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Dermatomyositis — SCE Dermatology MCQ

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HardConnective Tissue & VasculitisDermatomyositisSCE Dermatology

A 56-year-old woman with dermatomyositis develops progressive dysphagia to both solids and liquids. Barium swallow shows oesophageal dysmotility affecting the proximal oesophagus. Which muscle group does proximal oesophageal dysphagia in DM reflect involvement of?

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Correct answer: C — Striated (skeletal) muscle of the pharynx and proximal oesophagus

The best answer is “Striated (skeletal) muscle of the pharynx and proximal oesophagus”. Dermatomyositis combines characteristic cutaneous signs with inflammatory myopathy; antibody phenotype helps estimate malignancy and interstitial-lung-disease risk but must be interpreted with the clinical picture. The alternatives “Laryngeal muscles, within an appropriate UK pathway”, “Oesophageal sphincter alone, after clinicopathological correlation, after specialist assessment”, “Smooth muscle of the distal oesophagus, after specialist assessment”, “Cardiac muscle, when the full phenotype supports it” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: BAD dermatomyositis information: https://www.bad.org.uk/pils/dermatomyositis