Cutaneous manifestations of dermatomyositis (DM) are heterogeneous and include macular erythema, papules, plaques, nodules, and skin ulceration.1 Cutaneous ulcers have been reported in 3% to 19% of patients with DM,2 and these can be extremely painful and disabling and present a risk of secondary infection. They are mainly located at the digital pulp or periungual areas, on lateral nail folds, on Gottron papules, on extensor surfaces, overlying joints, and on sun-exposed areas such as the anterior chest and helix.2 Vasculopathy, vasculitis, epidermal necrosis secondary to interface dermatitis, and excoriation in response to pruritus have been reported to be involved in their development.
Combalia A, Giavedoni P, Tamez L, Grau-Junyent JM, Mascaró JM. Bosentan for Cutaneous Ulcers in Anti-MDA5 Dermatomyositis. JAMA Dermatol. 2018;154(3):371–373. doi:10.1001/jamadermatol.2017.5462
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