scholarly journals Inverse Gottron’s papules and mechanic’s hands after a tug of war: triggered by friction and pressure?

2021 ◽  
Author(s):  
Hanlin Yin ◽  
Bei Liu ◽  
Liangjing Lu
Keyword(s):  
Mechanic’S Hands

A Helpful Hand in Diagnosis: A Case Report of Anti-Synthetase Syndrome with Mechanic's Hands

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Mary Ramirez ◽  
Ramya Vangipuram ◽  
Jerry Kirkland ◽  
Todd Bell
Keyword(s):  
Case Report ◽  
Mechanic’S Hands

scholarly journals SAT0529 CLINICAL CHARACTERISTICS AND TREATMENT PATTERNS IN A PATIENT GROUP WITH INTERSTITIAL LUNG DISEASE.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1222.2-1222
Author(s):  
R. Ortega Castro ◽  
P. S. Laura ◽  
F. U. Pilar ◽  
J. Calvo Gutierrez ◽  
A. Requejo-Jimenez ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Smoking Habit ◽  
Inflammatory Myopathy ◽  
Usual Interstitial Pneumonia ◽  
Treatment Patterns ◽  
Common Symptom ◽  
Radiological Pattern ◽  
Mechanic’S Hands

Background:Diffuse interstitial lung disease (ILD) is frequently associated with connective tissue diseases (CTD) and is one of the main causes of morbidity and mortality in these patients. Recently, the concept of Interstitial Pneumonia with Autoimmune Features (IPAF) has been defined to characterize ILD associated with systemic manifestations limited to subtle serological and clinical autoimmune abnormalities and not fulfilling the international criteria for the diagnosis of a given CTD.Objectives:The objective of this study is to describe the clinical, serological and radiological characteristics, as well as the treatment patterns of patients with ILD referred to a Rheumatology Service for suspected CTDMethods:Observational, cross-sectional study of 43 patients with ILD referred for evaluation to the medical consultation of CTD of the Rheumatology service at the Reina Sofía Hospital. Patients were classified as patients with defined CTD, patient with IPAF and patients with other types of pneumopathy. We conducted a descriptive study of all patients and compared the clinical-analytical-radiological characteristics and treatment patterns of the first two groups.Results:Of the 43 patients, 67.40% were women with a mean age at diagnosis of 65.65 (10.42) years and 53.50% of smoking patientsOf the total of patients, 16 (37.2%) were included in the CTD group, 17 (39.5%) met criteria for IPAF and 10 (23.3%) had another type of pneumopathy.In the CTD group scleroderma was the most frequent disease (6/16), followed by inflammatory myopathy (4/16), Sjögren’s syndrome (3/16), rheumatoid arthritis (2/16) and polymyalgia rheumatic (1/16). In this group of patients, the most common symptom was Raynaud’s phenomenon (RP) (7/16), followed by arthritis (7/16) and mechanic’s hands (3/16). Regarding the most frequently antibodies were ANA (100%), anti-RO (41.7%), anti-citrullinated protein antibodies (30%) and rheumatoid factor (RF) (28.6%).In patients with IPAF, as in the CTD group, the most observed clinical criterion was RP (5/17), followed by arthritis (1/17) and mechanic’s hands (1/17). Among the serological criteria the most common antibodies were ANA (100%), followed by anti-RO (33.3%), anti-RNA synthetase (28.6%) and RF (22.2%).Regarding the radiological pattern, in both groups the most frequent was nonspecific interstitial pneumonia, followed by the indeterminate pattern and usual interstitial pneumonia (UIP) in third place. There were no significant differences by gender and age, between the group of CTD and IPAF, observing in both groups a predominance of women with a similar mean age, being the upper smoking habit in the IPAF group (70.6% vs 31.5%, p= 0.02). Regarding the treatment used, the use of immunosuppressants (IS) was more frequent in CTD group (56.3% vs 11.8%, p = 0.007).Conclusion:The clinical-serological and radiological characteristics were similar among patients with IPAF and CTD, which supports the notion of a similar pathophysiology in both groups. In our cohort patients with CTD received IS more frequently than IPAF group, however, future work would be necessary to assess whether the response to treatment is similar in these populations and if IS can benefit patients with IPAF to long term. In addition, it could be useful to include the UIP pattern within the IPAF classification criteria, not currently included, since it is the third most frequent radiological pattern.References:[1]Respirology, 21 (2016), pp. 245-258[2]Eur Respir J, 46 (2015), pp. 976-987Disclosure of Interests:Rafaela Ortega Castro: None declared, Pérez Sánchez Laura: None declared, Font Ugalde Pilar: None declared, Jerusalem Calvo Gutierrez: None declared, Antonio Requejo-Jimenez: None declared, Simona Espejo-Pérez: None declared, Teresa Gonzalez-Serrano: None declared, María del Carmen Castro Villegas: None declared, Gómez García Ignacio: None declared, Alejandro Escudero Contreras: None declared, Eduardo Collantes Estevez Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene, Maria A Aguirre: None declared

Re-examining mechanic's hands as a characteristic skin finding in dermatomyositis

2018 ◽  
Vol 78 (4) ◽  
pp. 769-775.e2 ◽  
Author(s):  
Josef Symon S. Concha ◽  
Joseph F. Merola ◽  
David Fiorentino ◽  
Victoria P. Werth
Keyword(s):  
Mechanic’S Hands

scholarly journals Dermatologische Differentialdiagnosen von idiopathischen entzündlichen Muskelerkrankungen

2021 ◽  
Vol 46 (04) ◽  
pp. 382-387
Author(s):  
Cord Sunderkötter ◽  
Linda Golle
Keyword(s):  
Systemische Therapie ◽  
Lupus Erythematodes ◽  
Systemische Sklerose ◽  
Mechanic’S Hands

ZusammenfassungDie Hautsymptome sind für die Differenzialdiagnose der Myositiden wichtig, da sie einmal entscheidend für die Unterscheidung der Dermatomyositis und des Anti-Synthetase-Syndroms von den anderen Autoimmun-Myositiden sind, und da sie bei Myositiden im Rahmen von Overlap Syndromen Hinweise auf die zugrunde liegenden Autoimmunerkrankungen (Lupus erythematodes, systemische Sklerose u. a.) geben können. Daher sollte bei Patienten mit einer Myositis eine genaue Inspektion der Haut erfolgen. Fast pathognomonisch für die Dermatomyositis ist die Trias aus symmetrischem, fliederfarbenem Erythem auf den Oberlidern (heliotropes Erythem), Erytheme oder flache Papeln oder Plaques über den proximalen interphalangealen und metacarpophalangealen Fingergelenken (so genannte Gottron Papeln) und Erytheme über Knien, Ellenbogen oder Knöcheln (so genanntes Gottron Zeichen). Daneben gibt es eine Reihe weiterer, typischer Hautsymptome (peitschenabdruckartige Erytheme, Poikilodermie, dystrophe Nagelhäutchen, Vaskulitiden, Juckreiz). Beim Anti-Synthetase-Syndrom treten neben einem Raynaud Phänomen als charakteristisches Symptom die sog. Mechanikerhände („mechanic‘s hands“) auf, d. h. Hyperkeratosen und Fissuren lateral an den Fingern. Klinisch und histologisch sind die Hautsymptome beim LE nicht eindeutig von denen der Dermatomyositis zu trennen, auch wenn es einige Unterschiede gibt. Die Hauteffloreszenzen sprechen nicht immer gut auf die Therapien der Myositis an. Ein Rückgang wurde unter Glukokortikoiden, Methotrexat, IVIG, Mycophenolatmofetil und Rituximab beobachtet. Als systemische Therapie gegen die Hautbeteiligung hat Hydroxychloroquin Wirksamkeit gezeigt, manchmal nur in Kombination mit Mepacrin. Zur zusätzlichen topischen Behandlung eignen sich Glukokortikoide und Calcineurin-Inhibitoren. Eine generelle Maßnahme ist der konsequente Sonnenschutz.

Polymyositis and dermatomyositis

2010 ◽  
pp. 3692-3698
Author(s):  
John H. Stone
Keyword(s):  
Cytotoxic T Cells ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Hla Class I ◽  
Muscle Enzymes ◽  
Calcinosis Cutis ◽  
Muscle Involvement ◽  
Cutaneous Manifestations ◽  
Associated Malignancy ◽  
Mechanic’S Hands

Polymyositis and dermatomyositis are two types of idiopathic inflammatory myopathy. The pathological findings in polymyositis suggest an HLA class I-restricted immune response mediated by cytotoxic T cells; dermatomyositis appears to be associated with humorally mediated destruction of muscle-associated microvasculature. Clinical features—polymyositis is characterized by symmetrical painless proximal muscle weakness that develops slowly, usually over weeks to months, and typically associated with significant elevation of serum creatine kinase and other muscle enzymes. The pattern of muscle involvement in dermatomyositis is clinically indistinguishable from that of polymyositis, but with cutaneous manifestations including Gottron’s sign, heliotrope rash, erythema, ‘mechanic’s hands’, periungual abnormalities, and calcinosis cutis. Extra-muscular features include interstitial lung disease (30% of cases), aspiration pneumonia, and associated malignancy (polymyositis 9%, dermatomyositis 15%)....

Childhood sclerodermatomyositis: report of a case with the anti-PM/Scl antibody and mechanic's hands

1996 ◽  
Vol 135 (4) ◽  
pp. 613-616 ◽  
Author(s):  
V. GARCIA-PATOS ◽  
R. BARTRALOT ◽  
V. FONOLLOSA ◽  
C. ARNAL ◽  
M. BORONAT ◽  
...  
Keyword(s):  
Mechanic’S Hands

Pseudocheckerboard pattern: an interesting histopathological finding in mechanic's hands

2015 ◽  
Vol 43 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Ayako Ito ◽  
Nanako Yamada ◽  
Yuichi Yoshida ◽  
Osamu Yamamoto
Keyword(s):  
Histopathological Finding ◽  
Mechanic’S Hands

Childhood sclerodermatomyositis: report of a case with the anti-PM/Scl antibody and mechanic's hands

1996 ◽  
Vol 135 (4) ◽  
pp. 613-616 ◽  
Author(s):  
V. GARCIA-PATOS ◽  
R. BARTRALOT ◽  
V. FONOLLOSA ◽  
C. ARNAL ◽  
M. BORONAT ◽  
...  
Keyword(s):  
Mechanic’S Hands

scholarly journals Immune myopathies with perimysial pathology

2018 ◽  
Vol 5 (2) ◽  
pp. e434 ◽  
Author(s):  
Robert C. Bucelli ◽  
Alan Pestronk
Keyword(s):  
Inflammatory Arthritis ◽  
Antinuclear Antibodies ◽  
Vascular Pathology ◽  
Comorbid Conditions ◽  
Raynaud Phenomenon ◽  
Regular Screening ◽  
Increased Risk ◽  
Antisynthetase Antibodies ◽  
Pathology Review ◽  
Mechanic’S Hands

ObjectiveImmune myopathies with perimysial pathology (IMPP) have a combination of damage to perimysial connective tissue and muscle fiber necrosis, more prominent near the perimysium. We studied the clinical and laboratory correlates of patients with pathologically defined IMPP.MethodsThis is a retrospective chart and pathology review of 57 consecutive patients with IMPP myopathology and, for comparison, 20 patients with dermatomyositis with vascular pathology (DM-VP).ResultsCompared with DM-VP, IMPP patients more commonly had interstitial lung disease (ILD) (p < 0.01), Raynaud phenomenon (p < 0.05), mechanic's hands (p < 0.05), arthralgias (p < 0.001), and a sustained response to immunomodulatory therapy (p < 0.05), and less frequently had a concurrent malignancy (p < 0.01). IMPP patients had higher serum creatine kinase values (p < 0.05), more frequent serum Jo-1 (p < 0.03) or SSA/SSA52 autoantibodies (p < 0.05), and less frequent antinuclear antibodies (p < 0.01). IMPP patients with serum Jo-1/antisynthetase antibodies were more likely to have ILD (p < 0.05) and inflammatory arthritis (p < 0.05) than IMPP patients without these antibodies.ConclusionsIMPP myopathology is associated with an increased risk of ILD, Raynaud phenomenon, mechanic's hands, and inflammatory arthritis when compared with another immune myopathy (DM-VP). IMPP patients require regular screening for ILD, particularly those with antisynthetase antibodies. The absence of myositis-specific autoantibodies in a large percentage of IMPP patients emphasizes the important role for myopathology in identifying patients at higher risk of severe comorbid conditions such as ILD.

scholarly journals Interstitial lung disease is a major characteristic of anti-KS associated ant-synthetase syndrome

2020 ◽  
Vol 11 ◽  
pp. 204062232096841
Author(s):  
Yongpeng Ge ◽  
Sizhao Li ◽  
Shanshan Li ◽  
Linrong He ◽  
Xin Lu ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Clinical Features ◽  
Malignant Tumors ◽  
Usual Interstitial Pneumonia ◽  
Transfer Rna ◽  
Critical Issues ◽  
Pulmonary Pathology ◽  
Mechanic’S Hands

Background: Anti-KS autoantibodies are rare myositis-specific autoantibodies that have been described to target asparaginyl-transfer RNA synthetase. Methods: Here, we review the published literature on critical issues concerning the detection of anti-KS antibodies and the clinical features associated with their presence. Results: Seven articles are reviewed, in all of which immunoprecipitation was employed for the detection of anti-KS antibodies. A total of 47 patients were included; the ratio of females to males was 1.9:1. In total, 46 (98%) of these patients had interstitial lung disease (ILD), which was the sole manifestation in half (50%) of them. Pulmonary pathology revealed 7 (27%) with usual interstitial pneumonia, and 16 (62%) with non-specific pneumonia. Arthritis was present in about one-quarter (26%) of patients, and the incidence of Raynaud’s phenomenon and mechanic’s hands was 19% and 32%, respectively. However, manifestations of myositis were rare (9%). In addition, three (11%) patients had malignant tumors. Most patients responded to glucocorticoid therapy. Conclusions: Identifying anti-KS in patients with ILD may be useful for treatment, but reliable practical detection is needed. Furthermore, clinicians need to be aware of the possible presence of anti-KS antibodies in patients with ILD, either isolated or in combination with myositis.

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