Vitamin D and Rashes

Vitamin D and Rashes

Introduction

The report is based on the case scenario; in this case scenario the main issue that has been raised is rashes. There are several reasons that became the main cause of these rashes; usually it has been observed that the deficiency of Vitamin D caused the rashes on the skin. The palms of the hands and the soles of the feet are always red and undergo keratosis which leads to fissuring and painful walking. Multiple skin biopsies while showing atypia have not been conclusive. A gene rearrangement study for T cell receptor was performed and was inconclusive. Blood work was done and everything is normal except for low vitamin D levels. Viruses were tested and were negative. IgA levels are slightly elevated. CD4:CD8 ratios are normal. Allergy tests were done and they were negative. Steroids were prescribed but the condition persists. The report evaluates the main cause of these rashes.

Analysis

All the symptoms that are mentioned in the case showed that the patient is diagnosed as some dermatomyositis (DM) is a rare muscle disease that belongs to a group known as 'inflammatory myopathies.' In addition to weakening muscles patients tend to develop skin rashes that can itch or burn.

Patients with DM develop a number of lesions throughout the body. These include red or bluish-purple patches on the cheeks, nose, chest, elbows and other sun-exposed areas. Heliotrope (purple eyelids), purple coloring of parts of the body where bones protrude, such as the knuckles (called Gottron's papules), ragged cuticles, amplified coloring of blood vessels on nail folds, loss of hair and a scaly scalp are all symptoms that are likely to develop before or at the same time as muscle weakness.

The most commonly affected muscles are those closest to the trunk of the body, which become tender and can ache while performing everyday activities. A common complication found in 40% of children is calcinosis, in which firm skin colored or yellow knots form over boney protrusions and can be easily infected.

Most of those with DM do survive but can become weak and disabled. If muscles become weak enough or malignancies develop, however, a chance of death does exist. Those with DM that are older than 60 have a heightened likelihood of growing tumors, making it crucial for patients to have any growths checked by a dermatologist.

In the United States approximately 5.5 people in every one million develop DM, with numbers increasing over past years. Women appear to be twice as likely to acquire DM as men are, but no trends in terms of race exist. While DM can occur at all ages, it peaks at age 50 in adults and between 5 and 10 years old in children.

In treating dermatomyositis, the foremost goal is to maintain weakening muscles. The most commonly prescribed medications are oral corticosteroids including prednisone, as well as diltiazem and colchicine for preventing calcinosis. Rest is also important for those with excessive inflammation of the muscles, but physical therapy is highly advisable ...