lunge after standing or sitting to standing position,arms to the strength, gait slow, wavering instability, or even a duck-step and so on. Scapular with upper limb muscle involvement, then there, dressing and combing their difficulties.involvement, the patient supine, lifting his head from the pillow or not from the supine position themselves serious cases, to recover, the first not immediately sit upright. When the throat muscles and esophageal muscle involvement, there Shenge, nasal articulation, vague and dysphagia. Respiratory muscle involvement, a shortness of breath, superficial and powerless. But facial and eye muscles almost never involved, it is with myasthenia gravis different. Myalgia appear only in a small number of patients early. Common medical examination, muscle tenderness. Amyotrophic often appear in advanced patients, and with the lower tendon reflex. General strength by six graded. 0: completely paralyzed; one: can muscle contraction, but it can not produce mobile movements; 2: Plane limbs in Mobile, but not anti-gravity can not be carried from the plane; 3: limb can be carried from the plane, but we can not resist resistance; 4: physical resistance to the resistance, but weaker strength; 5: normal muscle strength. Muscle strength can be used as inspection and grading observation of the development and treatment of diseases of important clinical indicators. (2) skin lesions skin lesions can appear in muscle lesions before or after, or simultaneous with myopathy. The rash dermatomyositis including: ① rash to the positive: the bilateral appear in the eyelids, often accompanied by edema. Extension and orbital lesions can be around, and even involved the whole facial. A or dark purple-red, is characteristic of this disease rash. ② "Gaucher": metacarpophalangeal joints and the skin near joints red purple demons papules, flat top surface, with a few scaling, long after the skin atrophy, decreased pigment is another characteristic dermatomyositis rash. ③ optically variable skin disease:Department, the Department of cervical, chest V-shaped district are diffuse dark purple, can be a flake of skin atrophy, and telangiectasia with, pigmentation and decreased formation of pigment spots . ④ craftsmen hand: finger stretch in the side or on both sides of a turn after dark black or sewage-like rash, it seems a long time oil-hand operation. ⑤ other: that the fate of congestive skin, scaling, rough, thickened nail bed, a week, such as erythema and scarring. In addition, there can be bright red facial erythema or edema deep red, like drunken-like appearance; with deep brown pigment spots and telangiectasia, and often suggested that the merger cancer. Raynaud's phenomenon, fingertip ulcers, necrosis, subcutaneous calcinosis also can be seen. Special parts of calcinosis can affect motor function. (3) joint lesions 40 percent a 60 percent of polymyositis and dermatomyositis patients, there will be joint pain or arthritis, with morning stiffness. The joint involvement with fingers, wrist, knee, ankle, shoulder. Sometimes joint deformity appeared as a muscle spasm, X-ray did not arise bone and joint damage. (4) pulmonary lesions ① interstitial lung disease: Patients with fever, dry cough, dyspnea, pulmonary sound a little Luo X-ray check and interstitial lung disease. ② human aspiration pneumonia: As the pharynx and respiratory muscle paralysis caused muscle weakness. ③ pleurisy: a small amount of pleural effusion often arise. Other pulmonary diseases including secondary infection, and atelectasis, such as emphysema. (5) changed half of the patients have heart palpitations, heart ago discomfort and breathing difficulty. Have arrhythmias, conduction disturbances, mitral valve prolapse, such as heart disease and pericardial effusion. (6) gastrointestinal lesions, there will be dysphagia, esophageal reflux and reflux by the nose, in more severe patients see. A small number of patients, there will be the gastrointestinal ulcers and bleeding. In addition, there may be diarrhea, constipation and intestinal malabsorption, and so on. (7) renal lesions kidney damage rare. The disease activity, there will be the proteinuria, with the condition to relax and disappeared. A continued myoglobin proteinuria, renal failure can occur. (8) and malignant tumors associated 10% -30% of patients with the disease of cancer, particularly 40-year-old over. To dermatomyositis common. (9) and other connective tissue disease associated with the disease can be complicated by other connective tissue diseases, such as rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma or nodular more artery.