Inverse Gottron's papules in patients with dermatomyositis: an underrecognized but important sign for interstitial lung disease

Abstract

region. Nonetheless, a considerable percentage of positive tests revealed a dermatophyte infection. In our clinical practice, tinea corporis is not one of the most common trunk dermatoses, but it should be kept in mind that old age, along with an immunocompromised status, represents a predisposing factor. 2 Our results provide for a real-life perspective in a particular poorly studied age group, the elderly patients. Our study, in line with literature and demographic data, allows us to have a match with the routine daily practice and makes us remember the fundamental clinical aspects with an everyday increasing aging population.

Mechanic Hands/Hiker Feet in a Patient With Amyopathic Dermatomyositis and Interstitial Lung Disease

“…Recently, a new histopathologic pattern for MH/HF similar to ours was reported in 3 patients by Ito et al, 12 and in 1 patient by Irie. 13 The patients presented with clinically established DM and hyperkeratotic lesions on their palmar surface, which were biopsied. Histopathology showed a characteristic checkerboard pattern of the hyperkeratotic corneum, with vertically and horizontally alternating parakeratosis and orthokeratosis.…”

Inverse Gottron Papules in Dermatomyositis

“…Inverse Gottron papules are keratotic papules located on the flexor aspects of the fingers (distal and proximal interphalangeal joints, and metacarpophalangeal joints), and are an infrequently reported clinical sign of dermatomyositis [ 1 , 2 ]. In some case series, an association between inverse Gottron papules and antiMDA5 antibodies or Juvenile dermatomyositis has been reported, and patients with this clinical sign might have an increased risk of developing interstitial lung disease, and a worse prognosis [ 1 , 2 ]. However, there is scarce literature regarding this manifestation, and clinical implications remain unclear and should be further assessed.…”

“…However, there is scarce literature regarding this manifestation, and clinical implications remain unclear and should be further assessed. Regarding physiopathology, inverse Gottron papules may be induced by keratinocyte damage secondary to mechanical injury [ 1 ].…”

Knuckle lesions in inherited and acquired disorders

“…[ 69 ] 'Inverse' Gottron papules refer to erythematous scaly or keratotic papules seen over the palmar aspect of the interphalangeal joints and are associated with anti-melanoma differentiation associated gene 5 (MDA5) antibodies and interstitial lung disease. [ 70 71 ] Lesions resembling Gottron papules without any features of dermatomyositis have been described in systemic lupus erythematosus as Gottron-like papules. [ 72 ]…”