37. Polymyositis/dermatomyositis Flashcards Preview

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Flashcards in 37. Polymyositis/dermatomyositis Deck (20)
1

polyomyositis - clinical presentation

progressive SYMMETRIC proximal weakness

2

polymyositis - most often involves ( area of the body(

shoulders

3

polymyositis - histology

endomysial inflammation with CD8+ T cells necrotic muscle fibers

4

polyomyositis - treatment

steroid followed by long term immunosuppressant theraoy ( methotrexate)

5

dermatomyositis - clinical presentation

1. progressive symmetric proximal weakness ( like polymyositis)
2, malar rash ( similar to SLE)
3. helitrope rash
4. Gottron papules
5. shawl ( or V-) and face rash
6. mechanics hands

6

heliotrope rash

erythematous periorbital rash

7

mechanics hands

cracking ( and hyperkeratosis( of the finger pad skin commonly involving the first, second, and third fingers

8

Gottron papules

red papules of the elbows , knees and knuckles ( MCP, ICP)

9

dermatomyositis - some cases are associated with

carcinoma ( eg. gastric )

10

dermatomyositis - histology

perimysial inflammation with perifascicular atrophy with CD4+ T cells

11

dermatomyositis - treatment

steroid followed by long term immunosuppressant therapy ( methotrexate) ( same as polymyositis)

12

dermatomyositis - labs

1. increased CK2. ANA+
3. anti- Jo 1+
4. anti- SRP +
5. anti- Mi -2+

13

polyomyositis - labs

(same as dermatomyositis )
1. increased CK
2. ANA +
3. anti-jo -1 +
4. anti-SRP +
5. anti-Mi -2+

14

polymyositis vs dermatomyositis - histology

dermatomyositis --> perimysial inflammation with perifascicular atrophy with CD4+ T cells
polymyositis--> endomysial inflammation with CD8+ T cells necrotic muscle fibers

15

polymyositis vs dermatomyositis accorfing t-cells

polymyositis --> CD 8
dermatomyositis --> CD4

16

• Polymyositis involves progressive ____ (proximal/distal) muscle weakness, most commonly in the ____ (shoulders/wrists/knees/feet).

Proximal, shoulders

17

• What is the pathophysiology of the disease polymyositis?

CD8+ T cells cause endomysial inflammation of skeletal myofibers

18

• Which lab results would you expect to be abnormal in polymyositis/dermatomyositis?

Elevated CK and positive antinuclear, anti-Jo-1, anti-SRP, and anti-Mi-2 antibodies

19

• Dermatomyositis demonstrates ____ (perimysial/endomysial) inflammation by ____ (CD4+/CD8+) T cells.

Perimysial; CD4+

20

• What cutaneous findings would support a diagnosis of dermatomyositis over polymyositis?

Malar rash, Gottron papules, heliotrope rash, shawl-and-face rash, mechanic's hands

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