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. 2022 Jun 27;13:937667. doi: 10.3389/fimmu.2022.937667

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Copyright © 2022 Tonutti, Motta, Ceribelli, Isailovic, Selmi and De Santis

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Manifestations of COVID-19-associated anti-MDA5 dermatomyositis. (A) Cutaneous manifestations presented as violaceous, maculo-papular lesions on both dorsal and volar sides. (B) Nailfold video-capillaroscopy illustrated reduced capillary density, neo-angiogenesis, and tortuous, ectasic and giant capillaries. (C) Anti-MDA5 antibodies detected by immunoprecipitation. (D, E) T1-weighted cardiac magnetic resonance images presenting increased signal intensity [native T1 = 1067 ± 37msec (NV < 1015)], which, in association with ECV = 30 ± 4% (NV < 29) and normal T2 intensity [native T2 = 46 ± 3 msec (NV < 50 msec)], indicates interstitial myocardial fibrosis and is consistent with previous myocarditis. (F) Skin punch biopsy of a Gottron-like lesion on the left hand showing patchy mixed superficial inflammatory infiltrated with leukocytoclastic vasculitis features (Hematoxylin and eosin, 20x magnification).