Skip to main content

Clinical Features of Myositis: Skin Manifestations

  • Chapter
  • First Online:
Book cover Managing Myositis

Abstract

Dermatomyositis is distinctive among the family of idiopathic inflammatory myopathies as patients display a characteristic set of skin manifestations. The cutaneous findings, which can be subdivided into active lesions or those resulting from scarring, occur in particular anatomic distributions. In this chapter, the skin manifestations of dermatomyositis are discussed including facial erythema, “heliotrope” rash, “V sign,” “shawl sign,” “Gottron’s papules,” “Gottron’s sign,” “holster sign,” “mechanic’s hands,” “ragged” cuticles with nailfold changes, and calcinosis cutis. This chapter will also highlight the prevalence of these findings within the various myositis subtypes. An understanding of the protean cutaneous features of dermatomyositis is essential to accurately diagnose and treat this autoimmune disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Armadans-Tremolosa I, Selva-O'Callaghan A, Visauta-Vinacua B, Guilera G, Pinal-Fernandez I, Vilardell-Tarres M. Health-related quality of life and Well-being in adults with idiopathic inflammatory myopathy. Clin Rheumatol. 2014;33(8):1119–25.

    Article  Google Scholar 

  2. Hundley JL, Carroll CL, Lang W, Snively B, Yosipovitch G, Feldman SR, et al. Cutaneous symptoms of dermatomyositis significantly impact patients' quality of life. J Am Acad Dermatol. 2006;54(2):217–20.

    Article  Google Scholar 

  3. Goreshi R, Chock M, Foering K, Feng R, Okawa J, Rose M, et al. Quality of life in dermatomyositis. J Am Acad Dermatol. 2011;65(6):1107–16.

    Article  Google Scholar 

  4. Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292(7):344–7.

    Article  CAS  Google Scholar 

  5. Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med. 1975;292(8):403–7.

    Article  CAS  Google Scholar 

  6. Uribe L, Ronderos DM, Diaz MC, Gutierrez JM, Mallarino C, Fernandez-Avila DG. Antisynthetase antibody syndrome: case report and review of the literature. Clin Rheumatol. 2013;32(5):715–9.

    Article  Google Scholar 

  7. Christen-Zaech S, Seshadri R, Sundberg J, Paller AS, Pachman LM. Persistent association of nailfold capillaroscopy changes and skin involvement over thirty-six months with duration of untreated disease in patients with juvenile dermatomyositis. Arthritis Rheum. 2008;58(2):571–6.

    Article  Google Scholar 

  8. Ponyi A, Constantin T, Garami M, Andras C, Tallai B, Vancsa A, et al. Cancer-associated myositis: clinical features and prognostic signs. Ann N Y Acad Sci. 2005;1051:64–71.

    Article  Google Scholar 

  9. Mautner GH, Grossman ME, Silvers DN, Rabinowitz A, Mowad CM, Johnson BL Jr. Epidermal necrosis as a predictive sign of malignancy in adult dermatomyositis. Cutis. 1998;61(4):190–4.

    CAS  PubMed  Google Scholar 

  10. Mahe E, Descamps V, Burnouf M, Crickx B. A helpful clinical sign predictive of cancer in adult dermatomyositis: cutaneous necrosis. Arch Dermatol. 2003;139(4):539.

    PubMed  Google Scholar 

  11. Shimizu M, Ueno K, Ishikawa S, Yokoyama T, Kasahara Y, Yachie A. Cutaneous calcinosis in juvenile dermatomyositis. J Pediatr. 2013;163(3):921.

    Article  Google Scholar 

  12. Muller SA, Winkelmann RK, Brunsting LA. Calcinosis in dermatomyositis; observations on course of disease in children and adults. AMA Arch Derm. 1959;79(6):669–73.

    Article  CAS  Google Scholar 

  13. Weinel S, Callen JP. Calcinosis cutis complicating adult-onset dermatomyositis. Arch Dermatol. 2004;140(3):365–6.

    Article  Google Scholar 

  14. Fisler RE, Liang MG, Fuhlbrigge RC, Yalcindag A, Sundel RP. Aggressive management of juvenile dermatomyositis results in improved outcome and decreased incidence of calcinosis. J Am Acad Dermatol. 2002;47(4):505–11.

    Article  Google Scholar 

  15. Rogers A, Chung L, Li S, Casciola-Rosen L, Fiorentino DF. The cutaneous and systemic findings associated with nuclear matrix protein-2 antibodies in adult dermatomyositis patients. Arthritis Care Res (Hoboken). 2017;69:1909.

    Article  CAS  Google Scholar 

  16. Bendewald MJ, Wetter DA, Li X, Davis MD. Incidence of dermatomyositis and clinically amyopathic dermatomyositis: a population-based study in Olmsted County, Minnesota. Arch Dermatol. 2010;146(1):26–30.

    Article  Google Scholar 

  17. Moghadam-Kia S, Oddis CV, Sato S, Kuwana M, Aggarwal R. Anti-melanoma differentiation-associated gene 5 is associated with rapidly progressive lung disease and poor survival in US patients with amyopathic and myopathic dermatomyositis. Arthritis Care Res (Hoboken). 2016;68(5):689–94.

    Article  CAS  Google Scholar 

  18. Fiorentino DF, Kuo K, Chung L, Zaba L, Li S, Casciola-Rosen L. Distinctive cutaneous and systemic features associated with antitranscriptional intermediary factor-1gamma antibodies in adults with dermatomyositis. J Am Acad Dermatol. 2015;72(3):449–55.

    Article  Google Scholar 

  19. Kovacs SO, Kovacs SC. Dermatomyositis. J Am Acad Dermatol. 1998;39(6):899–920. quiz 1–2.

    Article  CAS  Google Scholar 

  20. Chansky PB, Olazagasti JM, Feng R, Werth VP. Cutaneous dermatomyositis disease course followed over time using the cutaneous dermatomyositis disease area and severity index (CDASI). J Am Acad Dermatol. 2018;79:464–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Victoria P. Werth .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chansky, P.B., Werth, V.P. (2020). Clinical Features of Myositis: Skin Manifestations. In: Aggarwal, R., Oddis, C. (eds) Managing Myositis. Springer, Cham. https://doi.org/10.1007/978-3-030-15820-0_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-15820-0_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15819-4

  • Online ISBN: 978-3-030-15820-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics