Environmental triggers for idiopathic inflammatory myopathies: unravelling the known and unknown

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of rare connective tissues diseases that usually share the common feature of immune-mediated muscle or lung injury. Whereas their pathogenesis is widely recognised as multifactorial, the specific triggers initiating their onset remain largely elusive. Factors such as infections, inhalants, or geoclimatic variables are implicated, yet due to the limitations inherent in studies involving small and non-homogeneous cohorts, findings often appear fragmented and inconclusive. This review endeavours to present the most updated evidence regarding the influence of environmental factors in determining the onset of IIM, with the aim of offering insight to optimise the routinary management of affected patients.