JUVENILE DERMATOMIOSITIS

Irma 1
Yenni ,
Yusmala Helmy 2

Departement of Child Health Medical School, Sriwijaya University

Dr. Mohammad Hoesin Hospital, Palembang - Indonesia

BACKGROUND
Juvenile dermatomyositis (JDM) is a rare systemic OBJECTIVE
autoimmune disorder in children, particularly
affecting proximal joints, muscles and skin.
Diagnosis may be difficult because similarities to To report a case of juvenile
other conditions such as juvenile rheumatoid dermatomyositis
arthritis and leprosy

CASE
A 14 years old boy presented with joint pain and stiffness that
started 4 years before admission
gowers sign(+)
erythematous rashes which later changed into
Heliotrope
hypopigmented papules Erythema of upper eyelids
Fullfilled 3 criteria of Bohan and Peter (symmetrical
weakness of proximal muscles, increased muscle
enzymes, and gottron papules. Electromyography
finding was also supportive of the diagnosis)
Differential diagnosis:
- juvenile rheumatoid arthritis which has joint pain and
stiffness, and
Distal phalanges are shortened,
- leprosy ( hipopigmentation on extremities)
which is associated wih bony
resorption
Therapy:
prednisone for 4 weeks and then gradually tapered. Treatment
was then continued with weekly methotrexate starting 4 weeks
after the initial administration of corticosteroids. Patient
demonstrated clinical improvement after one week of
corticosteroid administration, the pain and stiffness were
reduced and was even regained ability to run Gotron papules on the dorsa
of the hands and fingers,
especially over the
interphalangeal joints

CONCLUSION
With appropriate history taking, physical, and supporting examination, the
diagnosis of JDM can be established. Timely diagnosis will prevent complications
such as contracture and deformity and will greatly improve prognosis

Keywords: Juvenile dermatomyositis