Cutaneous ulceration in amyopathic dermatomyositis

Plaque with central crust and mild scale overlying the third metacarpal-phalangeal (MCP) joint in a patient with amyopathic dermatomyositis and antibodies to melanoma differentiation-associated gene 5 (MDA-5). The initial lesion was a spontaneous vasculopathic ulcer. The surrounding plaque developed as part of the healing process. A second healing plaque is present overlying the fifth MCP joint.