Necrotizing myopathy with pipestem capillaries and minimal cellular infiltration: A case associated with cutaneous signs of dermatomyositis

In 1991, Emslie-Smith and Engel described a distinct form of idiopathic inflammatory myopathy they called ''necrotizing myopathy with pipestem capillaries, microvascular deposition of the complement membrane attack complex (MAC) and minimal cellular infiltration.'' We describe a patient with exercise-dependent painful myopathy related to a necrotizing myopathy with pipestem capillaries in whom mild cutaneous signs of dermatomyositis were detected 7 years after onset and who subsequently developed multiple cerebral infarcts.