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The skin manifestations include a heliotrope rash (blue-purple discoloration) on the upper eyelids with edema, a flat red rash on the face and upper trunk, and erythema of the knuckles with a raised violaceous scaly eruption (Gottron rash) (27

In this process, a vital role in causing considerable harm to the Schwann cells and neurons in the peripheral nervous system is played by pro-inflammatory cytokines produced by cells that are resident or have infiltrated [26]

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