Pravastatin-Associated Inflammatory Myopathy

To the Editor: It has been reported that lovastatin, a potent 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, can cause a toxic, noninflammatory myopathy. 1 , 2 We describe a 66-year-old woman treated for five months with pravastatin (10 mg per day), a HMG-CoA reductase inhibitor different from lovastatin, in whom a syndrome resembling dermatomyositis developed over a period of five weeks. She was admitted with severe subacute proximal-muscle weakness in the upper limbs and had prominent bullous erythematous skin lesions on her face, neck, shoulder, chest, and arms. The serum creatine kinase level was elevated (>4000 U per liter), a muscle biopsy revealed . . .