<prompt> Gottron sign seen inPolymyositisDermatomyositisPolymyositis Sjogrens syndromePolymyositis SLE  <response>: Dermatomyositis 760-CMDT-10, 2696-H 17th Gottron sign - scaly patches over of the dorsum of PIP and MCP joints are highly suggestive of dermatomyositisDERMATOMYOSITIS - the characteristic rash is dusky red and may appear in a malar distribution mimicking the classic rash of SLE Facial erythema beyond the malar distribution is also characteristic of dermatomyositis Shawls sign Periorbital edema and a purplish heliotrope suffusion over the eyelids are typical signs, periungual erythema, dilations of nailbed capillaries Bilateral proximal muscle weakness Increased risk of malignancy - in descending order of frequency are ovarian, lung, pancreatic, stomach, colorectal and NHL Biopsy of clinically involved muscle is the only specific diagnostic test A pathologic hall mark of dermatomyositis is perifascicular atrophy. In polymyositis - endomysical infiltration of the inflammatory infiltrate Various auto antibodies against nuclear antigens antinuclear antibodies and cytoplasmic antigens are found in upto 20 of patients with inflammatory myopathies Glucocorticoids: oral prednisone is the initial treatment of choice Myositis may also be associated with other connective tissue diseases especially - Scleroderma, lupus, mixed connective tissue disease and Sjogren syndrome, overlap syndrome Antisvnthetase syndrome - polymyositis and dermatomyositis develops- inflammatory arthritis, Raynaud phenomenon, interstitial lung disease, auto antibodies eg anti Jo I antibodies Most common myositis-specific antibody -anti Jo-I antibody ILD Anti Mi-2 associated with dermatomyositis Anti SRP anti- signal recognition particle associated with polymyositisPolymyositis can occur as a complication of HIV or HTLV-1 infection and with zidovudine therapy as well Anti-endomysial antibody - Celiac sprue Anti mitochondrial antibody - Primary biliary cirrhosis Anti-smooth muscle antibody - Auto immune hepatitis Anti centromere antibody - CREST syndrome limited scleroderma Histidyl-t-RNA antibody - Inflammatory myopathy Anti DNA topoisomerase antibody Scl-70- Systemic sclerosis Antibodies of ribonucleoprotein antigen containing ULRNP- Mixed connective tissue disease SSbLa SSbLaAntibodies to ribo nucleoprotein antigen- Sjogren syndrome 