IFIH1 and myositis disease: These do not find a mention in previous reports from India.5,6,10 The largest report of anti-MDA5 positive patients till date referred to 121 patients from France reported three phenotypic clusters: one with RPILD and poor prognosis(18%), another with skin and rheumatic manifestations and a good prognosis (55%) and a third with severe myositis and cutaneous vasculopathy(26%).15 We had two clusters, skin and rheumatic manifestation being commoner (77%) compared to the RPILD phenotype (16%).Digital necrosis has been used to define one of three clusters.