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Polymyositis/Dermatomyositis

Nehal R. Shah, MD and Christopher M. Wise, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

  • Systemic connective tissue disease characterized by inflammatory and degenerative changes in proximal muscles, sometimes accompanied by characteristic skin rash

    • If skin manifestations...

DIAGNOSIS

HISTORY

  • Symmetric proximal muscle weakness causing difficulty when

    • Arising from sitting or lying positions

    • Climbing stairs

    • Raising arms

  • Joint pain/swelling

  • Dysphagia

  • Dyspnea

  • Rash on face, eyelids, h...

TREATMENT

GENERAL MEASURES

T Approach to treatment has varied by specialty involved (dermatology, rheumatology, neurology), but a consensus statement is available  (3). Treatment approach should be inf...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Follow muscle enzymes along with muscle strength and functional capacity.

  • Monitor for steroid-induced complications (e.g., hypokalemia, hypertens...

REFERENCES

1
Senécal  JL, Raynauld  JP, Troyanov  Y. Editorial: a new classification of adult autoimmune myositis. Arthritis Rheumatol.  2017;69(5):878–884. [View Abstract ...

ADDITIONAL READING

  • Anh-Tu Hoa S, Hudson M. Critical review of the role of intravenous immunoglobulins in idiopathic inflammatory myopathies. Semin Arthritis Rheum. 2017;46:488–508...

CODES

ICD10

  • M33.20 Polymyositis, organ involvement unspecified

  • M33.90 Dermatopolymyositis, unspecified, organ involvement unspecified

  • M33.92 Dermatopolymyositis, unspecified with myopathy

  • M33.22 Polymyosi...

CLINICAL PEARLS

  • Corticosteroids alone may be sufficient in patients who have rapid improvement in weakness and muscle enzymes. However, most patients require azathioprine, methotrexate, or other immun...

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