Heliotrope Rash, Gottron Papules and Ragged Cuticles in Darker Skin

Published:September 20, 2022DOI:
      A 62-year-old darker skinned woman (Fitzpatrick type V) presented to the emergency department with muscle weakness, fatigue, anorexia and progressive pruritic rash of the periorbital face, elbows and dorsal hands.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Waldman R
        • DeWane ME
        • Lu J.
        Dermatomyositis: Diagnosis and treatment.
        J Am Acad Dermatol. 2020; 82: 283-296
        • Lundberg IE
        • Tjärnlund A
        • Bottai M
        • et al.
        EULAR/ACR Classification Criteria for Adult and Juvenile Idiopathic Inflammatory Myopathies and their Major Subgroups HHS Public Access.
        Ann Rheum Dis. 2017; 76: 1955-1964
        • Mariampillai K
        • Granger B
        • Amelin D
        • et al.
        Development of a New Classification System for Idiopathic Inflammatory Myopathies Based on Clinical Manifestations and Myositis-Specific Autoantibodies.
        JAMA Neurol. 2018; 75: 1528-1537
        • Babool S
        • Bhai SF
        • Sanderson C
        • Salter A
        • Christopher-Stine L.
        Racial Disparities in Skin Tone Representation of Dermatomyositis Rashes: A Systematic Review.
        Rheumatology (Oxford). 2021; 29: keab809
        • DeWane ME
        • Waldman R
        • Lu J.
        Dermatomyositis: Clinical features and pathogenesis.
        J Am Acad Dermatol. 2020; 82: 267-281
        • Oddis CV
        • Fertig N
        • Goel A
        • et al.
        Clinical and serological characterization of the anti-MJ antibody in childhood myositis.
        Arthritis Rheum. 1997; 40: S139
        • Albayda J
        • Pinal-Fernandez I
        • Huang W
        • et al.
        Dermatomyositis Patients with Anti-Nuclear Matrix Protein-2 Autoantibodies Have More Edema, More Severe Muscle Disease, and Increased Malignancy Risk.
        Arthritis Care Res. 2017; 69: 1771-1776
        • Yang H
        • Peng Q
        • Yin L
        • et al.
        Identification of multiple cancer-associated myositis-specific autoantibodies in idiopathic inflammatory myopathies: a large longitudinal cohort study.
        Arthritis Res Ther. 2017; 19: 259
        • Qiang JK
        • Kim WB
        • Baibergenova A
        • Alhusayen R.
        Risk of Malignancy in Dermatomyositis and Polymyositis.
        J Cutan Med Surg. 2017; 21: 131-136