Gottron Papules

Gottron papules are a type of skin rash that causes small, raised bumps on your joints. They most often appear on the back of your hands over your knuckles. They can also appear on your toes, ankles, knees and elbows. The bumps are red to purple or darker than your natural skin tone.

Gottron papules are important because they can help doctors diagnose dermatomyositis. This is a rare condition that affects your skin and muscles.

If you notice these bumps — especially with new muscle weakness — see a healthcare provider. Signs of muscle weakness include trouble standing from a chair or lifting objects. Dermatomyositis can sometimes affect other organs. While rare, in adults, it may be associated with cancer. Getting diagnosed and treated early can help manage symptoms and lower the risk of complications.

What do Gottron papules look and feel like?

Gottron papules have several features, including:

• Clustered over joints (most often your knuckles)
• Raised patches of skin with flat-topped bumps
• Red, purple or darker than your natural skin tone
• Scaly or crusted

They don’t usually cause pain. But they can itch or burn, and these feelings may get worse after sun exposure. Some people don’t notice any symptoms at all.

What are the types of Gottron papules?

Your provider may use different terms to describe Gottron papules and related rashes:

• Classic Gottron papules: Raised bumps that look red, purple or dark. They show up over joints.
• Gottron’s sign: Flat, discolored patches in the same areas, but without raised bumps.
• Inverse Gottron papules: A rare rash that appears on the palm side of your hands instead of the back.

What causes Gottron papules?

Gottron papules are a skin change that happens with dermatomyositis. This is a rare inflammatory condition that involves both your skin and muscles.

What are early Gottron papules?

Gottron papules are often one of the first signs of dermatomyositis. When they show up at the start of the condition, they’re called “early Gottron papules.” These can appear before muscle weakness or other symptoms begin. If you see this, let a healthcare provider know so they can check what’s going on.

Gottron papules can also come and go. They may fade after appearing early, then return or get worse during symptom flare-ups (times when the condition becomes more active in your body).

How are Gottron papules treated?

Gottron papules may not go away completely, but treatment can help you manage their effects. Your provider will focus on treating dermatomyositis, the condition that causes the papules. They may recommend:

• Topical treatments, like corticosteroid creams or calcineurin inhibitors, to reduce inflammation on your skin
• Systemic medications, like hydroxychloroquine or methotrexate, to manage inflammation throughout your body
• Medications or skin care to ease itchiness or burning, like antihistamines, moisturizers or ointments

If you’re going outside, it’s important to protect your skin. Sun exposure can make papules worse. To lower your risk of irritation:

• Limit your time in direct sunlight.
• Stay in the shade when possible.
• Wear broad-spectrum sunscreen and reapply it often.

Can Gottron papules be prevented?

Because the exact cause of dermatomyositis isn’t known, there’s no sure way to prevent Gottron papules. But you can manage symptoms and reduce irritation. Your healthcare provider can recommend treatments that work best for your skin.

When should Gottron papules be treated by a healthcare provider?

Tell a provider about any skin changes that don’t go away. You should also contact one if your symptoms get worse — especially if you notice both a rash over your joints and muscle weakness. These may be signs of dermatomyositis. A provider can examine you and explain what’s going on.

What’s the difference between Gottron papules and a heliotrope rash?

Dermatomyositis causes both Gottron papules and a heliotrope rash. Here’s the difference:

• Gottron papules: A bumpy skin rash around your joints, usually your knuckles.
• Heliotrope rash: A swollen, purple or dark rash around your upper eyelids.

Your provider will look for these when making a diagnosis.