Open Access

Table I

Cutaneous manifestations of dermatomyositis.

Signs Description
Heliotrope rash
Shawl sign
Psoriasiform scaly plaques of the scalp
Periungual telangiectasia
Red to violet poikilodermatous periorbital eruption with oedema. Figure 1A
Rash on the back and shoulders. Figure 1B
Rash on the anterior chest
Gottron's papule
Gottron's Sign
A raised violaceous rash at the knuckles of the hands, including the metatarsophalangeal and interphalangeal joints. Figure 1C
Erythematous or violaceous macules and patches overlying the extensor tendons of extremities, including over the elbows and knees.
Holster sign
Periorbital edema without skin colour change
Facial swelling
Combined hyper and hypopigmentation, telangiectasia, and superficial atrophy in the photoexposed skin on the upper portions of the chest and extensor surfaces of the arms
Lateral aspects of the hips and upper thighs with macular, violaceous erythema
Dystrophic calcinosis cutis
Cutaneous small vessel vasculitis
Specific for JDM, seen in 70% cases, superficial or flesh coloured to white papules and nodules found on bony surfaces and potential inflammatory sites
Includes petechial macules, purpura, urticaria, livedo reticularis, and skin or oral ulceration
Mechanic's hands
Follicular hyperkeratosis (Wong type DM), Erythema flagellatum, Panniculitis, Mucinosis, Erythroderma and oral mucosal changes
Hyperkeratotic, scaly plaques on the radial and ulnar aspects of the thumb, index, and third fingers
Inverse Gottron's papules
Digital pulp ulcerations
Sleeve sign
White, atrophic or triangular hyperkeratotic palmar creases of the knuckles
Due to underlying vasculitis/vasculopathy
Lateral aspects of the upper arms with violaceous, macular erythema
Raynaud's phenomenon

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