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The erythematous, sometimes scaly, rash of dermatomyositis characteristically occurs on the knuckles of the hands and overthe patellae, olecranon processes, and medial malleoli. In fact, violaceous plaques (Gottron’s papules) appearing over the metacarpophalangeal andinterphalangeal joints—but sparing the dorsal phalangeal surfaces—are virtually pathognomonic of dermatomyositis.
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