1. Figure 2 Clinical and histological features of the skin in dermatomyositis and conditions that mimic dermatomyositis
Figure 2 | Clinical and histological features of the skin in dermatomyositis and conditions that mimic dermatomyositis. Cutaneous clinical manifestations of dermatomyositis include Gottron sign, presenting as erythema over areas that experience stretching, including the elbows (part a), the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints (part b) and the knees (part c); the presence of heliotrope erythema on the eyelids (part d); poikiloderma, including hyperpigmentation distributed on the upper back, referred to as a ‘shawl sign’ (indicated by arrows; part e); and Gottron papules, presenting as erythematous papules over joints on the hands (indicated by arrows; part f). One histological feature of dermatomyositis is interface dermatitis of the skin, which presents as lichenoid inflammation at the dermal–epidermal junction, vacuolar changes in the epidermis and perivascular inflammation (part g). Various skin conditions can mimic dermatomyositis, including eczema, in which patients present with erythema over joints on hands that show spongiotic changes consistent with hand dermatitis but not dermatomyositis.
Lundberg, I. E. et al. (2018) Classification of myositis
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