Polymyositis

Presents with weakness in the large muscles that spares the small muscles. About a third of patients have a rash (dermatomyositis) – the one I always remember is the blue-purple discolouration on the eyelids, but it can also prseent as a flat red rash on the face & upper trunk or as raised purple-red scaly patches on the knuckles.

Check muscle enzymes – CK, LDH, transaminases, aldolase (whatever that is). Muscle biopsy confirms the diagnosis. Diagnose early, as delay in starting treatment leads to further muscle deterioration and reduced chance recovery.

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About Dr Sarah

I'm a GP with a husband and two young children.
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