This article originally appeared on the Hospital for Special Surgery website.
Case Report
In May 2019, a 32-year-old woman developed a rash on her face, chest, and knuckles, initially thought to be contact dermatitis. She saw a second dermatologist to evaluate persistent symptoms, who found positive results on antinuclear antibody (ANA) testing. She was referred to rheumatology, but additional lab testing was unrevealing. She learned that she was pregnant, and the rash resolved spontaneously 4 weeks into the pregnancy. She delivered a heathy son at 40 weeks' gestation. Approximately 8 weeks postpartum, the rash on her face, chest, and knuckles recurred. About 4.5 months postpartum, she developed fatigue and weakness of her proximal arms and legs, and came to HSS for evaluation. She had no shortness of breath or dysphagia.
The patient had a prior uncomplicated pregnancy, no prior surgeries, and no family history of autoimmunity, but she did have a first-degree relative with a BRCA mutation. She was breastfeeding and planned to wean in the setting of possibly needing additional medications. She was married, with two young children, and worked full-time.
Her physical exam was notable for erythema of her cheeks and upper chest, with erythematous papules over the metacarpophalangeal joints, consistent with Gottron papules.
