Dermatomyositis - Gallery

Gallery

• Gottron's papules. Discrete erythematous papules overlying the metacarpal and interphalangeal joints in a patient with juvenile dermatomyositis.

• Gottron's papules. Erythematous to violaceous raised papules overlying the metacarpal and interphalangeal joints in a patient with juvenile dermatomyositis.

• Gottron's papules. Characteristic raised erythematous papule overlying the proximal interphalangeal joint in a patient with dermatomyositis.

• Gottron's papules. Erythematous plaques overlying the elbows in a patient with juvenile dermatomyositis. In some patients, small erythematous plaques may overly the extensor aspects of larger joints, such as the elbows, knees, and medial malleoli. This is considered to be an extended part of the spectrum of Gottron's papules.

• Gottron's papules. Erythematous plaques overlying the elbows in a patient with juvenile dermatomyositis. In some patients, small erythematous plaques may overly the extensor aspects of larger joints, such as the elbows, knees, and medial malleoli. This is considered to be an extended part of the spectrum of Gottron's papules. Note in Figure, a focal area of dystrophic calcification at the site of Gottron's papules, which is indicative of damage, as discussed below.

• Gottron's papules with telangiectasia. Gottron's papules with prominent atrophy, porcelain white scarring, and telangiectasia.

• Gottron's sign. Confluent macular erythema with scale confined to the skin overlying the patellae in a girl with juvenile dermatomyositis.

• Gottron's papules showing secondary atrophy and telangiectasia in a girl with severe juvenile dermatomyositis. These changes are seen in association with prominent periungual erythema, a cutaneous finding indicative of ongoing disease activity.

• Heliotrope. Confluent macular erythema confined to the upper eyelid, with associated periorbital edema.

• Heliotrope. In patients who have darker skin types (type III - VI skin), heliotrope can be subtle and perceived as inactive or normal, resulting in under-diagnosis in this presenting sign of dermatomyositis.

• Heliotrope is often associated with periorbital edema and telangiectasias of the upper eyelids. In the resolution stage, atrophy or dyspigmentation (hypo- or hyperpigmentation) may be apparent. Heliotrope. Subtle erythema and minimal edema involving both upper eyelids, with extension to the lower eyelids.

• Malar and facial erythema. Acute onset of confluent macular erythema in a periorbital and malar distribution with extension to the chin in a girl with juvenile dermatomyositis. Note the perioral sparing.

• Malar and facial erythema. Striking malar and facial erythema with facial edema and scale represents a recent disease flare in an adult patient with dermatomyositis.

• Linear extensor erythema. Confluent erythema of the skin overlying the interphalangeal and extensor tendons of the hand, with extension to the forearm in a patient with dermatomyositis

• Linear extensor erythema involving the forearm. This image demonstrates linear violaceous discrete and confluent macules, and erosions secondary to excoriation. Pruritus is an under-recognized symptom of active dermatomyositis.