Polymyositis - Symptoms and Signs

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What are signs and symptoms of polymyositis and dermatomyositis?

Weakness of muscles is the most common symptom of polymyositis. The muscles involved usually are those that are closest to the trunk of the body. Both sides of the body are affected. The onset can be gradual or rapid. This results in varying degrees of loss of muscle power and atrophy. The loss of strength can be noticed as difficulty getting up from chairs, walking, climbing stairs, or lifting above the shoulders. Trouble with swallowing and weakness lifting the head from the pillow can occur. Occasionally, the muscles ache and are tender to the touch.

Patients can also feel fatigue, a general feeling of discomfort, and have weight loss and/or low-grade fever.

Weakness of the muscles that produce the voice can lead to a weak-sounding voice (dysphonia).

With skin involvement (dermatomyositis), the eyes can be surrounded by a violet discoloration with swelling. There can be scaly reddish discoloration over the knuckles, elbows, and knees (Gottron's sign). There can also be reddish rash on the face, neck, and upper chest. The skin changes can occur with or prior to the development of muscle weakness. Hard lumps of calcium deposits can develop in the fatty layer of the skin, most commonly in childhood dermatomyositis.

Heart and lung involvement can lead to irregular heart rhythm, heart failure, and inflammation of the lungs with shortness of breath.

Because polymyositis can appear in combination with other illnesses (see related articles on systemic lupus erythematosus, scleroderma, and rheumatoid arthritis), it can also have overlap features with them. These illnesses are discussed elsewhere.

Both polymyositis and dermatomyositis can sometimes be associated with cancers, including lymphoma, breast cancer, lung cancer, ovarian cancer, and colon cancer. The cancer risk is reported to be much greater with dermatomyositis than polymyositis.

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Comment from: still kicking, 55-64 Female (Patient) Published: January 05

I've had polymyositis and dermatomyositis for 30 years. One morning I couldn't get out of bed due to weakness and had red squally scabs all over my body. I looked like a lobster. I rushed to the hospital and was diagnosed with polymyositis. My CPKs were at 20,000, yes 20,000. I was given 220 mg of prednisone and was told that if this didn't work I had a month to live. Well, 30 years later I'm still kicking. It has been a very difficult journey as when first diagnosed the doctors didn't know what to do with me but after a great deal of research they were able to help me and save my life. I'm still on prednisone, Imuran and many other medicines due to side effects from the prednisone. Methotrexate didn't work for me and I have tried quite a few IV injections and other medications with no luck. I will live with this the rest of my life but I never give up. I fight every day to keep going as my muscles are always weak and sore but enjoy my life with my kids and grandchildren. Never give up your struggle you can enjoy every day to the fullest. Best of luck.

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Comment from: Frannyfran, 45-54 Female (Patient) Published: January 20

I was just diagnosed with polymyositis. I just had a muscle biopsy done that shows that I have the disease, but before that I was struggling for 3 years with severe pain and stiffness. I was deficient in vitamin to put as borderline diabetic. My rheumatologist said I put a wrench in the diagnosis for this autoimmune disease. It does affect my trunk, shoulders, but also my feet, hands, arms, and legs. The muscles contract and stay stiff and stay contracted sometimes seconds, minutes, or hours.

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