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Gottron's sign
Medical sign
Medical sign
Gottron's sign is a pathognomonic cutaneous manifestation associated with dermatomyositis (DM), which is an inflammatory disorder affecting the skin and muscles. The primary lesion of dermatomyositis appears as a violaceous, macular erythema with a symmetric distribution, which may progress and become poikilodermatous (atrophic with telangiectasia and pigmentary changes) and indurated (as a result of mucin deposition). They were first described by Heinrich Adolf Gottron.
Gottron's papules

Gottron's papules are violaceous erythematous papules that commonly occur overlying the dorsal interphalangeal (DIP) or metacarpophalangeal joints (MCP), as well as the elbows or knee joints. They are found in approximately 70 percent of patients diagnosed with dermatomyositis.
Gottron's sign
Gottron's sign is erythematous or violaceous macules or plaques overlying the elbows and/or knees, and it is considered a less specific finding for DM. The macules or plaques follow the same symmetric distribution pattern as Gottron's papules but do not appear in the interphalangeal spaces. This is a contrasting dermatologic distribution pattern to what is observed in patients with systemic lupus erythematosus.
Differential diagnosis
Source:
| Primary dermatomyositis | Secondary dermatomyositis | Not dermatomyositis |
|---|---|---|
| Classic adult dermatomyositis | Drug induced (Statins, NSAID, chemotherapeutics, antibiotics) | Lupus |
| Paraneoplastic dermatomyositis | Infection induced (HIV, HSV) | Lichen planus |
| Amyopathic dermatomyositis | Psoriasis | |
| Juvenile dermatomyositis | Polymorphous light eruption | |
| "overlap syndrome" dermatomyositis | Granuloma annulare | |
| Dermatitis (contact, seborrheic, atopic) | ||
| Trauma-induced knuckles |
References
References
- "Dermatomyositis - About the Disease - Genetic and Rare Diseases Information Center".
- (2001-11-01). "Dermatomyositis". American Family Physician.
- "UpToDate".
- "Gottron Papules: A Key Sign of an Autoimmune Muscle Disease".
- "Adult-onset dermatomyositis {{!}} DermNet".
- (2013). "The Pathognomonicity of Gottron's Sign". Canadian Journal of General Internal Medicine.
- (2012). "Clinical Presentation and Evaluation of Dermatomyositis". Indian Journal of Dermatology.
- (2012). "Clinical Presentation and Evaluation of Dermatomyositis". Indian Journal of Dermatology.
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