Myositis, in this case mostly Dermatomyositis and Antisynthetase Syndrome, is sometimes accompanied by other conditions, one of those being Mechanic’s Hands.
Mechanic’s Hands is a descriptive term for the changes in the hands of patients with dermatomyositis and polymyositis. Mechanic’s hand is usually associated with anti-synthetase autoantibodies, including the myositis-specific anti-Jo1 autoantibodies.
Mechanic’s hands is a roughening and cracking of the skin of the tips and sides of the fingers, resulting in irregular, dirty-appearing lines that resemble those of a mechanic or manual laborer.
Clinical definition and explanation of Mechanic's Hands
Fissuring with hyperkeratotic papules, scale, and painful fissures along the sides of the fingers and palm is characteristic of this disease which has been described in patients with polymyositis and dermatomyositis. The cuticles may have periungual erythema, telangiectasias and/or splinter hemorrhages. Nearly all patients that present with Mechanic’s Hands have an inflammatory myopathy and these changes seem to be more common in patients with the presence of aminoacyl-tRNA synthetases (e.g., Jo-1).
Treating Mechanic's Hands
A topical steroid may be tried for the specific skin changes of Mechanic’s Hands. Of course, any associated condition (e.g., dermatomyositis, antisynthetase syndrome, etc.) should be addressed with proper treatment.
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