Dermatomyositis is an inflammatory disease with proximal muscle weakness and diverse dermatologic findings. Gottron papules are violaceous papules over bony prominences, such as the knuckles, elbows, or knees. Light-purple (heliotrope) periorbital swelling is common, and, like Gottron papules, is considered pathognomonic of the disease. A violaceous macular erythema is frequent, especially in sun-exposed areas, including the V distribution over the upper chest. Erythematous macules are often present on the upper-lateral thighs (holster sign) and in the “shawl” distribution over the shoulders, arms, and back. These lesions may be poikilodermatous, indicating a combination of hyperpigmentation, hypopigmentation, dermal atrophy, and telangiectasias. Periungual erythema, telangiectasias, and irregular cuticles occur in the nail fold, which, when examined with magnification, demonstrates capillary changes of thrombosis, hemorrhage, enlarged loops, or loss of vessels. The findings of “mechanic’s hands” include hyperkeratosis with scaling, horizontal fissuring, and hyperpigmentation of the digits and palms, which make the hands look soiled. The scalp is often pruritic, scaly, and red or violaceous.