Evaluation and Management of The Adult Patient With Dermatomyositis: A Review for The Advanced Practice Nurse
PURPOSE: To examine a case of adult dermatomyositis (DM) and provide a clinical review that clarifies the pathogenesis, diagnosis, evaluation, and management of DM in the adult patient.
DATA SOURCES: Findings from the history, physical examination, and diagnostic testing of a 57-year-old woman with dermatomyositis. A search of literature from 1970 to 2013 was conducted including textbooks, Pub Med and CINAHL databases with the search terms "dermatomyositis," "idiopathic inflammatory myopathies," "polymyositis," "pathogenesis," "myopathies," "pathogenesis," "therapy," and "treatment."
CONCLUSION: Dermatomyositis is one of the idiopathic inflammatory myopathies affecting individuals of all ages. Its underlying pathology is related to humoral and cellular immunemediated muscle and capillary injury. The disease presents with characteristic cutaneous findings, proximal muscle inflammation, and weakness. The disease is associated with malignancy and can have further disease manifestations on other organ systems .
IMPLICATIONS FOR PRACTICE: With the current shortage of rheumatologists to provide care to these patients, there will be increasing opportunities for the advance practice nurse to partner with other health care providers to manage this patient population. This knowledge will facilitate astute diagnosis and appropriate treatment, thereby decreasing the risk of both shortand long-term adverse health effects associated with the disease