DERMATOMYOSITIS, A NUTRITIONAL PERSPECTIVE
Keywords:
Dermatomyositis, idiopathic inflammatory myopathies, nutritional assessment, nutritional treatment, dysphagia.Abstract
Dermatomyositis is an autoimmune disease, considered the most common idiopathic inflammatory myopathy, with a prevalence of 30-40% within this group of diseases. It is characterized by specific skin lesions, muscle weakness, and heterogeneous systemic manifestations, which can have a negative impact on nutritional status. Weight and muscle loss, difficulty ingesting food orally due to oropharyngeal dysphagia, and vitamin D deficiency are some of the most common problems. To date, there is no specific nutritional treatment for this pathology. Therefore, intervention is aimed at correcting the problems identified in the nutritional assessment. Based on this and the limited information available on the subject, the objective of this review is to describe the main nutritional implications of dermatomyositis, secondary to inflammation, oxidative stress, muscle deterioration, and pharmacological treatment, as well as to provide an overview of nutritional strategies that may be effective in this group of patients.
Downloads
References
1. Qudsiya Z, Waseem M. Dermatomyositis. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
2. Anquetil C, Benveniste O. Dermatomyositis [Internet]. Orphanet. 2021. Disponible en: https://www.orpha.net/en/disease/detail/221?name=dermatomyositis&mode=name
3. Galindo-Feria AS, Rojas-Serrano J, Hinojosa-Azaola A. Clinical and Prognostic Factors Associated With Survival in Mexican Patients With Idiopathic Inflammatory Myopathies: JCR: Journal of Clinical Rheumatology. 2016;22(2):51–6.
4. Gonçalves Júnior J, Shinjo SK. Assessment of cardiovascular risk factors in patients with idiopathic inflammatory myopathies: a systematic review. Clin Rheumatol. 2023;42(11):2943–50.
5. Fania L, Didona D, Tonanzi T, Mazzanti C, Didona B. Simvastatin-associated dermatomyositis: LUCA FANIA et al. Dermatologic Therapy. 2017;30(4):e12480.
6. Xiong A, Zhou S, Liu C, Hu Z, Xie C, Zheng X, et al. Vitamin D levels in idiopathic inflammatory myopathy patients: a meta-analysis. Postgraduate Medicine. 2024;136(2):141–9.
7. Cheng I, Wong CS. A systematic review and meta‐analysis on the prevalence and clinical characteristics of dysphagia in patients with dermatomyositis. Neurogastroenterology Motil. 2023;35(9):e14572.
8. Zeng R, Schmidt J. Impact and Management of Dysphagia in Inflammatory Myopathies. Curr Rheumatol Rep. 2020;22(10):74.
9. Cassard L, Seraly N, Riegert M, Patel A, Fernandez A. Dermatomyositis: Practical Guidance and Unmet Needs. ITT. 2024; 13:151–72.
10. Nombel A, Fabien N, Coutant F. Dermatomyositis With Anti-MDA5 Antibodies: Bioclinical Features, Pathogenesis and Emerging Therapies. Front Immunol. 2021;12:773352.
11. Hill CL, Zhang Y, Sigurgeirsson B, Pukkala E, Mellemkjaer L, Airio A, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. The Lancet. 2001;357(9250):96–100.
12. Ebert EC. Review article: the gastrointestinal complications of myositis. Aliment Pharmacol Ther. 2010;31(3):359–65.
13. Middelink M, Voermans NC, Van Engelen BGM, Janssen MCH, Groothuis JT, Knuijt S, et al. Indications for Tube Feeding in Adults with Muscular Disorders: A Scoping Review. JND. 2023;10(5):777–85.
14. Wu XS, Miles A, Braakhuis AJ. Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review. Healthcare. 2021;9(6):624.
15. Marie I, Menard J ‐F., Hatron PY, Hachulla E, Mouthon L, Tiev K, et al. Intravenous immunoglobulins for steroid‐refractory esophageal involvement related to polymyositis and dermatomyositis: A series of 73 patients. Arthritis Care & Research. 2010;62(12):1748–55.
16. Folwarski M, Kłęk S, Zoubek-Wójcik A, Szafrański W, Bartoszewska L, Figuła K, et al. Home Enteral Nutrition in Adults—Nationwide Multicenter Survey. Nutrients. 2020;12(7):2087.
17. Bischoff SC, Austin P, Boeykens K, Chourdakis M, Cuerda C, Jonkers-Schuitema C, et al. ESPEN guideline on home enteral nutrition. Clinical Nutrition. 2020;39(1):5–22.
18. Mundi MS, Mohamed Elfadil O, Olson DA, Pattinson AK, Epp LM, Miller LD, et al. Home enteral nutrition: A descriptive study. J Parenter Enteral Nutr. 2023;47(4):550–62.
19. Triplett JD, Pinto MV, Hosfield EA, Milone M, Liewluck T. Myopathies featuring early or prominent dysphagia. Muscle and Nerve. 2020;62(3):344–50.
20. Stumpf F, Keller B, Gressies C, Schuetz P. Inflammation and Nutrition: Friend or Foe? Nutrients. 2023;15(5):1159.
21. Vincze A, Gaál J, Griger Z. Bone Health in Idiopathic Inflammatory Myopathies: Diagnosis and Management. Curr Rheumatol Rep. 2021;23(7):55.
22. Tang IYK, Luk L, Wong V, Pang S, Lao V, So H. Reduced bone mineral density in patients with idiopathic inflammatory myopathies: a case-control study. Therapeutic Advances in Musculoskeletal. 2023;15:1759720X231181968.
23. Aguado Acín MP. Osteoporosis inducida por glucocorticoides: ¿qué hay de nuevo? Reumatología Clínica. 2007;3:S3–8.
24. Laurent MR, Goemaere S, Verroken C, Bergmann P, Body JJ, Bruyère O, et al. Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club. Front Endocrinol. 2022;13:908727.
25. Ali GF, Hassanein EHM, Mohamed WR. Molecular mechanisms underlying methotrexate-induced intestinal injury and protective strategies. Naunyn-Schmiedeberg’s Arch Pharmacol. 2024; 397(11): 8165-8188.
26. Murillo Godínez G. Homocisteína, otro factor de riesgo cardiovascular. Med Int Mex. 2022;38(4):903–13.
27. Álvarez-Femayor KDJ, Aray-Álvarez JA, Fuentes-Silva YJ. Adverse effects of methotrexate in a rheumatology outpatient clinic. Rev parag reumatol 2022;8(2):72–6
28. Gutiérrez-Restrepo J. Efectos adversos de la terapia con glucocorticoides. Iatreia. 2021;34(2):137–50.
29. Pofi R, Caratti G, Ray DW, Tomlinson JW. Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad ? Endocrine Reviews. 2023;44(6):975–1011.
30. Sánchez‐Rosales AI, Posadas‐Calleja JG, Serralde‐Zúñiga AE, Quiroz‐Olguín G. Nutritional interventions as modulators of the disease activity for idiopathic inflammatory myopathies: a scoping review. J Human Nutrition Diet. 2024;37(3):772–87.
31. Sánchez Valle V, Méndez Sánchez N. Estrés oxidativo, antioxidantes y enfermedad. Rev Invest Med Sur Mex. 2013;20(3):161–8.
32. Giannini M, Charles AL, Evrard C, Blaess J, Bouchard-Marmen M, Debrut L, et al. Sarcopenia assessed by DXA and hand-grip dynamometer: a potential marker of damage, disability and myokines imbalance in inflammatory myopathies. Rheumatology. 2024;63(9): 2503-2514..
33. Yang S, Luo C, Zheng W, Li X, Zhang X, Jiang Y, et al. Patterns of body composition and alteration after treatment in patients with newly diagnosed idiopathic inflammatory myopathies. Rheumatology. 2022;62(1):270–80.
34. Lee CWS, Muo CH, Liang JA, Sung FC, Hsu CY, Kao CH. Increased osteoporosis risk in dermatomyositis or polymyositis independent of the treatments: a population-based cohort study with propensity score. Endocrine. 2016;52(1):86–92.
35. Cichero JAY, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, et al. Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework. Dysphagia. 2017;32(2):293–314.
36. Lozano-Estevan MDC, González-Rodríguez LG, Cuadrado-Soto E, Bermejo LM, Salas-González MD. Protocol of action in the dietary and nutritional approach in patients with dysphagia. Nutr Hosp 2023; 40 (Spec 2): 55-61.
37. Martínez Olmos M, Bellido Guerrero D. Nutrition and dysphagia. Fisioterapia. 2003;25(5):306–10.
38. Gramlich L, Hurt RT, Jin J, Mundi MS. Home Enteral Nutrition: Towards a Standard of Care. Nutrients. 2018;10(8):1020.
39. Da Silva JSV, Seres DS, Sabino K, Adams SC, Berdahl GJ, Citty SW, et al. ASPEN Consensus Recommendations for Refeeding Syndrome. Nutr Clin Pract. 2020;35(2):178–95.
40. Dawson Hughes B. Vitamin D deficiency in adults: Definition, clinical manifestations, and treatment. 2024. Disponible en: https://www.uptodate.com/contents/vitamin-d-deficiency-in-adults-definition-clinical-manifestations-and-treatment?search=vitamina%20d%20suplementacion&source=search_result&selectedTitle=2%7E150&usage_type=default&display_rank=1
41. Giustina A, Bilezikian JP, Adler RA, Banfi G, Bikle DD, Binkley NC, et al. Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows. Endocrine Reviews. 2024; 45(5): 625-654.
42. Cox M, Sandler RD, Matucci-Cerinic M, Hughes M. Bone health in idiopathic inflammatory myopathies. Autoimmunity Reviews. 2021;20(4):102782.
43. Okogbaa J, Batiste L. Dermatomyositis: An Acute Flare and Current Treatments. Clin Med Insights Case Rep. 2019;12:117954761985537.
44. Tarnopolsky MA. Creatine as a therapeutic strategy for myopathies. Amino Acids. 2011;40(5):1397–407.
45. Kley RA, Tarnopolsky MA, Vorgerd M. Creatine for treating muscle disorders. Cochrane Neuromuscular Group, editor. Cochrane Database of Systematic Reviews 2013: CD004760.
46. Barsotti S, Lundberg IE. Current Treatment for Myositis. Curr Treat Options in Rheum. diciembre de 2018;4(4):299–315.
47. Chung Y, Alexanderson H, Pipitone N, Morrison C, Dastmalchi M, Ståhl‐Hallengren C, et al. Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six‐month, double‐blind, randomized, placebo‐controlled trial. Arthritis & Rheumatism. 2007;57(4):694–702.
48. Da Silva BISL, Dos Santos BRJ, Carneiro JA, Silva FMFE, De Souza JM. Physical exercise for dermatomyositis and polymyositis: a systematic review and meta-analysis. Clin Rheumatol. 2022;41(9):2635–46.
49. Corrado B, Ciardi G, Lucignano L. Supervised Physical Therapy and Polymyositis/Dermatomyositis—A Systematic Review of the Literature. Neurology International. 2020;12(3):77–88.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Andrea Valencia de León, Luis Eduardo González-Salazar, Aurora Elizabeth Serralde Zúñiga

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Warning of rights of author
The authors that publish in this journal agree with the following terms:
The authors conserve the rights of author and concede to the journal the right of the first publication, fulfilling with the license Creative Commons Attribution License that allows to others share the work with recognition of the authorship of their articles, and the initial publication in this journal.
The authors can establish separately additional agreements for the no exclusive distribution of the version of the work published in the journal (for example, situate it in an institutional repository, in a personal blog or publish it partial or totally in a book), with a recognition of their initial publication in this journal.
To be able to send the manuscript or part of him passed three months of published, for his evaluation to other publishers, identifying it or not with the same title; whenever allusion is made to our journale and know it the new publisher.
The publishing committee of the Cuban Journal of Rheumatology authorizes to other publishers, to reproduce the articles published in our magazine, whenever it indicate the origin of the same.
The authors should send a document in Office Word application format through the electronic address of the magazine with a similar format to that we include next:
---------------------------------------------------------------------------------------------------------------------
Statement of authorship and cede of articles for the publication of the scientific work in the Cuban Journal of Rheumatology
Date:
Those who subscribe certify that are the authors of the work:
Of this form communicate the originality of our article clearing that the concepts and knowledges of other authors that have included in the text of the article, have been quoted properly in the bibliography.
We do proof besides that the article in question is original and has not been published, total neither partially, in another journal.
To be approved for his publication in the Cuban Journal of Rheumatology, do secession of the rights of publication to the same one through the method that realizes it usually.
In front of any catchword that exist by the article that send to evaluate, relieve of of the responsibility to the Cuban Journal of Rheumatology holding us responsible with all the difficulties that can berelated by any situation.
We include to continuation the name and the signature of all authors and collaborators of this article.
Name: Signature:
