Pages

Tuesday, February 14, 2017

A 55-year-old woman complains of generalized fatigue, weakness and a rash.....

A 55-year-old woman complains of generalized fatigue, weakness, inability to climb stairs, arthralgias, and dysphagia.
Physical examination reveals definite proximal muscle weakness, a periorbital heliotrope rash, and skin findings associated with the hands (shown here).

The most likely diagnosis is
A) Lupus erythematosus
B) Sarcoidosis
C) Sjögren’s disease
D) Dermatomyositis
E) Polymyalgia rheumatica

Answer:
The answer is D. (Dermatomyositis)

Discussion: Dermatomyositis presents with a heliotrope rash and the presence of Gottron’s papules. The rash is violaceous in color and involves the periorbital areas. Gottron’s papules are erythematous or violaceous papules or plaques that form over the bony prominences, particularly the metacarpophalangeal joints, the proximal and distal interphalangeal joints. The condition is also associated with a myopathy that involves the proximal muscles. The shoulders and pelvic
girdle are mainly affected in a symmetric pattern.

 Symptoms include fatigue, weakness, inability to climb stairs, or weakness in rising from a
squatting or sitting position. Dysphagia is also seen. Approximately 20% of patients have an associated malignancy.

Laboratory tests include elevated serum creatine kinase or aldolase, or both. Electromyographic studies and a muscle biopsy can also provide additional diagnostic information.

The mainstays of treatment are systemic steroids. Other options include immunosuppressant agents and hydroxychloroquine. Those who are older and have severe myositis, dysphagia, associated malignancy, and a poor response to corticosteroids have a poorer prognosis.

5 comments:

  1. http://studymedicalphotos.blogspot.com/2017/02/acute-right-ventricular-myocardial.html

    ReplyDelete
  2. Don't You Think It's High Time You Tried Herbal Remedy?

    In 2015, I was diagnosed of genital herpes.. I was 21 years old and I had no idea what that was. When my doctor explained to me what Genital Herpes was all about and what type I had...I was freaked out! if I had missed coming to the ER any sooner, I would have possibly died without having the slightest clue of what led to my death, as i have never heard of, or experienced the virus before! The rashes grew and i have been living with it ever since then. Most of the time, I feel dirty knowing i was living with herpes. Though the doctor already encouraged me to keep using my medications even though there is no permanent cure for the virus. So i continued with my medications, which only makes the rashes to disappear, and reappear after some days. Late last year, I started surfing the web, seeking for herbal treatment as alternative. So i was on YouTube one evening,i stumbled upon a comment about Dr. Ugo and how his herbal medications cured a woman's daughter of Herpes and I decided to reach out to him. He asked me some questions which i answered, after which He prepared some herbs and sent them to me. He then guided me on how to use them. i used the herbal medications for about ,21days. The rashes gradually dried up. So i went for a test and came back home Herpes free. So My experience with this virus made me to realize, people should find out more about themselves before it's too late. So that when tested positive, they will know how to go about it before it becomes late. If you are having any sickness or virus and needs deliverance contact Dr.Ugo (for your permanent healing) He is the right person to tell your health challenges to. You can contact the doctor via his email address : ugoherbalhome@gmail.com

    ReplyDelete

  3. I feel so excited today because it's just a year since I got my breakthrough from Herpes.I was diagnosed of HSV1 on the 12/4/2015 and latter i got affected with the HSV2. That was my 2nd outbreak after i lost my ex fiance that got me affected with the virus. I was so scared when he died and what i heard about the Herpes virus as he's deathly and such has no cure. I feel so pity and and a disgrace to my personality,in my career and my family to have been in with the deathly sickness, and that would makes my love ones siblings stay far from me. I was going to my regular church activities when i begin to hear testimonies of how people get cure online, i never gave it a thought till my cousin Stephanie who was affected with HIV told me, Lenny you need not to worry cos i met i man today online , i traditional herbal healer whom two of her friends confirmed he cure them with his herbal herbs that i should give it a try. I saw the interest in her and she did contact the herbal doctor again in my present, luckily for me he picked and show up himself, behold he was at about to attain to some patients that have came back with appreciation of how he cure them from Cancer, HIV, and off much too the herpes he cured an 18 years old daughter.
    I was so happy that day, i wanted to be there but the distance was a barrier to me. I told him how the virus had eaten me up and and a truly believe there's cure for herpes. He told me me with assurance that my case wont be different and he had been curing lots of people With his herbal medicine and most people due contact him from the States and preperd the medicine and made use of the DHL to reach him.
    Honestly speaking Dr. Akpu power his a great and gifted herbalist,His destined to herbs.
    He made me do away with the medical prescription,the acyclovir (Zovirax), famciclovir(Famvir), and valacyclovir (valtrex). you don't know him because you haven't meet this man try and contact him yourself Dr. Akpu in Africa is popularly known in his City,and you can request for his address yourself. I'm so happy now cos,I and my cousin had been confirmed negative till date..the Lord is good in my life. Dr. Akpu sent me his herbal medicine that heal me too, 🙏 🙏 Dr. Akpu for giving me another life.
    Contact Dr.akpu for all kids of sickness@
    Dr.akpupowerherbscenter@gmail.com

    ReplyDelete
  4. Thank you so much all the way for taking your time to share this unique articles, testimonies and videos about herpes cure.
    It's my first time to share my feelings publicly, but I made a vow to accomplish it this way so through me others can be safe to reach out Dr. Odey Abang for any cure to their viruses/ Diseases
    I'm David Mark. I had this feelings that they could be a cure to all this deathly and common Diseases. My case was admitted after a ran for my reqular monthly checkup and was shocked when I was tested Herpes Simplex Virus.
    I thought this could be a way the wants be to keep patronizing them, Encouraging me to be taking in the antibiotics, the Acyclovir medicine, but wasn't comfortable living on drugs, the case was getting out of hand, affecting my job and life , sore keeps reappearing lots of nightmare thinking about my cure.
    Had to engage myself seacking for means online since I'm and information technologist.
    I made lots of reaserches seeing Dr. Odey Abang, curing people
    Yes, I never met him before,but when I did contact him from the email given, he fulfilled his promise as said and sent me the Herpes medicine together with the powder and instructions on how to apply, two weeks later it finished and was allowed to go for test, then I was confirmed negative.
    Have been to different hospitals and the results still shows negative, in me I knew it works and the confidence in me made my friends who where both Herpes carrier where very curious and they all got their cures.
    Don't think your not saved with what you have, God has saved us, Dr. Odey Abang can cure you from HIV/Aids/Cancer/Diabetes/Sickle cell/And most dangerous sickness.
    Contact him
    odeyabangherbalhome@gmail.com
    Or Whatsapp
    +2349015049094

    ReplyDelete
  5. I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their website at www.ultimatelifeclinic.com I can breath much better and It feels comfortable!

    ReplyDelete