Keratodermia blenorrhagica, arthritis, and polymyositis with cardiopulmonary complications

A patient is described who had polymyositis with arthritis, keratodermia blenorrhagica, pulmonary fibrosis, and cardiac failure with a right bundle branch block. The cutaneous lesions on his palms and soles, considered to be specific for Reiter's syndrome, pointed to an overlapping of polymyositis with features of this syndrome. Findings typical of myositis were present. In addition a muscle biopsy showed sarcolemmal and endomysial deposits of IgG and IgM, and the serum level of IgM was elevated. Because skin lesions appeared at the height of symptoms in other organs, the possibility is raised that both might stem from a common immune process.