The hands can offer a clue in making the diagnosis for dermatomyositis: joint-focused erythematous to violaceous to even hyperpigmented flat-topped papules and plaques; perionychial erythema, edema, and dilated capillary loops at the nail fold along with ragged cuticles; digital ulcerations and calcinosis cutis; and finally a nondescript keratoderma.

Erythematous patches can be present on the face, chest, and hands which can appear red to a more violaceous color. Notice the classic feature of the heliotrope rash around the eyes that has a deeper red and edematous appearance in darker skin tones.

Notice how the “dusky reddish” rash presents in the spectrum of skin tones.

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