The Pathognomonicity of Gottron’s Sign
Bibliographic record
Abstract
Summary This article presents the case of a previously healthy 43-year-old female who presented with a 3-month history of progressive, symmetrical, bilateral, proximal muscle weakness accompanied by a violaceous-to-erythematous rash involving her hands, arms, thighs, chest, and face. She had conspicuous non-edematous periorbital violaceous patches with telangiectasia and prominent warm violaceous macules overlying the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. Muscle biopsy confirmed dermatomyositis. Gottron’s sign is the most specific cutaneous finding of dermatomyositis and is present in at least 70% of patients. The lesions begin as non-palpable flat macules or patches (Gottron’s “sign”) or are firm and raised (Gottron’s “papules”), but the lesions eventually coalesce into raised non-blanching plaques that occur over bony prominences – typically the MCP, PIP, and/or distal interphalangeal joints. Gottron’s sign (and papules) are pathognomonic for dermatomyositis, although some other conditions may have similar presentations. Gottron’s sign must always be explained, as dermatomyositis may be primary or secondary to malignancy or other connective tissue diseases, and none of the conditions that make up the differential diagnosis are benign.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".