{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:46:50Z","timestamp":1782488810270,"version":"3.54.5"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,7]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Anti- melanocyte differentiation-associated protein 5 (MDA5) associated dermatomyositis is a rare, heterogeneous disease with multiple phenotypes. This case describes a patient with indolent myopathy, skin lesions and normal creatine kinase (CK). After a period of diagnostic uncertainty, the patient was found to have positive anti-MDA5 and anti-Ro52 antibodies, confirming anti-MDA5 dermatomyositis with cutaneous vasculopathy. Recognition of vasculopathy as a manifestation of dermatomyositis could have led to a much earlier diagnosis. The European Alliance of Associations for Rheumatology \/American College of Rheumatology classification criteria can aid diagnosis. Antibody profile correlates with disease phenotype in dermatomyositis. Anti-MDA5 dermatomyositis is typically associated with rapidly progressive interstitial lung disease and amyopathic dermatomyositis. Some patients may present with myopathy despite a normal CK. Vasculopathic skin lesions are common, but frequently under-recognised, and can develop from Gottron\u2019s papules. All phenotypes are associated with increased morbidity and mortality. This underscores the importance of recognising such vasculopathy as a sign of anti-MDA5-associated dermatomyositis, thus contributing to earlier diagnosis and treatment.<\/jats:p>","DOI":"10.1136\/bcr-2025-268344","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T14:30:53Z","timestamp":1774449053000},"page":"e268344","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cutaneous clues to diagnosis: the vasculopathic form of anti-MDA5 dermatomyositis"],"prefix":"10.1136","volume":"19","author":[{"given":"Martin","family":"Regan","sequence":"first","affiliation":[{"name":"Kellgren Centre, Rheumatology, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Ho","family":"Chiu","sequence":"additional","affiliation":[{"name":"Kellgren Centre, Rheumatology, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Culley","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust, Manchester, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Kellgren Centre, Rheumatology, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"2026062607551075000_19.3.e268344.1","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/art.42308","article-title":"Identification of Three Different Phenotypes in Anti\u2013Melanoma Differentiation\u2013Associated Gene 5 Antibody\u2013Positive Dermatomyositis Patients: Implications for Prediction of Rapidly Progressive Interstitial Lung 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