Skin histopathology (medium power). There is a mild lichenoid tissue reaction with subtle vacuolar change in the basal layer and occasional Civatte bo...
Eyelid involvement in DM. (a) There is lilac erythema of the upper eyelids, which are also oedematous. In this patient with DM the facial skin is gene...
The nail folds and cuticles are usually affected in dermatomyositis. (a) Dilated nail fold capillary loops are visible. (b) The cuticles are hypertrop...
The dermatosis of dermatomyositis can affect the gluteal skin and proximal thighs. Involvement of the skin overlying the hips is known as the holster ...
Muscle biopsy. (a) Capillary staining for C5b‐9, the membrane attack complex, is an early pathological finding in dermatomyositis. (b) Diffuse up‐regu...
The upper chest is a common site of skin involvement in dermatomyositis.
Gottren's papules: violaceous, flat‐topped, shiny papules on the skin overlying the interphalangeal joints and metacarpophalangeal joints.
Vasculopathic ulcers, which have dusky margins and are ‘punched‐out’, may occur in DM patients, particularly those who are positive for anti‐MDA5 anti...
Facial erythema in dermatomyositis is often widespread and can mimic many dermatoses, including lupus erythematosus.
Erythema of the upper central back is known as the shawl sign.
There are streaks of erythema on the dorsal aspects of the fingers, extending onto the backs of the hands.
In severe dermatomyositis, skin involvement on the torso can become extensive and fixed.
A diffuse, non‐scarring alopecia is common in dermatomyositis. The scalp is inflamed with violaceous erythema and mild scaling.
Poikiloderma occurs in dermatomyositis; it is composed of telangiectatic erythema, epidermal atrophy and dyspigmentation.
Involvement of the extensor surfaces of the arms is typical in dermatomyositis.
Non‐inflammatory hyperkeratosis occurring on (a) the fingers and (b) the feet may be seen in Jo‐1‐positive DM. Involvement of the radial surfaces of t...