Dermatomyositis
Dermatomyositis is an autoimmune disease characterized by inflammation affecting the skin, striated muscles, and small blood vessels. It can involve multiple organs. Myositis without skin involvement is called polymyositis, while skin inflammation without myopathy is called clinically amyopathic dermatomyositis. Dermatomyositis and polymyositis often occur alongside other autoimmune diseases.
Dermatomyositis resembles “muscle impediment” (肌痹, jī bì) described in classical Chinese medical texts. For example, the Basic Questions: Treatise on Acupuncture at Length (《素问·长刺节论》) states: “When the disease affects the muscles and skin, the muscles and skin are painful throughout. This is called muscle impediment, caused by injury from cold and dampness.” The Basic Questions: Treatise on Bi Syndrome (《素问·痹论》) states: “When muscle impediment persists, and the person is again exposed to pathogenic factors, these lodge internally in the spleen”; and “In spleen bi, the limbs become weak and limp, coughing and vomiting of fluid may occur, and there may be severe fullness in the upper body.” The General Treatise on the Causes and Symptoms of Diseases: Symptoms of Deficiency Taxation, Wind, Flaccidity, and Bi with Impaired Movement (《诸病源候论·虚劳风痿痹不随候》) states: “When wind, cold, and dampness combine, they cause bi. When the disease affects the yin, the person’s muscles and bones become withered and weak, and the body is painful. This is a condition of flaccidity and bi.”
TCM Pattern Differentiation and Medication Reference
| Common Symptoms
Clinical description:
Acute onset, with extensive edematous erythema or purplish-red patches on the skin, muscle pain and weakness, joint swelling and pain or difficulty swallowing, accompanied by high fever, bitter taste in the mouth, dry throat, thirst with a desire to drink, palpitations and irritability, dry stools, and dark yellow urine; crimson tongue with a yellow coating, and a slippery, rapid pulse.
In plain language:
- Symptoms begin suddenly and progress rapidly.
- Large areas of swollen-looking redness or purplish-red patches appear on the skin.
- Muscles are painful and weak.
- Joints may be swollen and painful, or swallowing may be difficult.
- High fever may occur.
- The mouth may taste bitter and the throat may feel dry.
- There may be thirst and a desire to drink plenty of water.
- Palpitations, unease, and irritability may occur.
- Stools may be dry and hard to pass.
- Urine may appear reddish or yellow.
- The tongue may be deep red or crimson, with a yellow coating.
- The pulse may feel smooth and somewhat rapid.
| Treatment Approach
Clinical description:
Clear heat and resolve toxins, cool and invigorate the blood, nourish yin, and generate fluids.
In plain language:
- May help clear internal heat and dispel pathogenic factors, easing discomfort such as fever, restlessness, sore or swollen throat, or painful sores and swelling.
- May help cool the blood and promote circulation, easing signs such as skin redness, purplish discoloration, pain, or swelling.
- May help nourish yin, generate fluids, and relieve thirst, easing discomfort such as dry mouth and throat, tidal fever, night sweats, or weight loss.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
The rash is dark red; muscles are sore and weak; appetite is poor and stools are loose; the tongue is pale with a white coating, and the pulse is deep and moderate.
In plain language:
- The rash appears dark red and not particularly bright in color.
- Muscles are sore and easily fatigued, with tiredness more noticeable after activity.
- Appetite is poor, and there may be little desire to eat.
- Stools are loose and poorly formed.
- The tongue may be pale with a white coating; the pulse may feel deep and slow.
| Treatment Approach
Clinical description:
Strengthen the spleen and dispel dampness; invigorate the blood and relieve pain.
In plain language:
- May help support spleen and digestive function and dispel dampness, easing discomfort such as poor appetite, a heavy feeling in the body, or loose stools.
- May help promote circulation and relieve pain, easing signs such as painful bruising, aching joints, or abdominal distension and pain.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Skin lesions appear as dark red patches with slight scaling; there is generalized muscle soreness and weakness, restricted movement or swelling of the hands and feet, accompanied by shortness of breath and fatigue, aversion to cold, and abdominal distension. The tongue is dusky and pale with a white coating; the pulse is deep and thready or deep and moderate.
In plain language:
- Dark red patches appear on the skin, with some scaling; the skin may look dull in color.
- Muscles throughout the body are sore and weak, making movement, walking, or handling objects difficult.
- The hands and feet may become swollen, with a noticeable and uncomfortable feeling of fullness.
- Breathing may feel shallow, with fatigue; even mild activity may cause tiredness.
- There may be a marked aversion to cold and uncomfortable abdominal fullness.
- The tongue may look pale and dusky, with a white coating and a lack of healthy color.
- The pulse may feel deep and thready or deep and slow, with reduced strength.
| Treatment Approach
Clinical description:
Warm yang and dispel cold; invigorate the blood and unblock the channels.
In plain language:
- May help warm and support yang and dispel internal cold, easing discomfort such as chills, cold limbs, soreness and weakness in the lower back and knees, or symptoms that worsen in cold conditions.
- May help promote blood circulation and unblock the channels, easing signs such as numbness in the limbs, aching joints, or restricted movement.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Skin lesions are dark red or purplish red, with fine scales; there may be localized muscle wasting and joint stiffness, bluish-purple and cold extremities, palpitations and shortness of breath, breathlessness with exertion, aversion to cold, abdominal distension, and loose stools. The tongue is pale and swollen with a moist white coating; the pulse is thready and weak.
In plain language:
- Skin lesions may be dark red or purplish red, with fine scaling on the surface.
- Some muscles may waste away, appearing thinner and smaller.
- Joints may feel stiff and inflexible, with limited bending, straightening, or rotation.
- The fingers, toes, hands, or feet may look purplish and feel cold to the touch.
- Palpitations and shortness of breath may occur, and activity may make breathing more difficult.
- There may be a marked aversion to cold, with discomfort worsening in cold conditions.
- The abdomen may feel distended and uncomfortable, and stools may be loose and poorly formed.
- The tongue may be pale and swollen, with a white, moist coating.
- The pulse may feel thready and weak, with little force when palpated.
| Treatment Approach
Clinical description:
Tonify the middle and boost qi; harmonize yin and yang.
In plain language:
- May help tonify middle qi, easing discomfort such as fatigue, shortness of breath, poor appetite, or low energy.
- May help harmonize yin and yang, easing signs such as chills and fever, restlessness and insomnia, or uneasiness.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Yin Yuanping. Five TCM approaches to the differentiation and treatment of dermatomyositis by Zha Yuping [J]. Liaoning Journal of Traditional Chinese Medicine, 2000, 27(4): 149–150.
- Zhao Yanxia, Chen Xuerong. Professor Chen Xuerong’s TCM pattern-differentiation approach to treating dermatomyositis and polymyositis [J]. Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine, 2010, 9(5): 274–275.
- Bian Tianyu. Dermatology in Integrated Traditional Chinese and Western Medicine [M]. Tianjin: Tianjin Science and Technology Press, 1987.
- Fan Ruiqiang, Deng Bingxu, Yang Zhibo. TCM Dermatology and Venereology [M]. Beijing: Science and Technology Literature Press, 2010.
- Cao Yi, Lu Xianchang. Contemporary TCM Dermatology Clinicians Series [M]. Beijing: China Medical Science Press, 2015.
- Duan Xingwu. Contemporary TCM Dermatology Clinicians Series [M]. Beijing: China Medical Science Press, 2015.
- Zhao Bian. Clinical Dermatology [M]. 3rd ed. Nanjing: Jiangsu Science and Technology Press, 2001.