q@1 - sk8432

[ArchivalUser]

Thanks everyone for discussion...

Mechanic hand is seen in dermatomyositis ...May be in polymyositis too but why answer is poly and not dermatomyosotis...Even wiki says dermatomyositis

@sk if the question has come with explaination please post it

http://images.rheumatology.org/viewphoto...Id=3011225

[ArchivalUser]

Sallu you are right. It is seen in both DM and PM.

[ArchivalUser]

But the main clinical picture of muscle involvement here reflects that of Polymyositis rather than Dermatomyositis. I believe that is why the answer here would be polymyositis.

[ArchivalUser]

Hi Psych..Both involves Proximal muscle weakness so what differs??..thanks

[ArchivalUser]

Yes, but in PM it is mostly the muscles that are involved. Usually there is no skin rash or all the other changes you can see in DM, like Gottron's papules, Raynaud's phenomenon, etc. Also, about one-third of patients only experience pain.

Now, DM affects muscles, and skin, and may also affect the joints, lungs, heart, and esophagus.
So there would be symptoms arising form many or all of those systems if the patient is to be diagnosed with DM.

[ArchivalUser]

Dermatomyositis--> Antibody mediated. They have more skin involvement

Polymyositis---> T cell mediated. More organ involvement like arrythmia, shortness of breath etc.
Thanks

[ArchivalUser]

Hi psychmledr
Didnt see your comment. Agree with you

[ArchivalUser]

Right. That's what Goljan says too.

[ArchivalUser]

Hi medicus. You mentioned a good point

[ArchivalUser]

So confusing guys..
@Psych in Poly one third of patients are associated with pain but here in Qs says no pain...

@Medicus agree Goli says Tcell and Ab mediated but there is no direct corelation with symptoms i guess...

If this Q comes for me in exam..My answer would be like lottery guess lol

Thanks for discussion >>