Systemic connective tissue disease characterized by inflammatory and degenerative changes in proximal muscles, sometimes accompanied by characteristic skin rash
If skin manifestations...
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...
Follow muscle enzymes along with muscle strength and functional capacity.
Monitor for steroid-induced complications (e.g., hypokalemia, hypertens...
M33.20 Polymyositis, organ involvement unspecified
M33.90 Dermatopolymyositis, unspecified, organ involvement unspecified
M33.92 Dermatopolymyositis, unspecified with myopathy
M33.22 Polymyosi...
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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Heliotropic rash of dermatomyositis. B. Gottron's papules of dermatomyositis.
Dale Berg , Katherine Worzala, Atlas of Adult Physical Diagnosis. Philadelphia: Lippincott Williams & Wilkins, 2006.
Dale Berg , Katherine Worzala, Atlas of Adult Physical Diagnos...
This patient with dermatomyositis has the characteristic facial (A) and extremity findings (B).
From Fleisher GR, MD, Ludwig S, MD, Baskin MN, MD. Atlas of Pediatric Emergency Medicine. Philadelphia: Lippincott Williams & Wilkins, 2004.
From Fleisher GR, MD, Ludwig S, MD, Baskin...
Classic Gottron's papules on the dorsum on the fingers of this patient with dermatomyositis.
Dale Berg, Katherine Worzala, Atlas of Adult Physical Diagnosis. Philadelphia: Lippincott Williams & Wilkins, 2006.
Dale Berg, Katherine Worzala, Atlas of Adult Ph...
Skin changes seen in dermatomyositis. A: Gottron's papules are scaly papules overlying the extensor surfaces of the hands (over the metacarpophalangeal and proximal interphalangeal joints in this case), elbows, knees, or malleoli. This patient also has sclerodactyly and arthritis of the metacarpophalangeal and proximal interphalangeal joints. B: The heliotrope rash is a purplish discoloration around the eyes, especially on the upper lids. C: Linear extensor erythema overlies the extensor surface of the hands beyond the usual location of Gottron's papules or sign. D: Periungual vasculitic changes and cuticular overgrowth. E: Photosensitive diffuse erythroderma with accentuated erythema in the V of the neck (V sign) in a patient with cancer-associated dermatomyositis. F: Drying and cracking of the skin over the lateral and palmar surfaces of the fingers, known as “mechanic's hands,” is seen frequently in patients with autoantibodies to aminoacyl-tRNA synthetases (the antisynthetase syndrome).
William J. Koopman, Larry W. Moreland, Arthritis and Allied Conditions A Textbook of Rheumatology, 15e. Philadelphia: Lippincott Williams & Wilkins, 2005.
Skin changes seen in dermatomyositis. A: Gottron's papules are scaly papules overlying the extensor surfaces of the hands (over the metacar...
FIG. 75.1. Skin changes seen in dermatomyositis. A: Gottron's papules are scaly papules overlying the extensor surfaces of the hands (over the metacarpophalangeal and proximal interphalangeal joints in this case), elbows, knees, or malleoli. This patient also has sclerodactyly and arthritis of the metacarpophalangeal and proximal interphalangeal joints. B: The heliotrope rash is a purplish discoloration around the eyes, especially on the upper lids. C: Linear extensor erythema overlies the extensor surface of the hands beyond the usual location of Gottron's papules or sign. D: Periungual vasculitic changes and cuticular overgrowth. E: Photosensitive diffuse erythroderma with accentuated erythema in the V of the neck (V sign) in a patient with cancer-associated dermatomyositis. F: Drying and cracking of the skin over the lateral and palmar surfaces of the fingers, known as “mechanic's hands,” is seen frequently in patients with autoantibodies to aminoacyl-tRNA synthetases (the antisynthetase syndrome).
FIG. 75.1. Skin changes seen in dermatomyositis. A: Gottron's papules are scaly papules overlying the extensor surfaces of the hands (over ...
William J. Koopman, Larry W. Moreland, Arthritis and Allied Conditions A Textbook of Rheumatology, 15e. Philadelphia: Lippincott Williams & Wilkins, 2005
<bold>FIG. 75.3.</bold> Histopathology of inflammatory myopathies. A,B: Muscle biopsies from polymyositis patients tend to show focal endomysial infiltration by mononuclear cells (A: hematoxylin and eosin stain), while those from dermatomyositis patients show more perivascular and interstitial inflammation with perifascicular myofiber atrophy (B: modified trichrome stain). C: Transverse fresh-frozen section of muscle from a patient with inclusion body myositis displaying purplish granular materia...
<bold>FIG. 75.3.</bold> Histopathology of inflammatory myopathies. A,B: Muscle biopsies from polymyositis patients tend to sho...
<bold>FIG. 75.1.</bold> Skin changes seen in dermatomyositis. A: Gottron's papules are scaly papules overlying the extensor surfaces of the hands (over the metacarpophalangeal and proximal interphalangeal joints in this case), elbows, knees, or malleoli. This patient also has sclerodactyly and arthritis of the metacarpophalangeal and proximal interphalangeal joints. B: The heliotrope rash is a purplish discoloration around the eyes, especially on the upper lids. C: Linear extensor erythema overli...
<bold>FIG. 75.1.</bold> Skin changes seen in dermatomyositis. A: Gottron's papules are scaly papules overlying the extensor sur...
FIG. 2.18. This patient with dermatomyositis has the characteristic facial (A) and extremity findings (B).
<bold><italic>Figure 7.31.</bold></bold> Classic heliotropic rash about the eyes of this patient with dermatomyositis.
<bold><italic>Figure 7.31.</bold></bold> Classic heliotropic rash about the eyes of this patient with dermatomyosit...
Dermatomyositis: face
Dermatomyositis: nail-fold dilated capillary loops