Diagnosis: Dermatomyositis (Gottron papules)
Slightly elevated, violaceous papules and plaques with slight scales are found over the metacarpophalangeal joints, the proximal interphalangeal joints, andthe distal interphalangeal joints.
Slightly elevated, violaceous papules and plaques with slight scales are found over the metacarpophalangeal joints, the proximal interphalangeal joints, andthe distal interphalangeal joints.
Submitted by Alaa Saad. Originally posted September 11, 2010.
See case discussion.
• Systemic lupus erythematosus • Polymyositis • Contact dermatitis • Seborrheic dermatitis • Psoriasis • Drug eruption • Photosensitive eruption • Trichinosis
• Classic cutaneous findings: heliotrope rash (violaceous periorbital erythema), Gottron papules (over MCPs/IPs/knees/elbows), V-sign, shawl sign • Gottron papules are pathognomonic for dermatomyositis • Adult dermatomyositis has significant malignancy association (~15-30%) — cancer screening essential • Myositis-specific antibodies: anti-Mi-2, anti-MDA5 (amyopathic DM with ILD risk), anti-TIF1-gamma (cancer association) • Amyopathic DM: skin disease without muscle involvement for ≥6 months • Anti-MDA5 DM associated with rapidly progressive interstitial lung disease • Nailfold capillaroscopy shows dilated, tortuous capillary loops with dropout
Tags: dermatomyositis, gottron, papules, alaa saad