{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:59:48Z","timestamp":1780347588063,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Antibodies to 3\u2010hydroxy\u20103\u2010methylglutaryl\u2010coenzyme A reductase (HMGCR) form a newly identified distinct serological marker for necrotizing autoimmune myopathy. Although anti\u2010HMGCR myopathy is currently classified into polymyositis, skin involvement has been reported, with its characteristics only vaguely described. We retrospectively examined the clinical and histological features of non\u2010dermatomyositis\u2010like persistent exanthema in five anti\u2010HMGCR myopathy patients followed up in the neurology and dermatology clinic of Huashan Hospital between December 2020 and September 2024. The exanthema presented as persistent violaceous or erythematous plaques, asymptomatic or itching, mainly distributed on the trunk, whereas dermatomyositis\u2010specific lesions such as Gottron's sign and papules, heliotrope rash, V or shawl signs, and nailfold telangiectasia were all absent. Skin rash in 80% of patients (4\/5) appeared earlier than muscle symptoms such as fatigue, proximal limb weakness, and hyperCKemia, with the median advanced time of 3\u2009years (8\u2009months to 7\u2009years). Biopsies revealed scant interface dermatitis, interstitial mucin, and perivascular lymphocytic infiltrate with occasionally plasma cells and\/or neutrophils. Notably, the exanthema showed no response to topical or even systemic corticosteroid but relieved after systemic immunosuppressive therapy for myopathy, in accordance with the improvement of muscle symptoms and hyperCKemia. Dermatologists should be aware of this rare entity of \u201cpseudo\u2010dermatomyositis\u201d, carefully evaluate muscle syndromes and carry out further investigations, including muscle biopsy and serum anti\u2010HMGCR antibodies assays if present.<\/jats:p>","DOI":"10.1111\/1346-8138.17717","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T18:24:44Z","timestamp":1743359084000},"page":"1083-1089","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Persistent exanthema mainly on the trunk with pathologically dermal interstitial mucin as anti\u2010\n                    <scp>HMGCR<\/scp>\n                    myopathy\u2010associated skin rash: Case series"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7201-3973","authenticated-orcid":false,"given":"Ziqi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Dermatology Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nachuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurology Huashan Hospital, Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"},{"name":"Huashan Rare Disease Center Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shucong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Huashan Hospital, Fudan University  Shanghai China"},{"name":"Institute of Rheumatology, Immunology and Allergy Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianjun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhua","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology Huashan Hospital, Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders  Shanghai China"},{"name":"Huashan Rare Disease Center Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00321-x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000832"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10621-7"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2019.10.005"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnen\/nlaa006"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000376"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40674-021-00174-1"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2021.102691"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26072"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annder.2018.12.010"},{"key":"e_1_2_5_12_1","doi-asserted-by":"crossref","DOI":"10.1177\/2050313X20984120","article-title":"Statin\u2010associated anti\u2010HMGCR immune\u2010mediated necrotizing myopathy with dermatomyositis\u2010like features: a case report","volume":"8","author":"Lim D","year":"2020","journal-title":"Sage Open Med Case Rep"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2024.152522"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3645"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12865-024-00622-2"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27572"}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.17717","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1346-8138.17717","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.17717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T14:52:45Z","timestamp":1772981565000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.17717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/1346-8138.17717"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.17717","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"value":"0385-2407","type":"print"},{"value":"1346-8138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]},"assertion":[{"value":"2024-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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