{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:49:44Z","timestamp":1792586984844,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":293,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016991","name":"Universidad de Guadalajara","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016991","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Dermatology Research and Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Heliotrope rash is a pathognomonic feature of dermatomyositis (DM); however, the molecular pathways implicated in cutaneous involvement have not been fully explored. Although the IL\u201023\/Th17 axis has been implicated in inflammatory and autoimmune diseases, the clinical significance of circulating IL\u201023 across the idiopathic inflammatory myopathy (IIM) spectrum, particularly in cutaneous disease expression, remains insufficiently defined. In this cross\u2010sectional study, we aimed to quantify serum IL\u201023 levels in patients with IIM and evaluate their association with cutaneous involvement, including overall skin disease activity assessed by the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) and the presence of specific skin manifestations, particularly pathognomonic lesions, using a univariate analysis. Serum IL\u201023 levels were measured by Enzyme\u2010Linked Immunosorbent Assay (ELISA) in patients with IIM and healthy controls (HCs), and their relationships with clinical and cutaneous variables were analyzed using univariable and multivariable approaches. Higher IL\u201023 levels were associated with cutaneous involvement, especially with pathognomonic skin manifestations and, most notably, heliotrope sign. IL\u201023 also showed a positive correlation with CDASI activity; the relationship with heliotrope sign remained consistent. Applying a multivariate model, heliotrope rash remained the only independent factor associated with IL\u201023 levels: in other words, IL\u201023 increases by 437.3\u2009pg\/mL when heliotrope is present. These findings suggest that IL\u201023 may be preferentially associated with a cutaneous phenotype characterized by heliotrope rash, rather than with global skin burden alone.<\/jats:p>","DOI":"10.1155\/drp\/4660804","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:36:37Z","timestamp":1792586197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increased IL\u201023 is Associated to Heliotrope Sign in Multivariate Model on Idiopathic Inflammatory Myopathies"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1247-3341","authenticated-orcid":false,"given":"Christian","family":"Juarez-Gomez","sequence":"first","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Reumatolog\u00eda y del Sistema M\u00fasculo-Esquel\u00e9tico (IIRSME) Departamento de Biolog\u00eda Molecular y Gen\u00f3mica Centro Universitario de Ciencias de la Salud Universidad de Guadalajara  Guadalajara Jalisco Mexico  udg.mx"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3635-7071","authenticated-orcid":false,"given":"Oscar","family":"Pizano-Martinez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Reumatolog\u00eda y del Sistema M\u00fasculo-Esquel\u00e9tico (IIRSME) Departamento de Biolog\u00eda Molecular y Gen\u00f3mica Centro Universitario de Ciencias de la Salud Universidad de Guadalajara  Guadalajara Jalisco Mexico  udg.mx"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8066-5966","authenticated-orcid":false,"given":"Mar\u00eda Guadalupe","family":"Ram\u00edrez-Due\u00f1as","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Reumatolog\u00eda y del Sistema M\u00fasculo-Esquel\u00e9tico (IIRSME) Departamento de Biolog\u00eda Molecular y Gen\u00f3mica Centro Universitario de Ciencias de la Salud Universidad de Guadalajara  Guadalajara Jalisco Mexico  udg.mx"},{"name":"Departamento de Fisiolog\u00eda Centro Universitario de Ciencias de la Salud Universidad de Guadalajara  Guadalajara Jalisco Mexico  udg.mx"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5153-4283","authenticated-orcid":false,"given":"Cynthia-Alejandra","family":"Gomez-Rios","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n en Reumatolog\u00eda y del Sistema M\u00fasculo-Esquel\u00e9tico (IIRSME) Departamento de Biolog\u00eda Molecular y Gen\u00f3mica Centro Universitario de Ciencias de la Salud Universidad de Guadalajara  Guadalajara Jalisco Mexico  udg.mx"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6758-5742","authenticated-orcid":false,"given":"Maribell","family":"Cabrera-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Medicina Interna Servicio de Reumatolog\u00eda SNP 004086-SECIHTI Nuevo Hospital Civil \u201cDr. Juan I. 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