The typical lesion of dermatomyositis, an edematous purplish-red patch on both upper eyelids, spreads to the periorbital area and gradually expands to the V-zone of the face, neck and upper chest. A purplish papule on the extremities of the elbows and knees, especially on the extensor side of the metacarpophalangeal and interphalangeal joints, with dilated capillaries and hypopigmentation, covered with fine scales, is called Gottron’s (Gordon’s) sign or Grottron’s papule. What are the causes of edematous purplish spots on both upper eyelids? The following is a brief description: 1. Periorbital dermatitis Periorbital dermatitis manifests as a scattered erythematous rash around the mouth, papules, and pustules on the back of the knuckles and neck. The above symptoms can be accompanied by transient erythema and maculopapular rash on the forehead, neck and trunk, which can progress to symmetrical myalgia and muscle weakness in the pelvis, upper limbs and shoulders and neck. 2, wandering erythema The tick bite forms a symmetrical macular rash or maculopapular rash that spreads from one (mostly lower extremities, to the periphery. The rash mostly appears on the thighs, trunk, and upper extremities, and is an early feature of Lyme disease, with no skin manifestations in about 25% of patients. It may be accompanied by fever, chills, headache, general malaise, nausea, vomiting, malaise, back pain, knee pain, and neck stiffness. 3. Follicular sebaceous gland mucin accumulation disease Follicular sebaceous gland mucin accumulation disease may appear as perifollicular papules, accompanied by significant hair loss. 4, Fox-Fordyce disease Fox-Fordyce disease is a chronic disease, manifested as pruritic papules in the axilla, pubic area and periareolar area, accompanied by sweat gland inflammation, where there is no hair growth.