• peak incidence 40-60 years
• muscle weakness and wasting proximal limb muscles
• main complaint is weakness
• muscle pain and tenderness in about 50%
• arthralgia or arthritis in about 50% (resembles distribution of rheumatoid arthritis)
• dysphagia in about 50% due to oesophageal involvement
• Raynaud's phenomenon
• consider associated malignancy: lung and ovary
The distinctive rash shows features of photosensitivity. There is violet discolouration of the eyelids, forehead and cheeks, and possible erythema resembling sunburn and periorbital oedema. There is a characteristic rash on the hands especially the fingers and nail folds. The knees and elbows are commonly involved.
The main features are summarised in Figure 28.4 .
hell otnopt- c-alijurid -~ phdcossnsinvity rash proximal mustJe weakness and casting
_ iflsh on dorsum Of hands;
Fig. 28.4 Clinical features of polymyositis/dermatomyositis
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