MECHANIC'S HANDS

By Gary M. White, MD

Mechanic's hands


Mechanic's hands is a term used to describe skin changes of the hands seen in a variety of connective tissue diseases with an inflammatory myopathy.

Clinical

Fissuring with hyperkeratotic papules, scale, and painful fissures along the sides of the fingers and palm is characteristic of this disease which has been described in patients with polymyositis and dermatomyositis. The cuticles may have periungual erythema, telangiectasias and/or splinter hemorrhages. The resemblance to mechanic's hands has been noted. Nearly all patients have an inflammatory myopathy and these changes seem to be more common in patients with the presence of aminoacyl tRNA synthetases (e.g., Jo-1).

Treatment

A topical steroid may be tried for these specific skin changes. Of course, any associated condition (e.g., dermatomyositis) should be addressed.

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