[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-443198-105":59,"doc-detail-443198-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","nxp-2-positive-dermatomyositis-unilateral-lower-extremity-subcutaneous-edema-case-report","NXP-2-positive Dermatomyositis - Unilateral Lower Extremity Subcutaneous Edema Case Report","","Anti-NXP2 antibody-positive dermatomyositis is described in a 56-year-old woman who developed 6 weeks of left lower extremity erythema, warmth, swelling, and a progressive pruritic eruption. Initial evaluation labeled refractory cellulitis and imaging showed panniculitis, with temporary improvement after antibiotics and prednisone. Edema and erythema recurred within days after steroid taper, and skin biopsies suggested interface dermatitis consistent with erythema multiforme, prompting further specialty assessment.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/nxp-2-positive-dermatomyositis-unilateral-lower-extremity-subcutaneous-edema-case-report/443198/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/nxp-2-positive-dermatomyositis-unilateral-lower-extremity-subcutaneous-edema-case-report/443198.png","ImageObject",300,407,{"name":92,"@type":93},"Olivia Brown","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-02","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical pattern is emphasized in this case report?","Question",{"text":112,"@type":113},"The report highlights anti-NXP2-positive dermatomyositis presenting with pronounced unilateral lower extremity subcutaneous edema rather than the more typical symmetric peripheral edema.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the condition initially diagnosed and treated?",{"text":117,"@type":113},"The patient was first diagnosed with refractory left lower extremity cellulitis, received antibiotics including IV vancomycin and piperacillin/tazobactam plus ertapenem, and was started on high-dose prednisone after CT showed panniculitis.",{"name":119,"@type":110,"acceptedAnswer":120},"What happened after prednisone therapy was completed?",{"text":121,"@type":113},"Improvement occurred during the prednisone course, but both erythema and edema recurred within days after the steroid taper ended.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},443198,1790943253,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},16904993612988,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","CASE REPORT  \nNXP-2-positive dermatomyositis presenting with pronounced unilateral lower extremity subcutaneous edema  \nMadisen A. Swallow, MS,a Alana Deutsch, MD,b Amanda Zhou, MD,b Jeff R. Gehlhausen , MD PhD,b Matthew Lempel, MD,c David Fernandez, MD PhD,d Lana Bernstein, MD,e Jean Bolognia, MD,b and  \nSarika M. Ramachandran, MDb  \nKey words: dermatomyositis; edema; leg; unilateral.  \nINTRODUCTION  \nIn dermatomyositis , there are characteristic cutaneous findings, for example Gottron papules and cuticular telangiectasias, as well as the production of autoantibodies.1 ,2 Several of these autoantibodies are associated with distinctive clinical presentations. In patients with anti-nuclear matrix protein 2 (NXP2) antibodies, the classic cutaneous findings of dermatomyositis are often accompanied by symmetric peripheral edema, calcinosis cutis, dysphagia, and myositis in addition to an increased risk of an underlying neoplasm.1 We report a patient with anti-NXP2 antibody-positive dermatomyositis who presented with unilateral lower extremity edema.  \nCASE REPORT  \nA healthy 56-year-old woman with no significant past medical history and on no chronic medications presented with a 6-week history of left lower extremity (LLE) erythema, warmth, and swelling, plus a progressive pruritic eruption, which the patient described as blotchy pink patches. Two days after the onset, she was exposed to narrowband ultraviolet B radiation via a home phototherapy unit utilized for photorejuvenation. She was diagnosed with cellulitis ofthe LLE by her local dermatologist and completed a 10-day course of doxycycline (100 mg twice daily) . Due to a lack of improvement, she was admitted to an  \nFrom the Yale School of Medicine, New Haven, Connecticuta; Department of Dermatology, Yale School of Medicine, New Haven, Connecticutb; Department of Rheumatology, Yale School of Medicine, New Haven, Connecticutc; Department of Rheumatology, Hospital of Special Surgery, New York, New Yorkd; and Rheumatology Section Head, Greenwich Hospital YNHH, Greenwich, Connecticut.e  \nDrs Swallow and Deutsch contributed equally to this article. Funding sources: None.  \nPatient consent: The authors obtained written consent from patients for their photographs and medical information to be published in print and online and with the understanding that this information may be publicly available. Patient consent  \nAbbreviations used:  \nAZA: azathioprine  \nCT: computed tomography  \nDVT: deep vein thrombosis  \nHCQ: hydroxychloroquine  \nIVIG: intravenous immunoglobulin  \nLLE: left lower extremity  \nLUE: left upper extremity  \nMTX: methotrexate  \nNXP2: nuclear matrix protien 2  \nRLE: right lower extremity  \nRUE: right upper extremity  \noutside hospital with the diagnosis of refractory cellulitis and received 2 days of intravenous vancomycin, piperacillin/tazobactam, and ertapenem, followed by a 7-day course of oral cephalexin. A computerized tomography (CT) scan ofthe LLE noted panniculitis for which she was started on prednisone (1 mg/kg/day), tapered over 3 weeks. There was improvement of the LLE erythema and edema, but within days of completing the course of prednisone, both recurred. Her dermatologist performed biopsies of the left thigh and upper back, which were read as interface dermatitis consistent with erythema multiforme. Four days following the conclusion of her prednisone taper, she was referred to our facility for further evaluation and treatment.  \nforms were not provided to the journal but are retained by the authors.  \nIRB approval status: Not applicable.  \nCorrespondence to: Sarika M. Ramachandran, MD, Department of Dermatology, Yale School of Medicine, 333 Cedar St, New  \nHaven, CT 06510. E-mail: [Sarika.ramachandran@yale.edu](Sarika.ramachandran@yale.edu). JAAD Case Reports 2026;67:197-201.  \n2352-5126  \n© 2025 The Author(s) . Published by Elsevier Inc. on behalf of the American Academy of Dermatology, Inc. This is an open access article under the CC BY license ([ht","cbCaiiT7451CoqmZ","https://ap.wps.com/l/cbCaiiT7451CoqmZ","pdf",6379104,"English","# Introduction\n# Case Report\n## Presentation and initial diagnosis\n## Treatments and recurrence\n# Results and clinical findings\n## Skin manifestations and imaging","[{\"question\":\"What clinical pattern is emphasized in this case report?\",\"answer\":\"The report highlights anti-NXP2-positive dermatomyositis presenting with pronounced unilateral lower extremity subcutaneous edema rather than the more typical symmetric peripheral edema.\"},{\"question\":\"How was the condition initially diagnosed and treated?\",\"answer\":\"The patient was first diagnosed with refractory left lower extremity cellulitis, received antibiotics including IV vancomycin and piperacillin/tazobactam plus ertapenem, and was started on high-dose prednisone after CT showed panniculitis.\"},{\"question\":\"What happened after prednisone therapy was completed?\",\"answer\":\"Improvement occurred during the prednisone course, but both erythema and edema recurred within days after the steroid taper ended.\"}]","NXP-2-positive Dermatomyositis - Unilateral Lower Extremity Subcutaneous Edema Case Report | PDF",1790703267,13]