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Cancer Res 71(16):5512-5521, 2011

Several types of rash may occur: Gottrons papules red or violet, slightly raised bumps over the knuckles and joints of the top part of the hand that are often scaly Gottrons sign red or violet coloured patches on the area of skin outside the elbow, knee, or ankle joints Shawl sign a widespread, flat, reddened area that appears on the upper back, shoulders, and back of the neck V sign looks similar to the shawl sign, but appears on the front of the chest in the area of skin exposed by a V-necked t-shirt Heliotrope rash blue/purple rash and swelling on the upper eyelids Holster sign reddish brown skin pigmentation around the buttocks and outer thighs Facial erythema abnormal red skin on the face

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That's why therapeutic doses taken on a daily basis can make such a difference in pain and progression