PMC6337756_01
Clinical findings of dermatomyositis. The patient had erythematous papules over the dorsal knuckles (Gottron's papules), with peri-ungual erythema and cuticle hypertrophy (a). Violaceous erythematous plaques were noted on the volar forearms (b) and posterior arms (Shawl sign; d). Also noted was photo distributed violaceous erythema of the forehead and midface, involving the nasolabial folds, as well as erythema and edema of the upper eyelids (heliotrope rash) (c). Poikiloderma with a mottled pattern of hyper-pigmented and hypo-pigmented macules interspersed with telangiectasia was noted on the upper back (d)
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Fig1
On follow-up clinical exam 8 months later, she had erythematous papules overlying the dorsal metacarpophalangeal joints, violaceous erythema affecting the face and upper eyelids, photo-distributed poikiloderma on the neck and shoulders, and scattered telangiectasia (Fig. 1).