Dermatomyositis (DM) is an autoimmune disorder with a characteristic pattern of skin and muscle disease. Preclinical studies have implicated abnormal stretch receptor signaling and external trauma as necessary components for the expression of certain cutaneous manifestations.1,2 These studies correlate with clinical findings, as DM preferentially affects UV-irradiated skin and frequently traumatized sites, such as over bony prominences on the hands and elbows. We evaluated a patient with residual hemiparesis from a stroke who developed cutaneous DM with a strikingly unilateral pattern on the hands: prominent disease on her functional side with sparing of her immobilized side. Our observation provides clinical evidence supporting the idea that external trauma, movement, and stretch may be requisite for the genesis of certain skin lesions in DM.
Kurtzman DJB, Ho A, Wright NA, Rubenstein MH, Vleugels RA. Unilateral Gottron Papules in a Patient Following a StrokeClinical Insights Into the Disease Mechanisms and Pathophysiology of Cutaneous Dermatomyositis. JAMA Dermatol. 2016;152(9):1062-1063. doi:10.1001/jamadermatol.2016.1537