Two children with skin rash and muscle weakness: juvenile dermatomyositis
Boogaard, R.; Drexhage, V.R.; van Suijlekom-Smit, L.W.A.
Nederlands Tijdschrift Voor Geneeskunde 149(3): 146-150
2005
ISSN/ISBN: 0028-2162 PMID: 15693592 Document Number: 593799
Two girls aged 1.5 and 3 years, presented with a skin rash, loss of proximal muscle power and malaise. The younger girl recovered quickly after a short course of corticosteroids but the elder girl proved more difficult to treat effectively with corticosteroids, methotrexate, ciclosporin, intravenous immunoglobulins and hydroxychloroquine. This combination of symptoms should make one consider the diagnosis of juvenile dermatomyositis (JDM). To make the diagnosis of JDM, a characteristic skin rash, proximal muscle weakness, elevated muscle enzymes and, possibly, an abnormal EMG or muscle biopsy should be present. Treatment consists, of steroids and, if necessary, immunosuppressive agents or intravenous immunoglobulins. If cutaneous lesions are serious or persistent, hydroxychloroquine may also be prescribed.