Paradigm shift in the classification of idiopathic inflammatory myopathies

      For decades there has been a controversy about the classification of idiopathic inflammatory myopathies (IIMs). In 1975, Bohan and Peter were the first to establish diagnostic criteria for polymyositis (PM) and dermatomyositis (DM) in which the distinction between DM and PM was solely based on the presence or absence of typical skin abnormalities. In the 1980s based on elegant studies by Engel and Arahata a histopathological classification was introduced in which both PM and inclusion body myositis (IBM) were characterized by non-necrotic muscle fibers invaded by cytotoxic T-lymphocytes and in the latter the presence of rimmed vacuoles was required.
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