case_images: PMC10113061_01
case_images: (a) Right and (b) left auricular involvement characterized by purplish redness and swelling of the pinna but sparing the lobules.
case_images: CRIRH2023-3719502.001.jpg
case_images: PMC10113061_01_CRIRH2023-3719502.001.jpg
case_images: fig1
case_images: He had swelling and tenderness of both auricles sparing the lobules (Figure 1) and erythematous and tender nose.
case_images: Erythematous, flat-topped, hyperkeratotic papules on the dorsal metacarpophalangeal joints bilaterally (gottron papules).
case_images: CRIRH2023-3719502.002.jpg
case_images: PMC10113061_01_CRIRH2023-3719502.002.jpg
case_images: fig2
case_images: Skin examination showed gottron papules (Figure 2), erythematous plaques overlying the knees and elbows, bilateral nontender subcutaneous nodules in the olecranon area, and patchy alopecia.
case_images: Biopsy of the posterior aspect of the right elbow showing perivascular lymphohistiocytic infiltration without lichenoid changes (hematoxylin and eosin stain, 100x).
case_images: CRIRH2023-3719502.003.jpg
case_images: PMC10113061_01_CRIRH2023-3719502.003.jpg
case_images: fig3
case_images: Skin biopsy of the elbow disclosed lymphocytic inflammatory infiltrates at the dermal-epidermal junction basement membrane and perivascular lymphocytic infiltrates without lichenoid changes with positive mucin in alcian blue stain consistent with DM (Figure 3).
case_images: Erythematous fingertip papules.
case_images: CRIRH2023-3719502.004.jpg
case_images: PMC10113061_01_CRIRH2023-3719502.004.jpg
case_images: fig4
case_images: However, gottron papules and subcutaneous nodules persisted, and he began presenting with painful fingertip papules (Figure 4).
case_images: Resolution of (a) fingertip papules and (b) gottron papules after rituximab therapy.
case_images: CRIRH2023-3719502.005.jpg
case_images: PMC10113061_01_CRIRH2023-3719502.005.jpg
case_images: fig5
case_images: Three months after rituximab treatment, gottron papules, subcutaneous nodules, and fingertip papules resolved (Figure 5).