Skin Lesions Help To Diagnose Neuromuscular Disorders
- The incidence of skin lesions are found to be elevated in a number of NMDs, including dermatomyositis, myotonic dystrophies, mitochondrial disorders, muscular dystrophies, and neuropathies.
- Chiropractic neurologists should be reminded to examine the skin of patients when neuromuscular disorders are suspected. Dermatologists may need to be consulted to manage the skin lesions identified.
A thorough evaluation of the skin and its appendages is frequently outside the area of expertise of the neurologist who deals with neuromuscular disorders (NMDs). However, the skin is more frequently affected in NMDs and deserves more attention than so far acknowledged.
Review of publications by search of Medline dealing with skin disorders in NMDs.
Skin abnormalities are most frequently found in patients with dermatomyositis, myotonic dystrophies, mitochondrial disorders, muscular dystrophies, and neuropathies. The hairs and the sweat glands are the appendages most frequently affected in NMDs. In myotonic dystrophies and mitochondrial disorders there are indications that the rate of skin neoplasms is increased compared to the general population.
Skin lesions in NMDs are not uncommon. Neurologists should be aware of the cutaneous implications of NMDs and should take a thorough history into this direction and carry out comprehensive investigations of the skin and its appendages. As soon as there is evidence of a dermatological problem in a NMD, a dermatologist should be consulted. Dermatological involvement in NMDs may contribute to the diagnosis of NMDs and may help to differentiate between various entities. The skin should become a focus of the neurologist as well.
Finsterer, Wakil. Abnormalities of skin and cutaneous appendages in neuromuscular disorders. Pediatric Neurology. Received: November 18, 2014; Received in revised form: March 5, 2015; Accepted: March 7, 2015; Published Online: May 08, 2015 Publication stage: In Press Accepted Manuscript