The ACR Image Competition 2021 Results

These images, submitted by Santhanam Lakshminarayanan, MD, associate professor of medicine in the Division of Rheumatology the University of Connecticut School of Medicine, Farmington, show a 32-year-old Black woman with classic cutaneous manifestations of dermatomyositis: heliotrope rash; periorbital edema with complete closure of the eyes; erythema nodosum on the lower extremity overlying the tibia; hyperkeratosis of hands (i.e., mechanic’s hands); post-inflammatory hypopigmentation on the metacarpophalangeal (MCP) joints, proximal interphalangeal (PIP) joints and distal interphalangeal (DIP) joints; Gottron’s sign over the PIP joints and elbow; periungal infarcts; and hyperkeratosis of feet (i.e., hiker’s feet).