Poor esophageal motility, dilatation and barium retention in the pyriform fossa are the digestive symptoms of dermatomyositis and polymyositis. dermatomyositis (DM) and polymyositis (PM) are currently considered to belong to the category of autoimmune diseases. dm presents as diffuse inflammation of the skin and muscles, with erythema and edema of the skin and muscle weakness, pain and swelling, Pain and swelling, which may be accompanied by arthralgia and multiple organ damage such as lung and heart muscle. Examination of poorly dilated esophageal peristalsis and barium retention in the pyriform fossa: Skin and muscle are the two main groups of symptoms, with skin often preceding muscle onset by weeks to years, or with myositis or simultaneous onset of muscle and skin. Skin and muscle symptoms are often not parallel and can be very severe in one and mild in the other. In individual cases, the first organ to show symptoms may not be the skin or muscle, but the heart, lungs, or pleura, manifesting as pericardial tamponade, pulmonary fibrosis, or pleurisy. Skin symptoms: Typical lesions are edematous purplish spots on both upper eyelids, spreading to the periorbital area and gradually expanding to the face, neck, and upper chest V-zone (Figures 1 to 3). The purplish papules on the extremities of the elbows and knees, especially on the extensor side of the metacarpophalangeal and interphalangeal joints, are accompanied by dilated capillaries, hypopigmentation and covered with fine scales, called Gottron’s sign or Grottron’s papules. Edematous purplish macules on the upper eyelid and Gottron’s sign are important for the diagnosis of DM, especially the former, which appears earliest and is significant for early diagnosis. Other types of skin lesions in DM include heterochromia, erythroderma, cutaneous vasculitis, urticaria, and calcium deposits. There is an increased likelihood of the presence of cutaneous heterochromatosis with malignancy. Cutaneous vasculitis and cutaneous calcium deposits occur mostly in JDM, and those with cutaneous vasculitis are prone to have systemic vasculitis at the same time, often with severe symptoms and poor prognosis when not treated properly. Those with cutaneous calcium deposits tend to have mild damage to important organs and a better prognosis, but there have been reports of extensive calcium deposits in the abdominal wall causing acute abdomen and intra-abdominal hemorrhage. Rarely occurring types of lesions include patchy cutaneous mucin deposits with blistering or maculopapular lesions. Mucin deposits tend to occur in middle-aged and older female patients and can be the first symptom of DM. The prognosis for blistering or maculopathy is poor. Muscle symptoms: Involvement of transverse muscles, but skeletal muscle involvement is much more common than cardiac muscle. Smooth muscles are rarely involved. The proximal muscles of the extremities are most susceptible, such as the deltoid and quadriceps. The onset is mostly symmetrical. The diseased muscles have symptoms such as weakness and pain, and show corresponding motor deficits, such as difficulty in raising the upper limbs, inability to lift the lower limbs and inability to stand up after squatting. In more severe cases, head lifting is difficult and turning over is not possible, showing the involvement of the neck and trunk muscles. In severe cases, the limbs could not be moved in bed or could only move a few centimeters, and even minor muscle contractions could not be seen. The involvement of esophageal and pharyngeal muscles may cause difficulty in swallowing, coughing and choking, and change in pronunciation. Shortness of breath and dyspnea may occur with respiratory muscle involvement. The eye muscles may be involved with diplopia. In a few patients, there may be no myalgia but only muscle weakness.