Image Challenge of the Week!

You are leading physical diagnosis rounds with your medical students and encounter a patient with the following finding:

Mechanic's hands
J Am Acad Dermatol. 1998 Dec;39(6):899-920

On closer examination, the skin appears hyperkeratotic with fissuring on the palmar and lateral aspects of the fingers.

What is this finding and classic associated disease states? Scroll down for answer.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Answer:

Mechanic’s hands, classically associated with dermatomyositis and antisynthetase syndrome

Discussion:

Mechanic’s hands are a cutaneous finding often associated with inflammatory myopathies, particularly dermatomyositis and antisynthetase syndrome. They are also frequently associated with autoantibodies associated with interstitial lung disease.

Patients may also have a similar finding termed “hiker’s feet” or “mechanic’s feet” that presents as bilateral hyperkeratotic, cracked, and dry skin on the plantar aspect of the feet and toes. The association of this finding with inflammatory myopathies and interstitial lung disease has not been as robustly established.

Hiker's feet
Clin Rheumatol. 2017 Jul;36(7):1683-1686.