Three cases of dermatomyositis presenting with inverse Gottron′s papules

Abstract

Three cases of dermatomyositis presenting with inverse Gottron′s papules were reported. Of the 3 patients, there were 2 males and 1 female aged 43, 41 and 46 years respectively, whose disease durations were 1, 6, 7 months respectively. Inverse Gottron′s papules manifested as papules overlying the palmar aspect of the metacarpal and interphalangeal joints, which were arranged in a linear pattern in 2 cases. Of the 3 cases, 1 presented with interstitial pneumonia, 3 with myositis, and 2 showed negative anti-nuclear antibody test. Histopathological examination of inverse Gottron′s papules in 1 case revealed focal liquefaction degeneration of basal cells and perivascular infiltration with inflammatory cells, especially lymphocytes, in the superficial dermis. The 3 patients received oral glucocorticoids and immunosuppressive agents in the early period of treatment. After 3-month treatment, clinical symptoms including muscle weakness and muscle pain were improved evidently, but no obvious improvement in inverse Gottron′s papules was observed. After 1-year treatment, these papules on the palmar aspect were markedly relieved in 1 case. Key words: Dermatomyositis; Lung diseases, interstitial; Inverse Gottron′s papules