Skip to content

We are currently in beta

Please enjoy the existing content while we continue to fix and enhance your experience.

We would love to receive any feedback or comments that you'd like to share.

You can contact us here

Journeys of Life StoryMD Health Communities

Why StoryMD
Our Story
Point of Care
Newsletter
Contact Us
Help Center

Privacy Policy
Terms of Service
Accessibility

Find us on facebook
Find us on instagram
Find us on linkedin
Find us on pinterest
Find us on twitter
Find us on youtube

© 2024 StoryMD Inc. All rights reserved.

Inflammatory Myopathies

Table of Contents

Inflammatory Myopathies

Inflammatory Myositis

The inflammatory myopathies are a group of rare diseases that involve chronic (long-standing) muscle inflammation, muscle weakness, and in some cases, muscle pain. The four main types are polymyositis, dermatomyositis, inclusion body myositis, and necrotizing autoimmune myopathy. Learn about symptoms and treatment.

Movements of myosin

Image by Victoria Foe, University of Washington

About

Dermatomyositis

Image by Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

Dermatomyositis

Dermatomyositis, Linear extensor erythema. Confluent erythema of the skin overlying the interphalangeal and extensor tendons of the hand, with extension to the forearm in a patient with dermatomyositis. Note the association with Gottron's sign. This is distinct from cutaneous lupus erythematosus, in which there is absence of erythema over the metacarpal and inter-phalangeal joints. Symmetric confluent macular erythema of the skin overlying the extensor tendon sheaths of the hands, forearms, thighs and/or feet in a patient with dermatomyositis.

Image by Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

What Are the Inflammatory Myopathies?

The inflammatory myopathies are a group of diseases that involve chronic (long-standing) muscle inflammation, muscle weakness, and, in some cases, muscle pain. Myopathy is a general medical term used to describe a number of conditions affecting the muscles. All myopathies cause muscle weakness.

The four main types of chronic, or long-term, inflammatory myopathies are:

polymyositis
dermatomyositis
inclusion body myositis
necrotizing autoimmune myopathy

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Additional Materials (10)

Living well with Inflammatory Myopathies

Video by Mayo Clinic/YouTube

Idiopathic inflammatory myopathies | PortalCLÍNIC

Video by Hospital Clínic de Barcelona/YouTube

Living with Polymyositis : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

What is Dermatomyositis? (Inflammatory Disease)

Video by healthery/YouTube

Dermatomyositis

Video by Learning in 10/YouTube

Inclusion Body Myositis (IBM) Disease Overview : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Polymyositis and Inclusion Body Myositis (IBM)

Video by Learning in 10/YouTube

Inclusion body myopathy - causes, symptoms, diagnosis, treatment, pathology

Video by Osmosis/YouTube

Polymyositis

Polymyositis: Inflammatory infiltrates in a muscle biopsy. Holes in the muscle cell vacuoles, deposits of abnormal proteins within the cells and in filamentous inclusions (hence the name inclusion body myositis} are clearly visible in the cellular interstitial space.

Image by Jensflorian

Myositis (Inflammatory Myopathy)

Histology section (paraffin embedded muscle biopsy) showing granulomatous myositis with giant cells, foamy macrophages and few skeletal muscle fibers

Image by Jensflorian

5:55

Living well with Inflammatory Myopathies

Mayo Clinic/YouTube

3:40

Idiopathic inflammatory myopathies | PortalCLÍNIC

Hospital Clínic de Barcelona/YouTube

4:58

Living with Polymyositis : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

2:29

What is Dermatomyositis? (Inflammatory Disease)

healthery/YouTube

12:59

Dermatomyositis

Learning in 10/YouTube

2:34

Inclusion Body Myositis (IBM) Disease Overview : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

7:59

Polymyositis and Inclusion Body Myositis (IBM)

Learning in 10/YouTube

6:25

Inclusion body myopathy - causes, symptoms, diagnosis, treatment, pathology

Osmosis/YouTube

Polymyositis

Jensflorian

Myositis (Inflammatory Myopathy)

Jensflorian

Risk Factors

Dermatomyositis

Image by Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

Dermatomyositis

Dermatomyositis, Heliotrope. Confluent macular erythema confined to the upper eyelid, with associated periorbital edema. A hallmark (i.e., pathognomonic) sign of dermatomyositis, consisting of violaceous to erythematous discrete or confluent macules confined to the upper eyelids. An eruption with similar characteristics can extend periorbitally. Heliotrope is often associated with periorbital edema and telangiectasias of the upper eyelids. In the resolution stage, atrophy or dyspigmentation (hypo- or hyperpigmentation) may be apparent.

Image by Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

Who Is at Risk for Inflammatory Myopathies?

The inflammatory myopathies are rare and can affect both adults and children. Dermatomyositis is the most common chronic form in children. Polymyositis and dermatomyositis are more common in females while inclusion body myositis affects more men. Inclusion body myositis usually affects individuals over age 50.

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Causes

Autoimmune Diseases

Image by TheVisualMD

Autoimmune Diseases

Disorders that are characterized by the production of antibodies that react with host tissues or immune effector cells that are autoreactive to endogenous peptides. (NCBI/NLM/NIH)

Image by TheVisualMD

What Causes Inflammatory Myopathies?

Myositis, or general muscle inflammation, may be caused by:

autoimmune disorders in which the immune system attacks muscle
an allergic reaction following exposure to a toxic substance or medicine
a virus or other infectious organism such as bacteria or fungi

Although the cause of many inflammatory myopathies is unknown, the majority are considered to be autoimmune disorders, in which the body’s immune response system that normally defends against infection and disease attacks its own muscle fibers, blood vessels, connective tissue, organs, or joints.

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Additional Materials (3)

What Are Autoimmune Diseases?

Video by Autoimmune Association/YouTube

Autoimmune Diseases - Causes, Symptoms, Treatments & More…

Video by Rehealthify/YouTube

Juvenile dermatomyositis

Dermatomyositis, Malar and facial erythema. Acute onset of confluent macular erythema in a periorbital and malar distribution with extension to the chin in a female with juvenile dermatomyositis. Note the perioral sparing. Confluent erythema in a malar distribution (involving the cheeks and extending over the nasal bridge) or more extensive involvement of the face including perioral, forehead, lateral face and ears. With malar erythema, nasolabial folds are often spared in dermatomyositis, which differs from systemic lupus erythematosus.

Image by Elizabeth M. Dugan, Adam M. Huber, Frederick W. Miller, Lisa G. Rider

2:01

What Are Autoimmune Diseases?

Autoimmune Association/YouTube

2:04

Autoimmune Diseases - Causes, Symptoms, Treatments & More…

Rehealthify/YouTube

Juvenile dermatomyositis

Elizabeth M. Dugan, Adam M. Huber, Frederick W. Miller, Lisa G. Rider

Symptoms

Dermatomyositis

Image by Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

Dermatomyositis

Dermatomyositis, Gottron's papules with telangiectasia. Gottron's papules with prominent atrophy, porcelain white scarring, and telangiectasia.

Image by Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

What Are the Signs and Symptoms of Inflammatory Myopathies?

General symptoms of chronic inflammatory myopathy include slow but progressive muscle weakness. Inflammation damages the muscle fibers, which causes weakness, and may affect the arteries and blood vessels that pass through muscle. Other symptoms include fatigue after walking or standing, frequent episodes of tripping or falling, and difficulty swallowing or breathing. Some individuals may have muscle pain or muscles that are tender to touch.

Polymyositis affects skeletal muscles (the type involved in body movement) on both sides of the body. It is rarely seen in persons younger than age 20. Generally, the onset occurs between age 30 and 60.

Signs and symptoms of polymyositis vary considerably from person to person, which can make it difficult to diagnose. Untreated progressive muscle weakness may lead to difficulty swallowing, speaking, rising from a sitting position, climbing stairs, lifting objects, or reaching overhead. Some people with polymyositis may also develop arthritis, shortness of breath, heart arrhythmias (irregular heartbeats), or congestive heart failure (when the heart is no longer able to pump out enough oxygen-rich blood).
Dermatomyositis is characterized by a skin rash that precedes or accompanies progressive muscle weakness. The rash appears patchy, with purple or red discolorations, and characteristically develops on the eyelids and on muscles used to extend or straighten joints, including knuckles, elbows, knees, and toes. Red rashes may also occur on the face, neck, shoulders, upper chest, back, and other locations. There may be swelling in the affected areas. The rash sometimes occurs without obvious muscle involvement and often becomes more evident with sun exposure.

Adults with dermatomyositis may experience weight loss or a low-grade fever, have inflamed lungs, and be sensitive to light. Adult dermatomyositis, unlike polymyositis, may accompany tumors of the breast, lung, female genitalia, or bowel. Children and adults with dermatomyositis may develop calcium deposits, which appear as hard bumps under the skin or in the muscle (called calcinosis). Calcinosis most often occurs one to three years after disease onset but may occur many years later. These deposits are seen more often in childhood dermatomyositis than in dermatomyositis that begins in adulthood.

In some cases of polymyositis and dermatomyositis, distal muscles, which are the muscles away from the center of the body, such as those in the forearms and around the ankles and wrists), may be affected as the disease progresses. Polymyositis and dermatomyositis may be associated with collagen-vascular or autoimmune diseases such as lupus. Polymyositis may also be associated with infectious disorders such as HIV, which causes AIDS.
Inclusion body myositis (IBM) is the most common form of inflammatory myopathy in people age 50 years and older and is characterized by slow, progressive muscle weakness and wasting over the course of months or years. IBM affects both proximal and distal muscles, typically in the thighs and forearms, and is often occurs on both sides of the body, although muscle weakness may affect only one side of the body. It also includes features of muscle degeneration with multi-protein aggregates (clumps) in the muscle that can contain toxins seen in Alzheimer’s disease and other neurodegenerative diseases.

Falling and tripping are usually the first noticeable symptoms. The disorder often begins with weakness in the wrists and fingers that causes difficulty with pinching, buttoning, and gripping objects. People may experience weakness in their wrist and finger muscles and atrophy (thinning or loss of muscle bulk) in their forearm muscles and quadriceps muscles in the thighs. Difficulty swallowing occurs in approximately half of IBM cases due to involvement of the throat muscles.

Symptoms of the disease usually begin after the age of 50, although the disease can occur earlier. Unlike polymyositis and dermatomyositis, IBM occurs more frequently in men than in women.

Necrotizing autoimmune myopathy (NAM) is a rare and relatively newly recognized subgroup of inflammatory myopathies. NAM can occur at any age but usually affects adults. Its symptoms are similar to polymyositis and dermatomyositis, with weakness in both the upper and lower body, difficulty rising from low chairs, climbing stairs, or lifting objects. However, the onset of these symptoms can be more severe and sudden, reaching their peak over a period of days or weeks. Other symptoms include fatigue, weight loss, and muscle pain.

NAM occurs alone or after viral infections, in association with cancer, in people with connective-tissue disorders such as scleroderma, or, rarely, in people taking cholesterol lowering medications (statins). Muscle weakness and pain may continue to worsen even after individuals stop taking the drugs.
Childhood inflammatory myopathies have some similarities to adult dermatomyositis and polymyositis. They typically affect children ages 2 to 15 years. Symptoms include proximal muscle weakness and inflammation, edema (an abnormal collection of fluids within body tissues that causes swelling), muscle pain, fatigue, skin rashes, abdominal pain, fever and contractures. Contractures result from shortening of muscles or tendons around joints, are caused by inflammation in the muscle tendons, and prevent the joints from moving freely.

Children with inflammatory myopathies may have difficulty swallowing and breathing. The heart may also be affected. Between 20 to 40 percent of children with juvenile dermatomyositis develop calcinosis, which can cause significant muscle weakness and pain, joint contracture, skin ulcers, and decreased muscle bulk.

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Additional Materials (5)

Inclusion Body Myositis (IBM) Signs & Symptoms : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Polymyositis Signs & Symptoms : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Dermatomyositis – Signs & Symptoms | Johns Hopkins

Video by Johns Hopkins Rheumatology/YouTube

Inclusion body myopathy - causes, symptoms, diagnosis, treatment, pathology

Video by Osmosis/YouTube

Dermatomyositis

Dermatomyositis, Linear extensor erythema. Intense erythema involving the anterior aspects of the thigh and tibia, with Gottron's sign over the knees, in a patient with juvenile dermatomyositis.

Image by Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

2:23

Inclusion Body Myositis (IBM) Signs & Symptoms : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

2:55

Polymyositis Signs & Symptoms : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

4:06

Dermatomyositis – Signs & Symptoms | Johns Hopkins

Johns Hopkins Rheumatology/YouTube

6:25

Inclusion body myopathy - causes, symptoms, diagnosis, treatment, pathology

Osmosis/YouTube

Dermatomyositis

Elizabeth M Dugan, Adam M Huber, Frederick W Miller, Lisa G Rider

Diagnosis

Needle EMG of paravertebral muscles(2J009)

Image by Kychot/Wikimedia

Needle EMG of paravertebral muscles(2J009)

The needle EMG of paravertebral muscles

Image by Kychot/Wikimedia

How Are the Inflammatory Myopathies Diagnosed?

Diagnosis is based on medical history, results of a physical examination that includes tests of muscle strength, and blood samples that show elevated levels of various muscle enzymes and autoantibodies. Diagnostic tools include:

electromyography to record the electrical activity generated by muscles during contraction and at rest
ultrasound to look for muscle inflammation
magnetic resonance imaging to reveal abnormal muscle anatomy.

A biopsy sample of muscle tissue should be examined for signs of chronic inflammation, muscle fiber death, vascular deformities, or other changes specific to the diagnosis of a particular type of inflammatory myopathy. A skin biopsy can show changes in the skin associated with dermatomyositis.

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Additional Materials (3)

Inclusion Body Myositis (IBM) Diagnosis : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Polymyositis Diagnosis : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Diagnostic Tests for Back Pain: Electromyography (EMG)

Video by AdventHealth Florida/YouTube

3:28

Inclusion Body Myositis (IBM) Diagnosis : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

2:09

Polymyositis Diagnosis : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

0:54

Diagnostic Tests for Back Pain: Electromyography (EMG)

AdventHealth Florida/YouTube

Electromyography (EMG) and Nerve Conduction Studies

Electromyography (EMG) and Nerve Conduction Studies

Also called: Electrodiagnostic study, Electrodiagnosis, EDX

Electromyography (EMG) and nerve conduction studies are tests that measure the electrical activity of muscles and nerves. They are used to find out if you have a disorder of your muscles, nerves, or both.

Electromyography (EMG) and Nerve Conduction Studies

Also called: Electrodiagnostic study, Electrodiagnosis, EDX

Electromyography (EMG) and nerve conduction studies are tests that measure the electrical activity of muscles and nerves. They are used to find out if you have a disorder of your muscles, nerves, or both.

Electromyography (EMG) and nerve conduction studies are tests that measure the electrical activity of muscles and nerves. Nerves send out electrical signals to make your muscles react in certain ways. As your muscles react, they give off these signals, which can then be measured.
- An EMG test looks at the electrical signals your muscles make when they are at rest and when they are being used.
- A nerve conduction study measures how fast and how well the body's electrical signals travel down your nerves.
EMG tests and nerve conduction studies can both help find out if you have a disorder of your muscles, nerves, or both. These tests can be done separately, but they are usually done at the same time.
You may need these tests if you have symptoms of a muscle or nerve disorder. These symptoms include:
- Muscle weakness
- Tingling or numbness in arms, legs, hands, feet, and/or face
- Muscle cramps, spasms, and/or twitching
- Paralysis of any muscles
For an EMG test:
- You will sit or lie down on a table or bed.
- Your provider will clean the skin over the muscle being tested.
- Your provider will place a needle electrode into the muscle. You may have slight pain or discomfort when the electrode is inserted.
- The machine will record the muscle activity while your muscle is at rest.
- Then you will be asked to tighten (contract) the muscle slowly and steadily.
- The electrode may be moved to record activity in different muscles.
- The electrical activity is recorded and shown on a video screen. The activity is displayed as wavy and spiky lines. The activity may also be recorded and sent to an audio speaker. You may hear popping sounds when you contract your muscle.
For a nerve conduction study:
- You will sit or lie down on a table or bed.
- Your provider will attach one or more electrodes to a certain nerve or nerves using tape or a paste. The electrodes, called stimulating electrodes, deliver a mild electrical pulse.
- Your provider will attach different types of electrodes to the muscle or muscles controlled by those nerves. These electrodes will record the responses to the electrical stimulation from the nerve.
- Your provider will send a small pulse of electricity through the stimulating electrodes to stimulate the nerve to send a signal to the muscle.
- This may cause a mild tingling feeling.
- Your provider will record the time it takes for your muscle to respond to the nerve signal.
- The speed of the response is called the conduction velocity.
If you are having both tests, the nerve conduction study will be done first.
If your results were not normal, it can indicate a variety of different conditions. Depending on which muscles or nerves are affected, it may mean one of the following:
- Carpal tunnel syndrome, a condition that affects nerves in the hand and arm. It's usually not serious, but can be painful.
- Herniated disc, a condition that happens when a part of your spine, called a disc, is damaged. This puts pressure on the spine, causing pain and numbness
- Guillain-Barré syndrome, an autoimmune disorder that affects the nerves. It can lead to numbness, tingling, and paralysis. Most people recover from the disorder after treatment
- Myasthenia gravis, a rare disorder that causes muscle fatigue and weakness.
- Muscular dystrophy, an inherited disease that seriously affects muscle structure and function.
- Charcot-Marie-Tooth disease, an inherited disorder that causes nerve damage, mostly in the arms and legs.
- Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. This is a progressive, ultimately fatal, disorder that attacks nerve cells in your brain and spinal cord. It affects all the muscles you use to move, speak, eat, and breathe.
If you have questions about your results, talk to your health care provider.

Additional Materials (7)

Schematic diagram of normal sinus rhythm for a human heart as seen on ECG.

Schematic representation of normal ECG trace (sinus rhythm) with waves, segments, and intervals labeled. The QT interval is marked by blue stripe at bottom.

Image by Created by Agateller (Anthony Atkielski), converted to svg by atom.

Limb leads

Limb leads, standard placement of the limb leads for electrocardiography.

Image by !Original: MoodyGrooveVector: Twisp This SVG diagram includes elements that have been taken or adapted from this diagram: Wikicouple.svg. /Wikimedia

Precordial leads in ECG

Placement of the precordial leads in electrocardiography.

Image by Mikael Häggström/Wikimedia

Limb leads of EKG

Derivation of the limb leads

Image by Npatchett/Wikimedia

Spatial orientation of EKG leads

Spatial orientation of EKG leads

Image by Npatchett

Animation of ECG Limb Leads and Electrical Conduction Through the Heart

This is a 30-frame animation of how the electrical conduction through the heart creates a normal ECG for all 3 limb leads.

Image by 10ebyu10e/Wikimedia

Willem Einthoven ECG

In contrast to what the name of this file may suggest, this picture does not represent the ECG machine built by Willem Einthoven and his team. It shows an early commercial ECG machine, built in 1911 by the Cambridge Scientific Instrument Company (Christoph Zywietz, A Brief History of Electrocardiography - Progress through Technology; S. L. Barron, The development of the electrocardiograph in Great Britain, British Medical Journal 1:720, 25 March 1950) to measure the human electrocardiogram according to the standards developed by Einthoven.

Image by /Wikimedia

Schematic diagram of normal sinus rhythm for a human heart as seen on ECG.

Created by Agateller (Anthony Atkielski), converted to svg by atom.

Limb leads

!Original: MoodyGrooveVector: Twisp This SVG diagram includes elements that have been taken or adapted from this diagram: Wikicouple.svg. /Wikimedia

Precordial leads in ECG

Mikael Häggström/Wikimedia

Limb leads of EKG

Npatchett/Wikimedia

Spatial orientation of EKG leads

Npatchett

Animation of ECG Limb Leads and Electrical Conduction Through the Heart

10ebyu10e/Wikimedia

Willem Einthoven ECG

/Wikimedia

Skin Biopsy

Skin Biopsy

Also called: Skin Lesion Biopsy

A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.

Skin Biopsy

Also called: Skin Lesion Biopsy

A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.

{"label":"Skin Biopsy Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"If your results are normal, it means no cancer or skin disease was found. If a skin lesion is benign (not cancer), you may not need any further treatment.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"Once the biopsy confirms the diagnosis, your provider will start a treatment plan.","conditions":["Bacterial or fungal infection","Psoriasis or dermatitis","Melanoma","Basal cell skin cancer","Squamous cell skin cancer"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
If your results are normal, it means no cancer or skin disease was found. If a skin lesion is benign (not cancer), you may not need any further treatment.
Related conditions
A skin biopsy is a procedure that removes a small sample of skin for testing. The procedure can help diagnose a skin lesion (an abnormal area of skin). The skin sample is looked at under a microscope to check for skin cancer, a variety of skin conditions, or skin infections. Only certain skin lesions need a biopsy. Your provider may be able to diagnose many types of lesions just by looking at them.
There are three main ways to do a skin biopsy. The type of biopsy you have depends on the location, size, and depth of the skin lesion:
- A shave biopsy removes a sample from the top layers of skin with a razor blade or scalpel (a small cutting blade used for surgery). Your provider will do a shave biopsy if your condition appears to involve only the top layers of skin.
- A punch biopsy uses a special tool with a round blade to remove the skin sample. Your provider will do a punch biopsy if your condition appears to involve the deep layers of skin.
- An excisional biopsy uses a scalpel to remove all of the skin lesion, usually with some normal skin around it. The sample may include the full thickness of the skin along with fat below the skin.
Most skin biopsies can be done in a health care provider's office or other outpatient facility.
A skin biopsy is used to help diagnose a variety of skin conditions including:
- Skin disorders such as psoriasis, eczema, actinic keratosis ("precancers"), and warts.
- Bacterial or fungal infections of the skin.
- Skin cancer. A biopsy can confirm or rule out whether a suspicious mole or other growth is cancer. If the result is cancer, the biopsy can show what type of skin cancer it is.
Skin cancer is the most common type of cancer in the United States. The two most common types of skin cancer are basal cell and squamous cell cancers. These cancers rarely spread to other parts of the body and can usually be cured with treatment. In many cases, the biopsy removes all the cancer, and no other treatment is needed.
The most serious type of skin cancer is melanoma. It's more likely than other skin cancers to spread to other parts of your body, including to your organs. Most deaths from skin cancer are caused by melanoma.
A skin biopsy can help diagnose skin cancer in the early stages, when it's easier to treat.
You may need a skin biopsy if you have certain skin symptoms, such as:
- A rash that doesn't go away
- Scaly or rough skin
- Open sores that won't heal
- A mole or skin growth that has changed in its shape, color, or size
- A mole or new growth that has the "A-B-C-D-Es" of melanoma:
  Asymmetrical - the shape is not regular
  Border - the edge is jagged
  Color - the color is uneven
  Diameter - the size is larger than a pea
  Evolving - the mole or growth has changed in the past few weeks or months
- Blistering skin, which may be a sign of pemphigus, an autoimmune disease
A provider will clean the site and give you an injection (shot) to numb your skin so you won't feel any pain.
For a punch biopsy:
- A provider uses a special tool with a hollow, round blade. The blade is placed over the abnormal skin area (lesion) and rotated to remove a small piece of skin about the size of a pencil eraser.
- The sample is lifted out with another tool.
- If a larger skin sample is taken, you may need one or two stitches to close the wound.
- Pressure will be applied to the wound until the bleeding stops.
- The wound will be covered with a bandage.
A punch biopsy is often used to diagnose rashes.
For a shave biopsy:
- A provider will use a razor or a scalpel to remove a sample from the top layer of your skin.
- To help stop the bleeding, pressure will be applied to the wound, or medicine may be spread over the wound.
- The wound will be covered with a bandage.
A shave biopsy is often used if your provider thinks you may have basal cell or squamous cell skin cancer or if you have a rash appears to affect only the top layer of your skin.
For an excisional biopsy:
- A doctor will use a scalpel to remove the entire skin lesion, usually with some normal skin around it called "a margin." If the skin lesion is large, your provider may remove only a piece of it. This is called an incisional biopsy.
- The doctor will close the wound with stitches.
- Pressure will be applied to wound until the bleeding stops.
- The wound will be covered with a bandage.
An excisional biopsy is often used if your provider thinks you may have melanoma, the most serious type of skin cancer. It may also be used for basal cell and squamous cell skin cancer.
After the biopsy, keep the area covered with a bandage until you've healed or until your stitches come out. If you had stitches, they will be taken out 3-14 days after the biopsy.
1. Skin Biopsy: MedlinePlus Lab Test Information [accessed on Oct 05, 2022]
2. Skin lesion biopsy: MedlinePlus Medical Encyclopedia [accessed on Dec 20, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (14)

Punch Biopsy

Empty pilar cyst removed from the scalp of a woman through a small punch biopsy hole through the scalp.

Image by Northerncedar (talk)

Hyperkeratosis

Low magnification micrograph of lichen simplex chronicus. Skin biopsy.

Image by Nephron

Lichen simplex chronicus

Very low magnification micrograph of lichen simplex chronicus, abbreviated LSC. H&E stain. Skin biopsy.Features:

Image by Nephron

Stevens-Johnson syndrome

Very high magnification micrograph of confluent epidermal necrosis. Skin biopsy. H&E stain.

Image by Nephron

Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.

Image by CDC/ Dr. Peter Drotman

Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.

Image by CDC/Dr. Peter Drotman

This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.

The dermis contains a dense cellular infiltrate, and narrow slit-like vascular spaces that are characteristic in these KS lesions. KS is a cancer that is common in those who’ve developed the human immunodeficiency virus (HIV), or an AIDS infection.

Image by CDC/ Dr. Steve Kraus

Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.

Note the thinning of the skin layers, most appreciably the dermis, which is reduced in thickness, and flattened due to the presence of a cellular subdermal infiltrate.

Image by CDC/ Dr. Steve Kraus

An illustration depicting the skin punch biopsy.

An illustration depicting the skin punch biopsy.

Image by BruceBlaus

Having a punch biopsy

Video by University Hospitals Birmingham NHS Foundation Trust/YouTube

Biopsy - What You Need To Know

Video by Rehealthify/YouTube

Study examines accuracy of melanoma biopsy findings

Video by UW Medicine/YouTube

What happens to your biopsy?

Video by Sunnybrook Hospital/YouTube

Skin Biopsy for Skin Cancer

Video by Dermatology Office of Dr. Ellen Turner/YouTube

Punch Biopsy

Northerncedar (talk)

Hyperkeratosis

Nephron

Lichen simplex chronicus

Nephron

Stevens-Johnson syndrome

Nephron

Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

CDC/ Dr. Peter Drotman

Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.

CDC/Dr. Peter Drotman

This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.

CDC/ Dr. Steve Kraus

Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.

CDC/ Dr. Steve Kraus

An illustration depicting the skin punch biopsy.

BruceBlaus

1:36

Having a punch biopsy

University Hospitals Birmingham NHS Foundation Trust/YouTube

0:47

Biopsy - What You Need To Know

Rehealthify/YouTube

3:13

Study examines accuracy of melanoma biopsy findings

UW Medicine/YouTube

3:26

What happens to your biopsy?

Sunnybrook Hospital/YouTube

0:26

Skin Biopsy for Skin Cancer

Dermatology Office of Dr. Ellen Turner/YouTube

Creatine Kinase Test

Creatine Kinase (CK) Blood Test

Also called: Creatine Kinase, Total CK, Creatine Phosphokinase, CPK

This test measures the amount of creatine kinase (CK) in a sample of your blood. CK is an enzyme that helps in producing energy from muscles. High CK levels may be a sign of damage or disease in your muscles, heart, or brain.

Creatine Kinase (CK) Blood Test

Also called: Creatine Kinase, Total CK, Creatine Phosphokinase, CPK

This test measures the amount of creatine kinase (CK) in a sample of your blood. CK is an enzyme that helps in producing energy from muscles. High CK levels may be a sign of damage or disease in your muscles, heart, or brain.

{"label":"Creatine kinase reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":24},"text":"Low CK levels often result from an individual having low muscle mass or body weight. People who have been confined to bed rest for extended periods of time will display abnormally low CK levels. A low CK level could be the result of alcoholic liver disease or a connective tissue disease.","conditions":["Alcoholic liver disease","Cachexia","Connective tissue disease","Kidney disease","Extreme weight loss","Lupus","Malnutrition","Myasthenia gravis","Muscular dystrophy","Rheumatoid arthritis","Sj\u00f6gren syndrome"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":24,"max":204},"text":"CK levels are a reflection of total muscle mass. The normal range for total CK varies by age and gender. Race is also known to affect CK levels. Black people have naturally higher levels of CK. Some people with a muscular build also have higher levels of CK. Women generally have lower CK levels than men, because they typically have less muscle mass. Additionally, a pregnant woman will display lower CK levels than a non-pregnant woman.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":204,"max":500},"text":"A high CK result generally means you have some type of muscle damage. High CK is found after trauma, surgery, and exercise. You may have more than one CK test to see if your levels go up or down. CK levels that stay high or increase may mean that muscle damage is continuing to happen. Further testing may be necessary to determine the type of muscles affected.","conditions":["Brain injury","Stroke","Heart attack","Seizures","Muscle disorder","Myopathy","Dermatomyositis","Polymyositis","Rhabdomyolysis","Electric shock","Myocarditis","Pulmonary infarction","Malignant hyperthermia","Hypothyroidism","Hyperthyroidism"]}],"units":[{"printSymbol":"U\/L","code":"U\/L","name":"enzyme unit per liter"}],"value":114,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
U/L
24
204
Your result is Normal.
CK levels are a reflection of total muscle mass. The normal range for total CK varies by age and gender. Race is also known to affect CK levels. Black people have naturally higher levels of CK. Some people with a muscular build also have higher levels of CK. Women generally have lower CK levels than men, because they typically have less muscle mass. Additionally, a pregnant woman will display lower CK levels than a non-pregnant woman.
Related conditions
A CK test is most often used to help diagnose and monitor:
- Muscle injuries, including injuries from accidents, serious burns, or extreme exercise.
- Muscle diseases, including:
  Muscular dystrophy, a group of inherited muscle diseases that weaken muscles over time.
  Rhabdomyolysis, or "rhabdo," a rapid breakdown of muscle tissue which releases proteins and electrolytes into the blood. This uncommon condition can damage the heart and lead to sudden kidney failure. Rhabdo has many causes, including serious injuries, working in very hot places, overusing muscles, and certain medicines and medical conditions that affect the muscles.
  Myositis, a group of rare diseases that involve long-term muscle inflammation (swelling), weakness, and sometimes pain.
In certain cases, a CK test may be used to help diagnose a heart attack. Another blood test, called a troponin test is used more often. That's because troponin testing is better at finding damage to the heart muscle from a heart attack.
If you've had a stroke, a CK test may be done to find out how severe it was. The test may also help predict the chance that you may have another stroke.
You may need a CK test if you have symptoms of a muscular disorder. These include:
- Muscle pain and/or cramps
- Muscle weakness
- Balance problems and/or falling a lot
- Numbness or tingling
- Dark colored urine (pee)
- Swollen legs or feet
You may also need this test if you:
- Have had an injury that crushed or tore your muscles
- Have had serious burns
- Take certain medicines that may cause muscle damage, such as statins to lower blood cholesterol
- Have had a stroke or traumatic brain injury (TBI)
Normal CK levels for you will depend on:
- Your age, sex, and race
- How much muscle you have
- How physically active you are
If your CK level is higher than normal, it usually means you have some type of muscle damage. CK levels may not reach their highest until up to two days after certain injuries. So, you may have more than one CK test to see if your levels go up or down. CK levels that stay high or increase may mean that muscle damage is continuing to happen.
But a CK test result can't show where the damage is or what's causing it. Your provider will consider your symptoms and medical history to understand what your test results mean.
If the source of high or increasing CK levels isn't clear, you may need a more specific type of CK test to find out if the CK is coming from your muscles, heart, or brain. This more specific test is called a CK isoenzymes test.
To diagnose the condition causing high CK levels, you may need other types of tests, too. The tests you have will depend on which types of CK enzymes are high as well as your symptoms and medical history.
If you have questions about any of your test results or diagnosis, talk with your provider.
1. Creatine Kinase: MedlinePlus Medical Test [accessed on Jan 27, 2024]
2. Creatine phosphokinase test: MedlinePlus Medical Encyclopedia [accessed on Jan 27, 2024]
3. Creatine Kinase (Blood) - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 27, 2024]
4. HealthMatters.io LLC. Creatine kinase - Lab Results explained | HealthMatters.io [accessed on Jan 27, 2024]
5. Creatine kinase (CK) Test - Bay Biosciences, LLC.. Oct 19, 2022 [accessed on Jan 27, 2024]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (16)

This browser does not support the video element.

Blockage Leads to Heart Attack

Risk factors increase the likelihood that you'll develop cardiovascular disease, and the more risk factors you have, the greater your chances of developing it. Fortunately, most of these risk factors are within your control, like high cholesterol and high blood pressure levels, being overweight, smoking, lack of exercise, overconsumption of alcohol, unmanaged diabetes, and stress. Factors you can't control include genetics and aging.

Video by TheVisualMD

This browser does not support the video element.

Women's Cardiovascular Health

Watch Dr. Mehmet Oz and other renowned cardiologists as they talk about this major killer, known in the medical world as a "myocardial infarction." Step inside the human body in a way that lets you completely understand what a heart attack is all bout, how and why they happen, what to do in the event of a heart attack, and how you can take steps to avoiding one.

Video by TheVisualMD

Heart attack (myocardial infarction) warning signs in women.

Image by U.S. Department of Health and Human Services Office on Women's Health

Myocardial Infarction (Heart Attack)

An illustration depicting a heart attack and chest pain.

Image by BruceBlaus

Myocardial infarction

Inferior wall infarction, short axis echocardiography view

Image by Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist

Myocardial infarction - Post-infarction ventricular septal defect

Post-infarction ventricular septal defect, short axis echocardiography view

Image by Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist

Myocardial infarction - Post-infarction ventricular septal defect

Post-infarction echocardiographic views of ventricular septal defect

Image by Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist

Heart Attack Symptoms

Symptoms of a heart attack are often more severe and longer-lasting than those of angina. Heart attacks can occur at any time or place, when you're resting or when you're in motion. Heart attacks can strike without warning, but there may be signs and symptoms, like angina, in advance.

Image by TheVisualMD

Heart Attack Symptoms

Symptoms of a heart attack are often more severe and longer-lasting than those of angina. Heart attacks can occur at any time or place, when you're resting or when you're in motion. Heart attacks can strike without warning, but there may be signs and symptoms, like angina, in advance.

Image by TheVisualMD

What Is a Heart Attack?

Sometimes the surface of a plaque in a coronary artery ruptures. The rupture releases substances that make platelets stickier, encouraging clots to form on the surface of the plaque. The clot can block the flow of blood through the already-narrowed artery entirely. Without blood, heart muscle tissue starts to die in what's termed a myocardial infarction- a heart attack.

Image by TheVisualMD

Lipoprotein (a) or Lp(a), Heart Attack

LDL, HDL and total cholesterol have become standard biomarkers for heart disease. And yet half of all people who suffer heart attacks have normal cholesterol levels. For that reason, researchers have looked for other biomarkers that might help identify people at risk for cardiovascular disease. Lp(a) is a lipoprotein that closely resembles LDL, and like LDL, elevated levels of Lp(a) are associated with a higher risk of heart disease. Unlike LDL, however, Lp(a) levels are believed to be largely genetic.

Image by TheVisualMD

Cholesterol, Low-Density Lipoprotein (LDL), Heart Disease, Heart Attack

There are two main types of cholesterol particles found in the bloodstream: HDL (high-density lipoprotein, or \"good\" cholesterol); and LDL (low-density lipoprotein, or \"bad\" cholesterol). LDL often leads to the formation of plaque deposits that can clog arteries and increase the risk of heart disease. Each year 1.2 million people have a heart attack (for nearly half of them, it's not their first). More than 600,000 individuals die from heart disease each year, making it the leading cause of death for both men and women.

Image by TheVisualMD

Heart Attack Caused by Ischemia

Thromboembolisms can cause heart attacks. A clot may lodge in one of the heart's coronary arteries (the arteries that supply the heart muscle tissue with blood) and block blood flow. The tissue becomes starved of oxygen (a condition called ischemia) and is damaged or dies.

Image by TheVisualMD

Lipoprotein (a) or Lp(a), Cardiovascular Disease

In order for fats to travel freely in the bloodstream, they must be packaged as lipoproteins. The two main types are HDL (high-density lipoprotein, or \"good\" cholesterol) and LDL (low-density lipoprotein, or \"bad\" cholesterol). There are other lipoproteins, however. Lipoprotein (a), or Lp(a), is one that resembles LDL and, like LDL, elevated levels of Lp(a) are associated with a higher risk of cardiovascular disease. Unlike LDL, however, Lp(a) levels are believed to be largely genetic.

Image by TheVisualMD

Heart attack (myocardial infarct) diagnosis | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

What causes a heart attack?

Video by multiedmedical/YouTube

0:23

Blockage Leads to Heart Attack

TheVisualMD

2:56

Women's Cardiovascular Health

TheVisualMD

Heart attack (myocardial infarction) warning signs in women.

U.S. Department of Health and Human Services Office on Women's Health

Myocardial Infarction (Heart Attack)

BruceBlaus

Myocardial infarction

Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist

Myocardial infarction - Post-infarction ventricular septal defect

Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist

Myocardial infarction - Post-infarction ventricular septal defect

Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist

Heart Attack Symptoms

TheVisualMD

Heart Attack Symptoms

TheVisualMD

What Is a Heart Attack?

TheVisualMD

Lipoprotein (a) or Lp(a), Heart Attack

TheVisualMD

Cholesterol, Low-Density Lipoprotein (LDL), Heart Disease, Heart Attack

TheVisualMD

Heart Attack Caused by Ischemia

TheVisualMD

Lipoprotein (a) or Lp(a), Cardiovascular Disease

TheVisualMD

10:45

Heart attack (myocardial infarct) diagnosis | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

2:54

What causes a heart attack?

multiedmedical/YouTube

Treatment

Prednisone: The Double-Edged Sword

Image by jsrcyclist

Prednisone: The Double-Edged Sword

It really is a wonder drug for my Crohn's Disease, however the side effects are truly horrific: en.wikipedia.org/wiki/Prednisone#Side-effects

Image by jsrcyclist

How Are Inflammatory Myopathies Treated?

Chronic inflammatory myopathies cannot be cured in most adults but many of the symptoms can be treated. Options include:

medication
physical therapy
exercise
heat therapy
orthotics and assistive devices
rest.

Dermatomyositis, polymyositis, and necrotizing autoimmune myopathy are first treated with high doses of corticosteroid drugs, such as prednisone. This is most often given as an oral medication but can be delivered intravenously.

Immunosuppressant drugs, such as azathioprine and methotrexate, may reduce inflammation in individuals who do not respond well to prednisone. Periodic treatment using intravenous immunoglobulin can increase the chance for recovery in individuals with dermatomyositis, polymyositis, or NAM. Other immunosuppressive agents that may treat the inflammation associated with dermatomyositis and polymyositis include cyclosporine A, cyclophosphamide, mycophenolate mofetil, and tacrolimus.

Injections of adrenocorticotropic hormone gel may be another option for people who do not respond to or cannot tolerate other drug treatment options. Biologic therapies such as rituximab or tumor necrosis factor (TNF) inhibitors such as infliximab or etanercept may be used in severe cases where other treatment options have failed. However, there are very few studies that have shown how well these agents treat polymyositis and dermatomyositis.

Physical therapy is usually recommended to prevent muscle atrophy as well as to maintain muscle strength and range of motion. Bed rest for an extended period of time should be avoided, as people may develop muscle atrophy, decreased muscle function, and joint contractures. A low-sodium diet may help to reduce edema (swelling) and cardiovascular (heart and blood vessel) complications.

Many individuals with dermatomyositis may need a topical ointment such as corticosteroids, tacrolimus, or pimecrolimus for their skin disorder. They should wear a high-protection sunscreen and protective clothing, particularly those who are light-sensitive. In rare instances, surgery may be required to remove calcium deposits that cause nerve pain and recurrent infections.

There is no standard, evidence-based course of treatment for inclusion body myositis. The disease is generally unresponsive to corticosteroids and immunosuppressive drugs. Some evidence suggests that immunosuppressive medications or intravenous immunoglobulin may have a slight, but short-lasting, beneficial effect in a small number of cases. Physical therapy may be helpful in maintaining mobility. Other therapy is symptomatic and supportive.

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Additional Materials (8)

Prednisone: Overview of Uses

Video by Drugs.com/YouTube

Inclusion Body Myositis (IBM) Treatment : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Inclusion Body Myositis (IBM) Lifestyle Options : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Myositis (Inflammatory Myopathy) Treatment

Video by Neurophysiology/YouTube

How important is physical therapy? - Essentia Health

Video by Essentia Health/YouTube

Myositis Care at Hospital for Special Surgery

Video by Hospital for Special Surgery/YouTube

Myositis & Neuromuscular Diseases | FAQ Treatment and Rehabilitation Options

Video by Johns Hopkins Medicine/YouTube

Polymyositis Treatment : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

2:11

Prednisone: Overview of Uses

Drugs.com/YouTube

3:03

Inclusion Body Myositis (IBM) Treatment : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

4:35

Inclusion Body Myositis (IBM) Lifestyle Options : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

9:48

Myositis (Inflammatory Myopathy) Treatment

Neurophysiology/YouTube

1:57

How important is physical therapy? - Essentia Health

Essentia Health/YouTube

5:50

Myositis Care at Hospital for Special Surgery

Hospital for Special Surgery/YouTube

4:06

Myositis & Neuromuscular Diseases | FAQ Treatment and Rehabilitation Options

Johns Hopkins Medicine/YouTube

5:43

Polymyositis Treatment : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

Prognosis

physical therapy

Image by Noun Project - https://thenounproject.com/icon/616 : Author undefined

physical therapy

Physical Therapy - The Noun Project icon from the Noun Project

Image by Noun Project - https://thenounproject.com/icon/616 : Author undefined

What Is the Prognosis for Inflammatory Myopathies?

In most cases, the symptoms of dermatomyositis resolve with therapy. The disease is usually more severe and resistant to therapy in individuals with heart problems. Approximately one-third of individuals with juvenile-onset dermatomyositis recover from their illness, one-third have a relapsing-remitting course of disease, and the other third have a more chronic course of illness.

The prognosis for polymyositis varies. Most individuals respond fairly well to therapy, but some people have a more severe disease that does not. These individuals may have significant disability. Since polymyositis can cause difficulty swallowing, people can become malnourished. They are also at increased risk for falling, which can lead to hip and other bone fractures, disability, or death. In rare cases people with severe and progressive muscle weakness can develop respiratory failure or pneumonia.

Although necrotizing autoimmune myopathy is more difficult to treat than polymyositis and dermatomyositis, it generally responds well to long-term combination immunosuppressive therapies.

IBM is generally resistant to all therapies and currently available treatments do little to slow its progression.

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Additional Materials (3)

Living with Polymyositis : Johns Hopkins Myositis Center

Video by Johns Hopkins Rheumatology/YouTube

Living well with Inflammatory Myopathies

Video by Mayo Clinic/YouTube

Dermatomyositis – Lifestyle Options | Johns Hopkins

Video by Johns Hopkins Rheumatology/YouTube

4:58

Living with Polymyositis : Johns Hopkins Myositis Center

Johns Hopkins Rheumatology/YouTube

5:55

Living well with Inflammatory Myopathies

Mayo Clinic/YouTube

2:39

Dermatomyositis – Lifestyle Options | Johns Hopkins

Johns Hopkins Rheumatology/YouTube

Research

DNA Genotyping and Sequencing

Image by National Cancer Institute (NCI) / Daniel Sone (photographer)

DNA Genotyping and Sequencing

A technician holds DNA samples that have been stored in a high-density format for automated handling at the Cancer Genomics Research Laboratory, part of the National Cancer Institute's Division of Cancer Epidemiology and Genetics (DCEG). See also https://dceg.cancer.gov/about/organization/programs-hgp/cgr.

Image by National Cancer Institute (NCI) / Daniel Sone (photographer)

What Research Is Being Done for Inflammatory Myopathies?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health, the leading supporter of biomedical research in the world.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is the primary funding institute for myositis and the inflammatory myopathies.

One challenge in treating inflammatory myopathies is that, for some individuals, there is little direct relationship between muscle inflammation and the degree of weakness and disability. While inflammation can be slowed or reversed, muscle weakness may not respond to treatments. NIH researchers are working to identify the causes of muscle weakness in order to discover effective treatments. In addition, researchers are working to develop objective, imaging-based methods for describing the muscle damage associated with inflammatory muscle disease.

Additionally, NIH-funded researchers are studying childhood-onset polymyositis and dermatomyositis to learn more about their causes, immune system changes throughout the course of the disease, and associated medical problems. For example, scientists are studying the role of genetics in the development of juvenile dermatomyositis. Researchers are examining the genetic differences between sets of twins in order to identify the relationship between genes and dermatomyositis that may lead to potential new treatment methods for the condition.

Currently, there are no therapies approved by the U.S. Food and Drug Administration for diagnosing inflammatory myopathies. NIH-funded researchers are looking for better, less invasive ways of diagnosing these disorders. For example, researchers are developing a non-invasive test that diagnoses IBM using circulating RNA molecules in the blood or urine. Researchers hope that this test will help clinicians identify individuals with IBM and assist them in monitoring their responses to clinical therapeutic trials.

Scientists are testing if the drug sodium thiosulfate can treat calcium buildup seen in people with juvenile and adult dermatomyositis. Other NIH-funded researchers are studying the genetic diversity disease susceptibility in the inflammatory myopathies. Researchers from the National Institute of Environmental Health Sciences (NIEHS) are evaluating possible contributing causes, including dietary supplements, tobacco smoke, and infectious agents. Other researchers are also investigating the impact of certain drugs on muscle inflammation. For example, NIH researchers are exploring the impact of autoimmune muscle disease triggered by statins.

More information about research on myositis and the inflammatory myopathies supported by NINDS and other NIH Institutes and Centers may be found using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other Federal agencies. RePORTER also includes links to publications and resources from these projects.

Source: National Institute of Neurological Disorders and Stroke (NINDS)

Additional Materials (1)

Dermatomyositis

Dermatomyositis, V-sign rash. Confluent macular erythema involving the face, the neck and extending to form a V-sign rash on the upper chest. Note the sparing in the submental area, a sun protected area. Photosensitivity is thought to play a role in dermatomyositis

Image by Elizabeth M. Dugan, Adam M. Huber, Frederick W. Miller, Lisa G. Rider/Wikimedia

Dermatomyositis

Elizabeth M. Dugan, Adam M. Huber, Frederick W. Miller, Lisa G. Rider/Wikimedia

Related HealthJournals

Muscle Disorders

Your muscles help you move and help your body work. Muscle disorders can cause weakness, pain or even paralysis. Read more about muscle disorders.

Dermatomyositis

Dermatomyositis is a rare condition that causes muscle inflammation and is characterized by muscle weakness and skin rash. It is one of a group of acquired muscle diseases called inflammatory myopathies (disorder of muscle tissue or muscles). Learn about symptoms, causes and treatment.

Polymyositis

Polymyositis is a type of inflammatory myopathy, which refers to a group of muscle diseases characterized by chronic muscle inflammation and weakness. The disease is more common among women and among black individuals. Learn about causes, symptoms and treatment options.

Autoimmune Diseases

Autoimmune diseases are a family of more than 80 chronic, and often disabling, illnesses that develop when underlying defects in the immune system lead the body to attack its own organs, tissues, and cells. There’s no cure for autoimmune diseases, but there are treatments to help manage their symptoms. Learn about the symptoms, tests, and treatments.

Inflammation

Inflammation is a normal part of the body's defense to injury or infection. Acute inflammation is characterized by redness, swelling, pain, and/or a feeling of heat in an area of the body. But, inflammation can be damaging when it occurs in healthy tissues or lasts too long, known as chronic inflammation. Learn more about inflammation and how it works.

Mixed Connective Tissue Disease

Mixed connective tissue disease (MCTD) is a rare autoimmune disorder that is characterized by features commonly seen in three different connective tissue disorders: systemic lupus erythematosus, scleroderma, and polymyositis.

Antisynthetase Syndrome

Antisynthetase syndrome is a chronic autoimmune disorder that can affect multiple systems of the body. It is a rare inflammatory myopathy (muscle disease) related to dermatomyositis and polymyositis.

Lupus

Lupus is a chronic, autoimmune disease that can damage any part of the body. Lupus is more common among women of childbearing age (ages 15 to 44 years). There is no cure, but treatments can help you feel better and improve your symptoms. Learn more about lupus symptoms and how to cope.

Women and Autoimmune Diseases

Many diseases of the immune system, also known as autoimmune diseases, are more common in women than in men. Some examples include multiple sclerosis, inflammatory bowel disease, and psoriasis. Learn about the different types of autoimmune diseases that affect women.

Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is a disorder that causes muscle pain and stiffness in your neck, shoulders and hips. Read about risk factors, symptoms, diagnosis, and treatment.

Share and discuss

Share your story, discuss an issue or get
advice from the community

Create conversation

Sign up here for full access to StoryMD

Get free access to in-depth articles and track your personal health.

Create Free Account Sign In

Share with others

Send this HealthJournal to your friends or across your social medias.

Inflammatory Myopathies

The inflammatory myopathies are a group of rare diseases that involve chronic (long-standing) muscle inflammation, muscle weakness, and in some cases, muscle pain. The four main types are polymyositis, dermatomyositis, inclusion body myositis, and necrotizing autoimmune myopathy. Learn about symptoms and treatment.

Copy Link