A 61-year-old man presented with a characteristic periorbital purplish discoloration (Heliotrope rash). It was associated with malar erythema and edema, less striking erythema of the neck and presternal area (Shawl sign) and atrophic papules over the knuckles of the fingers (Gottron’s papules). The skin signs had appeared simultaneously with muscle symptoms (weakness of proximal muscles). No underlying tumour was found. Investigations revealed: Negative ANA , Elevated CPK and abnormal EMG.
A 50-year-old woman presented with asymptomatic atrophic patches on the side of the neck of 8 months duration. The skin overlying the patches was thin, pale white and slightly bulging. On palpation, the lesions gave the palpating finger just like the sensation as a hernial orifice.
A 24-year-old male presented with a pinkish nodule on the right shoulder of many months duration. The lesion was asymptomatic, seemed to be hollow on palpation with positive button hole sign. He has no associated systemic disease or a primary skin disease in the affected area prior to the appearance of the lesion.