Common features include skin ulcerations, palmar papules, mechanic's hands, alopecia, and oral ulcers.9 Fewer than 10 adult cases of dermatomyositis with panniculitis and positive anti-MDA5 antibodies have been reported, and no pediatric cases have been found.2 A study by Labrador-Horrillo et al. found that panniculitis occurs significantly more in adult-DM patients with anti-MDA5 antibodies (35.7%) than in those without (12.6%), alongside a complication rate of 35.7%.10 There is also a positive correlation between anti-MDA5 antibody levels and disease activity in JDM. This evidence concerns the gene IFIH1 and Skin ulcer.