PMC7350393_01
Gottron's papules on hand at the time of presentation.
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PMC7350393_01_10.1177_2324709620940496-fig1.jpg
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On examination, he had small papules on the metacarpophalangeal and proximal interphalangeal joints of the fingers, consistent with Gottron's papules (Figure 1).
Scattered circular skin lesions on back and an area of full-thickness skin separation on the right shoulder.
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Over the following 3 days, the skin lesions evolved to separation, suggestive of epidermal necrosis (Figure 2).