Dermatomyositis physical examination: Difference between revisions
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Skin findings occur in dermatomyositis but not [[polymyositis]] and are generally present at diagnosis. Gottron's sign is an erythematous, scaly eruption occurring in symmetric fashion over the [[Metacarpophalangeal joint|MCP]] and interphalangeal joints (can mimic psoriasis). Heliotrope rash (or ''lilac rash'') <ref name=Kumar151> Page 151 in: {{cite book |author=Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson |title=Robbins Basic Pathology|publisher=Saunders |location=Philadelphia |year= 2007|pages= |isbn=1-4160-2973-7 |oclc= |doi=}} 8th edition. </ref> is a violaceous eruption on the upper eyelids, often with swelling (most specific, though uncommon). Shawl (or V-) sign is a diffuse, flat, erythematous lesion over the chest and shoulders or in a "V" over the anterior neck and chest, worsened with UV light. [[Erythroderma]] is a flat, erythematous lesion similar to the shawl sign but located in other areas, such as the malar region and the forehead. Periungual [[telangiectasia]]s and [[erythema]] occur. | Skin findings occur in dermatomyositis but not [[polymyositis]] and are generally present at diagnosis. Gottron's sign is an erythematous, scaly eruption occurring in symmetric fashion over the [[Metacarpophalangeal joint|MCP]] and interphalangeal joints (can mimic psoriasis). Heliotrope rash (or ''lilac rash'') <ref name=Kumar151> Page 151 in: {{cite book |author=Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson |title=Robbins Basic Pathology|publisher=Saunders |location=Philadelphia |year= 2007|pages= |isbn=1-4160-2973-7 |oclc= |doi=}} 8th edition. </ref> is a violaceous eruption on the upper eyelids, often with swelling (most specific, though uncommon). Shawl (or V-) sign is a diffuse, flat, erythematous lesion over the chest and shoulders or in a "V" over the anterior neck and chest, worsened with UV light. [[Erythroderma]] is a flat, erythematous lesion similar to the shawl sign but located in other areas, such as the malar region and the forehead. Periungual [[telangiectasia]]s and [[erythema]] occur. | ||
Mechanic's hands (also in PM) refers to rough, cracked skin at the tips and lateral aspects of the fingers forming irregular dirty-appearing lines that resemble those seen in a laborer (this is also associated with the anti-synthetase syndrome) | Mechanic's hands (also in PM) refers to rough, cracked skin at the tips and lateral aspects of the fingers forming irregular dirty-appearing lines that resemble those seen in a laborer (this is also associated with the anti-synthetase syndrome) (See: [[sclerodactyly]]). Psoriaform changes in the scalp can occur. Centripetal flagellate erythema comprises linear, violaceous streaks on the trunk (possibly caused by itching pruritic skin). [[Calcinosis cutis]](deposition of calcium in the skin) is usually seen in juvenile DM, not adult DM. [[Dysphagia]] (difficulty swallowing) is another feature, occurring in as much as 33% of cases. | ||
[[Image:heliotrope_rash_(Dermatomyositis).jpg|thumb|500px|center|Heliotrope rash (Dermatomyositis) Proximal muscle weakness | [[Image:heliotrope_rash_(Dermatomyositis).jpg|thumb|500px|center|Heliotrope rash (Dermatomyositis) Proximal muscle weakness | ||
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Copyleft images obtained courtesy of Radswiki [http://www.radswiki.net Images courtesy of RadsWiki] | Copyleft images obtained courtesy of Radswiki [http://www.radswiki.net Images courtesy of RadsWiki] | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 15:29, 30 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical Examination
Skin findings occur in dermatomyositis but not polymyositis and are generally present at diagnosis. Gottron's sign is an erythematous, scaly eruption occurring in symmetric fashion over the MCP and interphalangeal joints (can mimic psoriasis). Heliotrope rash (or lilac rash) [1] is a violaceous eruption on the upper eyelids, often with swelling (most specific, though uncommon). Shawl (or V-) sign is a diffuse, flat, erythematous lesion over the chest and shoulders or in a "V" over the anterior neck and chest, worsened with UV light. Erythroderma is a flat, erythematous lesion similar to the shawl sign but located in other areas, such as the malar region and the forehead. Periungual telangiectasias and erythema occur.
Mechanic's hands (also in PM) refers to rough, cracked skin at the tips and lateral aspects of the fingers forming irregular dirty-appearing lines that resemble those seen in a laborer (this is also associated with the anti-synthetase syndrome) (See: sclerodactyly). Psoriaform changes in the scalp can occur. Centripetal flagellate erythema comprises linear, violaceous streaks on the trunk (possibly caused by itching pruritic skin). Calcinosis cutis(deposition of calcium in the skin) is usually seen in juvenile DM, not adult DM. Dysphagia (difficulty swallowing) is another feature, occurring in as much as 33% of cases.
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Copyleft images obtained courtesy of Radswiki Images courtesy of RadsWiki
References
- ↑ Page 151 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). Robbins Basic Pathology. Philadelphia: Saunders. ISBN 1-4160-2973-7. 8th edition.
- ↑ http://picasaweb.google.com/mcmumbi/USMLEIIImages/photo#5089143195781344626