Decoding dermatomyositis: All you need to know

When news of actor Suhani Bhatnagar’s death broke last week, web searches for ‘dermatomyositis’ immediately shot up. The 19-year-old, who played the young Babita Kumari Phogat in Aamir Khan’s Dangal (2016), was undergoing treatment for the rare autoimmune disease at AIIMS Delhi, before she succumbed to it due to medical complications and weakened immunity, aggravated by steroid-use. While symptoms started appearing two months ago, Bhatnagar was only diagnosed 10 days before she died.

Breaking it down

Its exact cause remains unclear, but dermatomyositis is mostly characterised by muscle weakness and skin rashes. “It is believed to share similarities with autoimmune disorders, wherein the immune system mistakenly targets the body’s own tissues,” says Dr Shweta Manchanda, consultant, Dermatology, Aakash Healthcare,” adding, “Genetic predisposition and environmental factors are also thought to play a role in the development of the disease.”

Adding on to the contributing causes, Dr Ankit Bhatia, pulmonologist at the Institute of Respiratory Sciences, Max Super Speciality Hospital, Vaishali, informs, “Certain genes, like HLA types, increase the risk. Infections, drugs like antibiotics and strong sunlight exposure may also trigger it.”

Symptoms to watch out for:

Dr Anil KV Minz, senior consultant, dermatology at Marengo Aisa Hospitals in Faridabad shared some of the symptoms that one can lookout for:

• Persistent red rashes on the face, hand and elbows
• Redness and burning upon sun exposure
• Difficulty in combing hair or getting up from squatting position
• Progressive muscle weakness, beginning slowly and affecting muscles around the trunk, hips, thighs, neck, arms and shoulders
• Swallowing difficulties
• Breathing problems

These initial symptoms may ultimately cause complications such as inflammation of the cardiac wall muscles, which can lead to heart failure, interstitial lung disease and aspiration pneumonia. Dr DS Bhakuni, rheumatologist at Max Super Speciality Hospital, Vaishali and Noida, explains that sometimes, lung cavities can also be filled by the fluids due to capillaries leakage and local inflammation, causing difficulties in breathing. Dr Amit Bangia, associate director, Dermatology, Asian Hospital, adds, “The disease is also linked to increased likelihood of developing certain cancers, particularly ovarian cancer in women.”

Path after diagnosis

Since it’s an autoimmune disease, treatment includes prescription of immunosuppressants along with antibody-infusion therapy. Sun protection also plays a crucial role in managing the condition, which has no known cure. Manchanda explains, “Corticosteroid medications are prescribed for four-six weeks and gradually reduced as muscle strength improves... If that isn’t enough, other medications to suppress the immune system are administered as alternatives.”

Be diet wise

Supplement your dermatomyositis treatment by having a well-balanced diet that includes a variety of fruits, vegetables, whole grains lean proteins and healthy fats.

Since the disease causes muscle inflammation, ensure you are consuming enough anti-inflammatory foods such as fatty fish (salmon, mackerel), nuts, seeds and olive oil

Have foods rich in vitamin D such as fatty fish (like salmon and tuna), fortified dairy products and egg yolks. Calcium-rich foods, including dairy products, leafy greens (like kale and broccoli) and fortified plant-based milk alternatives, are also recommended, especially if taking medications that may affect bone density.

Limit processed foods, refined sugars and saturated fats, as these may contribute to inflammation

Consume a moderate amount of protein to support muscle health

Have smaller, frequent meals to manage energy levels, as fatigue is a common symptom

(Inputs by dietician Garima Goyal)