‘Dangal’ actor Suhani Bhatnagar, 19, is dead. Know all about dermatomyositis that took her life

Despite seeking medical opinions from multiple doctors, her condition remained unidentified.

Suhani was admitted to AIIMS on 7 February. Subsequent tests revealed that she was having the extremely rare ‘dermatomyositis’ disease. Her father disclosed that the sole treatment for this affliction involved the administration of steroids.

Unfortunately, this remedy adversely impacted her autoimmune system, resulting in a weakened immunity.

However, the compromised immunity left Suhani vulnerable to infections within the hospital setting. Fluid accumulated in her lungs, leading to breathing difficulties. On 16 February evening, she breathed her last.

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What is dermatomyositis?

Dermatomyositis is a rare inflammatory disease that affects both muscles and skin. It is characterised by muscle weakness and distinctive rashes that can appear suddenly or develop gradually over time.

The condition can affect adults and children. Dermatomyositis affects more females than males. The female-to-male ratio is approximately 2:1 to 3:1.

The cause of dermatomyositis is unknown, but it has much in common with autoimmune disorders, in which the immune system mistakenly attacks the body’s tissues. Genetic and environmental factors may also play a role

Genetic and environmental factors may also play a role. There is no cure for dermatomyositis, but treatment can help clear the skin rash and help regain muscle strength and function.

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Symptoms of dermatomyositis

The symptoms of dermatomyositis can appear suddenly or develop gradually over time.

The most common symptoms are muscle weakness and violet or dusky-coloured rashes on the skin, mostly on the face and eyelids, as well as on the knuckles, elbows, knees, chest, and back.

Other symptoms include difficulty swallowing, aspiration pneumonia, breathing problems, calcium deposits, joint pain, and fatigue.

Dermatomyositis can also cause heart and lung problems, and increase the risk of developing certain types of cancer, particularly ovarian cancer in women.

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Cause of dermatomyositis

The exact cause of dermatomyositis is unknown, but experts consider it may be due to a viral infection of the muscles or a problem with the body’s immune system.

It may also be caused by abnormal genes that you are born with, cancer, autoimmune disease, an infection, medication, or another exposure in your environment that triggers the disease. Environmental factors could include viral infections, sun exposure, certain medications, and smoking.

Dermatomyositis is part of a group of rare diseases called inflammatory myopathies that involve chronic muscle inflammation, muscle weakness, and in some cases, muscle pain.

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Diagnosis 

Diagnosis of dermatomyositis involves a combination of clinical, laboratory, and histopathological findings. The diagnostic process typically includes:

• Medical history and physical examination to identify characteristic skin manifestations (E.g., Gottron’s papules, heliotrope rash) and muscle weakness.
• Blood tests to rule out other conditions that cause rashes and muscle weakness, such as systemic lupus erythematosus.
• Electromyography to assess muscle function and detect abnormalities.
• Muscle and skin biopsies to confirm the diagnosis and identify pathological features of dermatomyositis.
• Screening for malignancy, as dermatomyositis is associated with cancer in about 25% of adults.
• Evaluation of lung, esophageal, or cardiac problems, as these may be affected in some cases.

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The treatment

The treatment for dermatomyositis involves a multidisciplinary approach and includes both pharmacologic(medicinal), and nonpharmacologic(non medicinal) therapies.

There is no single pharmacologic or nonpharmacologic therapy for the management or treatment of dermatomyositis, and the specific treatment plan may vary based on individual symptoms and response to therapy.

Pharmacologic treatments for dermatomyositis include:

• Systemic glucocorticoids (steroid): Such as prednisone, which is the first-line treatment for dermatomyositis. The initial dosage is typically higher and then tapered over time.
• Immunosuppressants: These are often used in combination with glucocorticoids to reduce the dose and minimise side effects. Commonly used immunosuppressants include methotrexate, mycophenolate mofetil, azathioprine, and tacrolimus.
• Antimalarial medications: Such as hydroxychloroquine, which may be prescribed for a persistent rash.
• Intravenous immunoglobulin: A purified blood product that can block the damaging antibodies attacking muscle and skin. It is given as an infusion through a vein and may need to be repeated regularly.
• Rituximab: An option if initial therapies don’t control the symptoms.

Nonpharmacologic treatments for dermatomyositis include:

• Sun avoidance and sunscreens: Sun exposure can worsen the cutaneous aspect of the disease, so protective measures are important.
• Physical therapy: To maintain and improve strength and flexibility.
• Speech therapy: If muscles that help in swallowing are affected.
• Dietetic Assessment: To address difficulties in chewing and swallowing.
• Surgical care: Sometimes necessary for the removal of painful calcium deposits and to prevent recurrent skin infections.

It is important to note that the treatment of dermatomyositis should be tailored to the individual patient and may require the coordinated efforts of a team of medical professionals. Early recognition and prompt initiation of treatment can reduce the morbidity and mortality of patients.

Also Read: Your skin can tell you a lot about your health!

‘Dangal’ team mourns Suhani’s death

Suhani Bhatnagar became a prominent face after appearing in the 2016 biographical drama, Dangal, about a wrestler who mentors his two daughters to success.

Zaira Wasim played young Geeta while Bhatnagar portrayed the role of Babita. The grown-up versions of the characters were played by Fatima Sana Shaikh and Sanya Malhotra. Aamir Khan played the role of their father, Mahavir Phogat.

In a social media post, Khan’s production house condoled Bhatnagar’s death.

“We are deeply saddened to hear about our Suhani passing away. Our heartfelt condolences to her mother Poojaji and the entire family. Such a talented young girl, such a team player, ‘Dangal’ would have been incomplete without Suhani.

“Suhani, you will always remain a star in our hearts. May you rest in peace,” Aamir Khan Productions said in a post on X.

The film’s director Nitesh Tiwari also mourned the death.

“Suhani’s passing away is absolutely shocking and heartbreaking. She was such a happy soul, so full of life. My deepest condolences to her family,” he said in a statement.

Suhani had taken a break from acting to complete her studies.