Gottron's sign explained

Gottron's sign is a pathognomonic cutaneous manifestation associated with dermatomyositis (DM), which is an inflammatory disorder affecting the skin and muscles.[1] The primary lesion of dermatomyositis appears as a violaceous, macular erythema with a symmetric distribution, which may progress and become poikilodermatous (atrophic with telangiectasia and pigmentary changes) and indurated (as a result of mucin deposition).[2]

Gottron's papules

Gottron's papules are violaceous erythematous papules that commonly occur overlying the dorsal interphalangeal (DIP) or metacarpophalangeal joints (MCP), as well as the elbows or knee joints. They are found in approximately 70 percent of patients diagnosed with dermatomyositis.[3] [4] [5] [6]

Gottron's sign

Gottron's sign is erythematous or violaceous macules or plaques overlying the elbows and/or knees, and it is considered a less specific finding for DM.[7] The macules or plaques follow the same symmetric distribution pattern as Gottron's papules but do not appear in the interphalangeal spaces. This is a contrasting dermatologic distribution pattern to what is observed in patients with systemic lupus erythematosus.[8]

Differential diagnosis

Source:[6]

!Primary dermatomyositis!Secondary dermatomyositis!Not dermatomyositis
Classic adult dermatomyositisDrug induced (dtatins, NSAID, chemotherapeutics, antibiotics)Lupus
Paraneoplastic dermatomyositisInfection induced (HIV, HSV)Lichen planus
Amyopathic dermatomyositisPsoriasis
Juvenile dermatomyositisPolymorphous light eruption
"overlap syndrome" dermatomyositisGranuloma annulare
Dermatitis (contact, seborrheic, atopic)
Trauma-induced knuckles

Notes and References

  1. Web site: Dermatomyositis - About the Disease - Genetic and Rare Diseases Information Center . 2023-12-25 . rarediseases.info.nih.gov . en.
  2. Koler . Ric Anthony . Montemarano . Andrew . 2001-11-01 . Dermatomyositis . American Family Physician . en-US . 64 . 9 . 1565–1573. 11730311 .
  3. Web site: UpToDate . 2023-12-25 . www.uptodate.com.
  4. Web site: Gottron Papules: A Key Sign of an Autoimmune Muscle Disease . 2023-12-25 . Verywell Health . en . 2023-10-19 . https://archive.today/20231019050303/https://www.verywellhealth.com/gottron-papules-4796612 . bot: unknown .
  5. Web site: Adult-onset dermatomyositis DermNet . 2023-12-25 . dermnetnz.org . en.
  6. BSc . Heather M. Babcock . PhD . Mohammed S. Osman MD . Md . Tiffany Kwok . Md . Stephen Chihrin . MSc . Stephanie O. Keeling MD . Mph . Sumit R. Majumdar MD . 2013 . The Pathognomonicity of Gottron's Sign . Canadian Journal of General Internal Medicine . en . 8 . 1 . 10.22374/cjgim.v8i1.97 . 2369-1778. free .
  7. Marvi . Umaima . Chung . Lorinda . Fiorentino . David F . 2012 . Clinical Presentation and Evaluation of Dermatomyositis . Indian Journal of Dermatology . 57 . 5 . 375–381 . 10.4103/0019-5154.100486 . 0019-5154 . 3482801 . 23112358 . free .
  8. Marvi . Umaima . Chung . Lorinda . Fiorentino . David F . 2012 . Clinical Presentation and Evaluation of Dermatomyositis . Indian Journal of Dermatology . 57 . 5 . 375–381 . 10.4103/0019-5154.100486 . 0019-5154 . 3482801 . 23112358 . free .

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