The five types of myositis are:

1. dermatomyositis,
2. inclusion-body myositis,
3. juvenile myositis,
4. polymyositis (polio),
5. toxic myositis.

Dermatomyositis

Dermatomyositis (DM) is the easiest form of myositis to diagnose due to the purple-red rashes in the shape of the heliotrope flower. The rash develops on the eyelids, face, chest, neck, and back. It also develops over joints such as knuckles, elbows, knees and toes. Muscle weakness normally follows.

Dermatomyositis (DM) is a primary type of Idiopathic Inflammatory Myopathy (IIM), a group of rare autoimmune disorders characterized by muscle inflammation (myositis) and, in the case of DM, distinct skin rashes. It is a systemic condition that causes proximal muscle weakness, fatigue, and can affect the lungs and heart. 

Dermatomyositis is an IIM but has additional symptoms that affect the skin. Children and adults can have this condition.

A doctor can determine the type of IIM through blood tests, imaging scans, and a muscle biopsy. Up to 6 percent of people with dermatomyositis do not have symptoms on their skin.

Skin symptoms of dermatomyositis

Some of the symptoms found on the skin include:

• small, tender bumps on the knuckles,
• swollen rash that is blue or purple in color,
• skin redness that may turn scaly,
• thickened or altered cuticles,
• cracked skin around the fingers.

These symptoms can be triggered by the sun and can be itchy. 

Other symptoms of DM

Other symptoms of DM include:

• scaly, dry, or rough skin,
• Gottron’s papules or Gottron’s sign (bumps found over the knuckles, elbows, and knees, often with a raised, scaly breakout),
• trouble rising from a seated position,
• fatigue,
• weakness in the neck, hip, back, and shoulder muscles,
• difficulty swallowing,
• hoarseness in the voice,
• hardened lumps of calcium under the skin,
• muscle pain,
• joint inflammation,
• nail-bed abnormalities,
• weight loss,
• irregular heartbeat,
• gastrointestinal ulcers.

Inclusion-body myositis

Inclusion-body myositis (IBM) is the only myositis which occurs more commonly in men than in women. Most people who develop this condition are over the age of 50. IBM begins with muscle weakness in the wrists and fingers and also in the thigh muscles. The muscle weakness is more prominent in smaller muscles and is asymmetrical, with one side of the body affected more than the other.

Symptoms of IBM include:

• difficulty walking,
• tripping and loss of balance and frequent falls,
• trouble rising from a seated position,
• weakened hand grip and diminished hand and finger dexterity,
• difficulty swallowing,
• muscle weakness,
• muscle pain,
• diminished deep tendon reflexes.

Juvenile myositis

Juvenile myositis (JM) occurs in children under 18. Girls are twice as likely to develop JM than boys. Similar to the other forms of myositis, JM is characterized by muscle weakness and skin rashes. 

Symptoms of JM include:

• visible, reddish-purple rash over the eyelids or joints, sometimes in the shape of the heliotrope flower,
• fatigue,
• moodiness or irritability,
• stomachaches,
• motor function difficulties, such as trouble climbing stairs, standing from a seated position, and getting dressed,
• difficulty reaching overhead, as when shampooing or combing hair,
• trouble lifting the head,
• swelling or redness of the skin around the fingernails,
• trouble swallowing,
• hardened lumps of calcium under the skin,
• muscle weakness,
• muscle and joint pain,
• hoarse-sounding voice,
• Gottron’s papules (bumps found over the knuckles, elbows, and knees),
• fever.

Polymyositis

Polymyositis is a rare condition that affects our muscles. It begins by inflaming and weakening the muscles near our abdomen and can move to other muscles as it progresses. It occurs mostly in adults in midlife (from 31 to 60) and is more frequently reported by women.

Polymyositis is a type of idiopathic inflammatory myopathy (IIM). These are considered systematic autoimmune disorders, and they affect our skeletal muscles.

With allopathic drug, polymyositis cannot be cured, but managed – patient may have no symptoms. It’s a rare condition that is currently curable only with Homeopathy.

Symptoms of PM include:

• muscle weakness,
• muscle pain,
• difficulty swallowing,
• falling,
• trouble rising from a seated position,
• fatigue,
• chronic dry cough,
• thickening of the skin on the hands,
• difficulty breathing,
• fever,
• weight loss,
• hoarse voice.

Weakness, pain, or tenderness may occur first in the muscles attached to the abdomen and move to other muscle groups, including: 

• neck,
• shoulders,
• back,
• upper arms,
• hips,
• thighs.

Toxic myositis

Toxic myositis is thought to be caused by some prescribed allopathic medications and illicit drugs. Cholesterol-lowering medications such as statins may be among the most common drugs to cause this condition. Other medications and substances that may cause myositis include:

• immunosuppressants,
• omeprazole,
• adalimumab,
• cocaine,
• toluene (a solvent used in paint thinners that is sometimes used illicitly) etc.

Symptoms of toxic myositis are similar to those of other types of myositis. People who experience this condition typically see improvement once they stop the allopathic medication that caused the toxicity.

Experts differ in their opinions as to the exact cause of myositis. Myositis is thought to be an autoimmune condition that causes the body to attack the muscles. Most cases don’t have a known cause. However, my (Dr. Qaisar Ahmed) opinion is that myositis could be the result of worms/parasites living in our muscles, joints, lungs, heart etc.

Some researchers believe that myositis may also be caused by:

• autoimmune diseases such as rheumatoid arthritis and lupus
• viruses such as the common cold, flu, and HIV
• allopathic drug toxicity.