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The exact cause of JDM is unknown but it is believed to be a problem with the immune system. These problems may cause inflammation of muscle cells and blood vessels that can lead to damage.

Risk Factors

JDM is more common in girls, children living in North American, and children of African American descent. Children with a family history of type 1 diabetes and systemic lupus erythematous are also at an increased risk.

Symptoms

The first JDM symptoms include:

Fever
Fatigue
Lack of appetite
Weight loss

As JDM progresses, symptoms may include:

Skin changes, such as:
- Violet-colored, bumpy, or scaly skin rash that occurs on the face, eyelids, knuckles, elbows, knees, chest, and back
- Skin ulcers
Muscle problems, such as:
- Muscle weakness, especially in the muscles closest to the trunk
- Muscle pain
- Problems swallowing and speaking
- Difficulty moving from a seated to a standing position
- Frequent falls
Sore throat
Abdominal pain
Shortness of breath

Skin Ulcer

Diagnosis

The doctor will ask about symptoms and medical history. A physical exam will be done, paying special attention to the skin and muscles. The appearance of a rash may help with diagnosis.

Your child’s blood and urine will be tested to look for changes in certain enzymes and indicators of inflammation.

Inflammation of the muscle may also be confirmed through:

MRI
Biopsy of your child’s muscle

Electromyography is an electrical test that can find nerve or muscle damage.

Treatment

There is no cure for JDM, although some children may enter a period where symptoms lessen or disappear. Treatment will focus on managing your child’s symptoms. Talk with the doctor about the best treatment plan for your child. Options include:

Medications

Mediations will be given to help manage symptoms. These may include:

Corticosteroids, methotrexate, and/or cyclosporine to reduce inflammation and suppress the immune system
Mycophenolate mofetil to suppress the immune system in severe cases
Hydroxychloroquine to relieve rash symptoms

Intravenous immunoglobin (IVIG) may be given to slow down the inflammatory process.

Therapy

Physical activity is an important part of treatment once inflammation is under control. Physical therapy will help your child:

Maintain and improve strength and flexibility
Prevent muscle wasting and stiffness
Choose appropriate activities for exercising regularly

Speech therapy can help teach how to cope with swallowing difficulties. A dietitian may also be advised to help with safe food selection and meal planning to promote good nutrition.

Skin Protection

Skin protection is needed to control the rash and skin ulcers. This may include:

Avoiding too much time in the sun
Wearing a long-sleeved shirt and long pants, a wide-brim hat, and sunglasses
Using sunscreens with a sun protection factor (SPF) of at least 30
Avoiding exposure during the peak hours of the day

Prevention

There is no method to prevent JDM, since the exact cause of JDM is unknown.

RESOURCES:

American College of Rheumatology
http://www.rheumatology.org

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

CANADIAN RESOURCES:

Canadian Rheumatology Association
https://rheum.ca

Health Canada
http://www.hc-sc.gc.ca

References:

Dermatomyositis. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T116942/Dermatomyositis. Updated April 11, 2016. Accessed January 23, 2017.

Dermatomyositis (juvenile). American College of Rheumatology website. Available at:
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Published 2015. Accessed January 23, 2017.

Juvenile dermatomyositis. Arthritis Foundation website. Available at:
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Accessed January 23, 2017.

Juvenile dermatomyositis. Genetic and Rare Diseases Information Center website. Available at: https://rarediseases.info.nih.gov/diseases/6805/juvenile-dermatomyositis. Accessed January 23, 2017.

Juvenile dermatomyositis. Stanford Children’s Health website. Available at:
...(Click grey area to select URL)
Accessed January 23, 2017.

Juvenile dermatomyositis (JDM). Cincinnati Children’s Hospital website. Available at: https://www.cincinnatichildrens.org/health/j/jdms. Updated March 2016. Accessed January 23, 2017.

Juvenile dermatomyositis in children. Boston Children’s Hospital website.
...(Click grey area to select URL)
Published 2011. Accessed January 23, 2017.

Last reviewed January 2017 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 9/20/2017

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