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Dermatomyositis and Polymyositis (DM/PM)

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Myopathy and Myositis
Dermatomyositis?
Polymyositis?
Symptoms
Diagnosis
Mortality/Prognosis
Treatments
Research
Personal Stories

Myopathy and Myositis

Dermatomyositis KaleidoscopeMyopathy vs. Myositis. Myopathy means muscle disease. Myositis means muscle disease that is caused by inflammation. There are three types of myositis: dermatomyositis, polymyositis, and inclusion body myositis. ISN.

Myopathy vs. Myositis
Myopathies and Scleroderma
Myopathies and Overlapping Diseases

What is Dermatomyositis?

Inflammatory muscle weakness plus skin rashes

Dermatomyositis is an inflammatory skin and muscle disease. Distinctive rashes on the hands, feet, elbows, face, and/or upper body, occurring along with muscle weakness, are hallmark symptoms. (Also see Autoimmune Diseases)

Dermatomyositis. "Dermatomyositis is an acute inflammatory condition of skin and muscle." Dr. Thomas Lehman.

What is Polymyositis?

Inflammatory muscle weakness without skin rashes

Polymyositis is an inflammatory muscle disease. It's hallmark symptom is extreme muscle weakness, usually in the neck, upper arms, and thighs. When polymyositis occurs along with a skin rash, it is called dermatomyositis.

What is Polymyositis? It is a muscle disease featuring inflammation of the muscle fibers, typically those closest to the trunk or torso. This results in weakness that can be severe. MedicineNet.com.

Symptoms of Dermatomyositis and Polymyositis

Overview
Dermatomyositis Symptoms
Polymyositis Symptoms

Diagnosis of Dermatomyositis and Polymyositis

The effect of prior corticosteroid (CS) use in muscle biopsies from patients with dermatomyositis (DM). Previous CS use did not influence the presence or the degree of inflammatory infiltrates found in muscle biopsies in DM with clinical and laboratory disease activity. Clinical and Experimental Rheumatology Online, 02/20/2015.

Role of bone scan in the assessment of polymyositis/dermatomyositis. The findings of this study suggest that bone scan is a useful imaging technique for the evaluation of PM/DM patients. PubMed, Clin Rheumatol, 12/12/2014.

Echocardiographic Abnormalities in New-onset Polymyositis (PM)/Dermatomyositis (DM). Tissue doppler imaging is a useful method to detect early cardiac abnormalities at the time of diagnosis of PM and DM complementing the conventional echocardiographic measurements. PubMed, J Rheumatol, 11/29/2014.

Cutaneous ulceration in dermatomyositis (DM): Association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease (ILD). There was a strong association between anti-MDA5 antibodies and cutaneous ulcers, with the novel finding that the association of cutaneous ulcers with ILD depends upon the presence of anti-MDA5 antibodies. PubMed, Arthritis Care Res (Hoboken), 2014 Oct 20.

Mortality and Prognosis of DM/PM

Muscle biopsy in combination with myositis–specific autoantibodies aids prediction of outcomes in juvenile dermatomyositis. Muscle pathology, in combination with MSA, predicts the risk of remaining on treatment in JDM and may be useful for discussing probable treatment length with parents and patients. PubMed, Arthritis Rheumatol, 05/23/2016.

Cardiac abnormalities in adult patients with polymyositis (PM) or dermatomyositis (DM) as assessed by non-invasive modalities. Patients with PM or DM had an increased prevalence of cardiac abnormalities compared to healthy controls and left ventricular diastolic dysfunction was a common occurrence and correlated to disease duration. PubMed, Arthritis Care Res (Hoboken), 10/26/2015. (Also see Complications with Heart Involvement)

Serum progranulin (PGRN) levels are elevated in dermatomyositis (DM) patients with acute interstitial lung disease, predicting prognosis. Serum PGRN is associated with disease activity and prognosis of DM with interstitial lung disease. Arthritis Research and Therapy, 02/18/2015.

Cytokine profiles in polymyositis (PM) and dermatomyositis (DM) complicated by rapidly progressive or chronic interstitial lung disease (ILD). Cytokine levels were high, especially in the ILD subset, and are associated with global disease activity in PM/DM. PubMed, Rheumatology (Oxford), 2014 Jun 26.

Treatments for Dermatomyositis and Polymyositis

Overview
Biological Agents
Combination Therapies
Exercise
Immunosuppressants
IVIg
Stem Cell Transplants

Research

The Prevalence of Individual Histopathologic Features Varies according to Autoantibody Status in Muscle Biopsies from Patients with Dermatomyositis (DM). The prevalence of different histological features varies according to autoantibody status in DM and muscle biopsy features are similar in anti-Jo1 patients with and without a rash. Journal of Rheumatology, 07/14/2015.

Nailfold capillaroscopic changes in dermatomyositis (DM) and polymyositis (PM). Significant differences were observed between PM and DM with higher frequency and mean score of nailfold videocapillaroscopy changes in DM. PubMed, Clin Rheumatol, 2015 Feb;34(2):279-84.

Is statin-induced myositis part of the polymyositis disease spectrum? Statin medications have recently been shown to cause not only a toxic myopathy but also an immune-mediated necrotizing myositis. PubMed, Curr Rheumatol Rep, 2014 Aug;16(8):433. (Also see Statins)

Activated IL-22 pathway occurs in the muscle tissues of patients with polymyositis or dermatomyositis and is correlated with disease activity. PubMed, Rheumatology (Oxford), 2014 Mar 5.

Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis. Anti-Ro-52 was correlated with pulmonary disorders in dermatomyositis, whereas Anti-Jo-1 was correlated with pulmonary alterations in polymyositis. Clinics, 2013 July; 68(7): 909-914. (Also see Autoantibodies)

Polymyositis: Can a gluten-free diet reduce symptoms? If you have polymyositis a rare connective tissue disease you may be at increased risk of celiac disease. In such cases, a gluten-free diet can improve signs and symptoms of celiac disease. But there's no evidence that a gluten-free diet can improve signs and symptoms of polymyositis. Mayo Clinic. (Also see Celiac Disease and Gluten Sensitivity)

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