Mediterr J Rheumatol 2022;33(2):268-70
Mechanic’s Hand Heralding Relapse in an Indian Adolescent with Anti-MDA5 Positive Juvenile Dermatomyositis
Authors Information

1Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Mumbai, India

2Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States

3Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

K Genatra, R Aggarwal, L Gupta


Anti-MDA5 antibodies characterise a distinct phenotype of dermatomyositis in adults as well as children, with ethnic disparity in clinical presentation and severity. They often present as a diagnostic conundrum with rash, ulceration, and polyarthritis, but minimal muscle disease. Mechanic's hands are typically associated with anti-synthetase syndrome, but their presence in anti-MDA5 antibody positive patients, although reported, is not well known. We present the case of a boy in whom mechanic's hand heralded a relapse of juvenile dermatomyositis which was suspected based on remotely assessed patient-reported outcome measures on teleconsultation.

This report suggests that mechanic's hands should also prompt testing for myositis antibodies including anti-MDA5 in Indian children with JDM. Diligent awareness of the condition, and timely use of patient reported outcome measures of muscle power and skin assessment may guide management while delivering remote care in challenging situations such as a global pandemic.

Cite this article as: Ganatra K, Aggarwal R, Gupta L. Mechanic’s Hand Heralding Relapse in an Indian Adolescent with Anti-MDA5 Positive Juvenile Dermatomyositis. Mediterr J Rheumatol 2022;33(2):268-70.

Article Submitted: 24 Mar 2021; Revised Form: 12 Jun 2021; Article Accepted: 25 Jun 2021; Available Online: 30 Jun 2022


This work is licensed under a Creative Commons Attribution 4.0 International License.

©Ganatra K, Aggarwal R, Gupta L.