Fashionably Late: A Case of Delayed Cutaneous Manifestations in Juvenile Dermatomyositis.

Fashionably Late: A Case of Delayed Cutaneous Manifestations in Juvenile Dermatomyositis. J Clin Med Res. 2018 Nov;10(11):848-852 Authors: Antoine M, Reeves PT, Rohena L, Jones O, Faux B Abstract Juvenile dermatomyositis (JDM) is a rare, but well recognized multi-systemic inflammatory myopathy in children defined by proximal muscle weakness and distinctive skin lesions, that if recognized and treated early result in decreased morbidity and mortality. The 1975 criteria established by Bohan and Peter center around the propensity for early development of heliotrope and Gottron's lesions in combination with specific laboratory abnormalities, and are still the leading diagnostic tool. The following case demonstrates a toddler with an atypical presentation of JDM in which delayed dermatologic manifestations hindered initial diagnosis. A previously healthy 2 years and 11 months old female presented to the emergency department with a 7-month history of bilateral knee pain and progressive muscular weakness. Initial evaluation yielded a diagnosis of idiopathic rhabdomyolysis but progressive deterioration prompted additional workup. During her course of care, the patient required admission at numerous facilities for specialty procedures including swallow studies, electromyography, Nissen fundoplication with G-tube insertion, and eventual muscle biopsy, resulting in pathology clinching the diagnosis. Post-diagnosis the development of a heliotrop...
Source: Clin Med Res - Category: Research Authors: Tags: J Clin Med Res Source Type: research