{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:43:27Z","timestamp":1741754607813,"version":"3.38.0"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acral lesions may represent the best\/only skin lesions to biopsy in patients suspected to have dermatomyositis (DM). However, histopathologic features of acral DM skin lesions are poorly characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed 50 acral biopsies from 46 DM patients and assessed numerous histopathologic features. The majority of biopsies (42\/50; 84%) were sampled from either Gottron papules or signs. We compared histopathologic features in acral biopsies to those in 197 non\u2010acral DM skin biopsies. We also compared histopathologic features in acral biopsies based on the presence of various clinical features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Interface dermatitis, dyskeratotic keratinocytes, and superficial perivascular inflammation were common in DM acral biopsies. However, the absence of &gt;\u20091 hallmark histopathologic feature (interface dermatitis, dyskeratosis, dermal mucin) was relatively common (56%). The presence of all three hallmark histopathologic features was significantly more likely in non\u2010acral compared with acral DM biopsies (68% vs. 44%; <jats:italic>p<\/jats:italic>\u2009=\u20090.0021). The hallmark histopathologic feature most commonly lacking in acral compared with non\u2010acral biopsies was increased dermal mucin. Histopathologic features in acral biopsies did not significantly differ based on acral location, DM subtype, therapeutic regimen, or myositis\u2010associated\/myositis\u2010specific antibody status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pathologists should recognize that acral biopsies in DM patients may lack hallmark histopathologic features commonly seen in biopsies from non\u2010acral locations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cup.14786","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T06:00:06Z","timestamp":1735970406000},"page":"299-308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Histopathologic Features of Acral Skin Biopsies in Dermatomyositis Patients and Comparison to Histopathologic Features in Non\u2010Acral Biopsies"],"prefix":"10.1111","volume":"52","author":[{"given":"Lydia","family":"Cassard","sequence":"first","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine at Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firdous","family":"Ali","sequence":"additional","affiliation":[{"name":"Northeast Ohio Medical University  Rootstown Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth M.","family":"Flatley","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson Medical School, Rutgers University  New Brunswick New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4490-8427","authenticated-orcid":false,"given":"Anthony Patrick","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Dermatology Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Pathology Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102017\u2010211468"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100560.2006.00706.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016\u2010015\u20108496\u20105"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.06.1309"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197502132920706"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197502202920807"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100560.1985.tb00434.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000000701"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e31818520e1"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13442"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2019.1668"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.14786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T23:20:16Z","timestamp":1741735216000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.14786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/cup.14786"],"URL":"https:\/\/doi.org\/10.1111\/cup.14786","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"type":"print","value":"0303-6987"},{"type":"electronic","value":"1600-0560"}],"subject":[],"published":{"date-parts":[[2025,1,3]]},"assertion":[{"value":"2024-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}