Subcutaneous edema: an "unrecognized" feature of acute polymyositis

The case of a man with acute onset of muscle pain, weakness, anasarca, severe dysphagia and dysphonia, and biochemical, electromyographic and histologic evidence of polymyositis is presented. The literature on the occurrence of subcutaneous edema in polymyositis was reviewed. It is concluded that this particular symptom, with no other apparent cause, including heart failure from the underlying disease, is a rare but definite feature of polymyositis itself. A correlation of that with severe bulbar muscle involvement is also suggested.