Skin Challenge: Dermatomyositis


Dermatomyositis is a rare acquired muscle disease accompanied by a skin rash and it may affect people of any race, age or sex, although it is twice as common in women than in men. The onset of the disease is most common in those aged 50–70 years.

In many people, the first sign of dermatomyositis is the presence of a symptomless, itchy or burning rash. The rash often, but not always, develops before the muscle weakness.

  • Reddish or bluish-purple patches mostly affect sun-exposed areas.
  • A violet color rash may also affect cheeks, nose, shoulders, upper chest and elbows.
  • Purple eyelids that look like flower petals
  • A scaly scalp and thinned out hair may occur
  • Poikiloderma which is less common is skin that appears atrophic (pale, thin skin), red (dilated blood vessels) and brown (post-inflammatory pigmentation).
  • Purple papules or plaques can be found on joints such as the knuckles (aka Gottron papules).
  • Ragged cuticles and prominent blood vessels on visible on nail folds

Calcinosis (formation of calcium deposits in any soft tissue) can also affect some people. 

  • It presents as hard yellow or white lumps under the skin, usually on fingers or over joints
  • Sometimes these lumps (nodules) may poke through the skin and can ulcerate, which can become infected.


What is the cause of dermatomyositis in your client?

Cause is unknown, however, this condition is considered one of the connective tissue diseases, like systemic sclerosis and lupus erythematosus. 

Determine any medications; contraindications and cautions before proceeding with any spa treatment.

Treatments that can be offered:

  • This sort of condition shows how we need to be aware of changes on the skin even though a service may be contraindicated.
  • Skin protective products, which include the use of protective clothing and the application of sunscreen with at least 15 SPF. Exposure to sunlight worsens the cutaneous aspect of the disease.
  • Any swelling, discoloration (hyper- and hypo-pigmentation), skin that is uncomfortable and irritated, and/or an itchy, painful rash in areas as discussed above, would not be deemed safe for esthetic services until okayed by the client’s healthcare professional.
  • Medical treatment for this condition is internal and topical corticosteroids; and topical antihistamines.  Be aware of additional side effects from these medications.

DISCLAIMER: Work within the scope of your license/certification.

Portrait of Mórag Currin. About the Author

Mórag Currin is a highly sought-after esthetic educator with more than 27 years of spa industry experience and more than twelve years of training and training management experience. She travels around the globe with her training and expertise, helping to raise the bar in the spa industry and to open the door to all people, regardless of skin type or health condition. To learn more about this topic and many other skin challenges, diseases, and symptoms, check out Mórag’s book, Health Challenged Skin: The Estheticians’ Desk Reference.

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