Polymyositis ☺️

Question 1

Epidemiology

Etiology and pathophysiology

Answer 1

Middle aged females

Idiopathic/associated with connective tissue disorders/malignancy

Type 4 hypersensitivity against muscle fibres

Question 2

Presentation of polymyositis and dermatomyositis

Skin features specific to dermatomyositis

Answer 2

Symmetrical proximal muscle weakness +- tenderness
Raynaud’s
Resp muscle weakness, ILD
Dysphagia, dysphonia

Skin features specific to dermatomyositis

• photosensitivity
• heliotrope rash around eyes
• macular rash on back, shoulders
• Gottron’s papules
• nail fold capillaries
• Dry, scaly hands with cracks on palmar, lateral fingers

Question 3

Investigations

• findings in polymositis
• additional findings in dermatomyositis

Answer 3

High CK, LDH, AST, ALT, aldolase
Anti synthetase, Jo1 AB
EMG
Muscle biopsy

ANA

Question 4

Management

Answer 4

Prednisolone