Difference between revisions of "Dermatomyositis"

(Clinical Features)
Line 8: Line 8:
#Proximal greater than distal weakness
#Proximal greater than distal weakness
*Deltoid and hip flexors
#*Deltoid and hip flexors
*difficulty standing from a chair
#*difficulty standing from a chair
#Onset over months
#Onset over months
#Mild myalgias
#Mild myalgias

Revision as of 13:47, 20 July 2015


  • Inflammatory myopathy
  • Affects proximal muscles > distal
  • Female:Male; 2:1
  • Peak incidence 40-50s

Clinical Features


  1. Proximal greater than distal weakness
    • Deltoid and hip flexors
    • difficulty standing from a chair
  2. Onset over months
  3. Mild myalgias


  1. Heliotrope rash on face scalp
  2. Gottron's papules (rash on MCP, PIP, and DIP joints)
  3. Shawl sign (rash above shoulders)


  1. Cardiac (cardiomyopathy)
  2. High association with malignancy
  3. Interstial lung disease

Differential Diagnosis


  • CK
  • ANA
  • Chem for creatinine
  • Troponin, can involve myocardium
  • EKG
  • Bedside PFTs (FEV1 and FVC)
  • UA for myoglobin
  • Consider malignancies


Mild disease

  • Prednisone 1mg/kg/day (up to 80mg/day)
    • Taper after 6-8 weeks

Severe disease

  • Respiratory muscle symptoms of CHF
    • Methylprednisolone 1000mg/day x 3 days


  • Admit to monitored bed for CHF symptoms, respiratory muscle weakness
  • Admit for dysphagia/aspiration risk
  • Out patient follow up with muscle biopsy for others

See Also

  • Weakness
  • Polymyositis
  • SLE
  • Rheumatoid arthritis