When Every Movement and Even Laughter Becomes Agony

The clinical care of patients with muscular weakness/inflammation and concurrent skin changes in the form of dermatomyositis has seen significant advancements in the last decade. On one hand, overlapping phenomena with systemic lupus erythematosus, scleroderma, and interferonopathies are increasingly being analyzed based on molecular pathophysiology. On the other hand, serological diagnostics based on dermatomyositis-/myositis-specific autoantibodies have become significantly more specific. They even include a prognostic assessment regarding the course and severity of the disease. Special manifestations with pulmonary involvement or particularly pronounced calcifications of muscles and connective tissue structures have been clinically described in much greater detail. Using the example of a young woman, we aim to illustrate this tension field of positioning dermatomyositis within various systemic autoimmune diseases, also based on classification and laboratory chemical autoantibody patterns. Previous conventional therapy strategies, as well as modern pathophysiology-based biologics, are explained.