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Indian Pediatr 2009;46: 728

Gottron’s Papules


Sanwar Agrawal and Raju Khubchandani*

Ekta Institute of Child health, Shantinagar, Raipur;
and Pediatric Rheumatology Clinic,
*Jaslok Hospital, Mumbai. 
Email: [email protected]
 

 

A 7 year-old male child presented with insidious onset of symmetric proximal muscle weakness over about 6 months and  Gottron’s papules (Fig.1). His serum aldolase was 9.8 units (normal 0–7.6 units). Other investigations including other muscle enzymes were essentially normal. His MRI showed hyperintensities in bilateral anterolateral, medial and posterior thigh and pelvic girdle muscles confirming the diagnosis of dermatomyositis (DM).

Fig.1 Hands showing Gottron’s Papules.

Gottron’s papules, named after Heinrich Adolf Gottron (1890-1974), a German dermatologist, are a late manifestation of the disease but are considered pathognomonic of DM. These are symmetric, lacy, pink to violaceous, raised or macular areas typically found on the dorsal aspect of metacarpophalangeal and interphalangeal joints, elbows, patellae and medial malleoli.They represent cutaneous vasculitis and in severe cases may ulcerate. Approximately 60% to 80% of DM patients have Gottron’s papules sometime during the course of the disease.
 

 

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