2004 Volume 114 Issue 1 Pages 43-48
Because patients with polymyositis or dermatomyositis associated with serum anti-aminoacyl-tRNA synthetase antibody, in which anti-Jo-1 antibody forms a vast majority, frequently have interstitial pneumonia, arthralgia, and Raynaud’s phenomenon as well as myositis, they are recognized as a clinical subset under the name of antisynthetase syndrome. A 64-year-old man presented with muscle weakness, arthralgia, general fatigue and skin changes including hyperkeratosis, scaling and fissuring, which were located on the ventral and lateral aspects of his fingers and the dorsal aspect of the finger joints of his bilateral hands. Nailfold bleeding was observed on his fingers, but no other cutaneous signs indicative of dermatomyositis were noted. A skin biopsy from the cutaneous lesion revealed chronic dermatitis-like pathological changes with scattered images of satellite cell necrosis. Serum CPK was 6,687 IU/l. The electromyography showed a myogenic pattern, and a muscle biopsy showed degeneration and atrophy of the muscle fibers. He also had interstitial pneumonia, and his serum contained anti-Jo-1 antibody. He was given a diagnosis of antisynthetase syndrome, and his skin changes were considered to be “mechanic’s hand”. We reviewed the reported cases of mechanic’s hand and discussed the relationship between mechanic’s hand and antisynthetase syndrome.
