Figure 2.

Examples of acral skin ulceration that has been associated with anti-MDA 5 and rapidly progressive ILD in CADM patients. The upper left and right images display solitary deep punched-out ulcers overlying the dorsal aspect of metacarpophalangeal joints of two different DM patients. The lower image shows papules of the palmar creases that have undergone ulceration in a DM patient. The photos in this figure were obtained from DM patients that the author of this review had cared for clinically during his earlier career. Unfortunately, the clinical and laboratory information concerning these patients are not available to determine their classification status as classic DM versus CADM. ILD, interstitial lung disease; CADM, clinically-amyopathic DM.