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Polymyositis/Dermatomyositis

Nehal R. Shah, MD and Christopher M. Wise, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

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

    • If skin manifestatio...

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,...

TREATMENT

GENERAL MEASURES

General evaluation for malignancy in all adults, particularly with dermatomyositis, at initial evaluation and during follow-up 

MEDICATION

First Line

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 on OvidMedline]
2
Mammen AL....

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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