Unilateral Gottron Papules in a Hemiparetic Patient with Dermatomyositis

We report a case of dermatomyositis in a 35-year-old woman with chronic right-sided hemiparesis, in whom cutaneous manifestations including Gottron papules were confined to the more functionally active left side, while the paretic right extremities were spared. PET-CT demonstrated asymmetric skeletal muscle FDG uptake and muscle bulk, compatible with long-standing functional asymmetry. This intraindividual comparison supports the hypothesis that movement and mechanical stress may contribute to the localization of cutaneous lesions in dermatomyositis, while neuroimmune and vascular factors may also play a role.