Dermatomyositis with heliotrope rash, shawl sign, and Gottron's papules A middle-aged man describes progressive difficulty combing his hair and rising from a seated position over a period of several months. What findings are present in the images? As everyone pointed out this is a case of dermatomyositis, with: 1) heliotrope rash, 2) shawl sign, and 3) Gottron's papules (more extensive than typical). Malignancy must be sought. Nutrient def. w dermatitis also possible but proximal muscle weakness usually indicates myopathy Dr. André Mansoor @AndreMansoor - Author of Frameworks for Internal Medicine https://amzn.to/2LmUODZ #Dermatomyositis #heliotrope #skinrash #shawl #sign #GottronsPapules #dermatology #clinical #photo