title: [Two children with skin rash and muscle weakness: juvenile dermatomyositis].
abstract: 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.
authors.affiliation: Albert Schweitzer Ziekenhuis, afd. Kindergeneeskunde, Dordrecht. r.boogaard@erasmusmc.nl
authors.forename: R
authors.initials: R
authors.lastname: Boogaard
authors.forename: V R
authors.initials: VR
authors.lastname: Drexhage
authors.forename: L W A
authors.initials: LW
authors.lastname: van Suijlekom-Smit
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003882:Dermatomyositis / Q000188:drug therapy / Q000473:pathology*; D004359:Drug Therapy, Combination; D005145:Face / Q000473:pathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D018482:Muscle, Skeletal / Q000473:pathology; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents