These are the hands of a 60-year-old black woman who, besides a chronic palmar discoloration, has a history of joint pain, muscle weakness, and Raynaud phenomenon. Physical examination showed proximal muscle weakness and mild synovitis in her metacarpophalangeal joints. She was mildly anemic, but renal function and urinalysis results were normal. Her creatine phosphokinase level was elevated at 3435 U/L. Her chest x-ray showed mild interstitial changes at the lung bases.
Answer: C. Antisynthetase syndrome
For more information:
Heimovski FE, Simioni JA, Skare TL. Systemic lupus erythematosus and Raynaud’s phenomenon. An Bras Dermatol. 2015;90:837-840.
Trăilă D, Mlădinescu OF, Oancea C, Tudorache V. Interstitial lung disease as first clinical manifestation within the antisynthetase syndrome—dermatomyositis. Pneumologia. 2015;64:37-40.
Sado DM, Kozor R, Corr L, Moon JC. Global myocardial edema in antisynthetase syndrome detected by cardiovascular magnetic resonance mapping techniques. Circulation. 2016;133:e25-e26.
Guma M, Macbruce D. Mechanic’s hands in a patient with antisynthetase syndrome. Rheumatology Network. June 27, 2012.
