Juvenile dermatomyositis, or JDM, is a disease marked by muscle weakness and skin rash. Skin changes around the eyelids and over the knuckles and finger joints are also seen.
Juvenile dermatomyositis is one of the conditions in a group of conditions called the dermatomyositis/polymyositis complex. The conditions in this complex are characterized by muscle damage due to an inflammatory process of the blood vessels that lie under the skin and muscles. Juvenile Myositis (JM) is found in children under the age of 18and affects 3,000 to 5,000 children in the United States. Juvenile dermatomyositis is the condition most often seen in children.
Juvenile dermatomyositis most probable has a genetic section, as other auto-immune disease tend to run in the families of patients. The disease is usually triggered by a condition that causes immune system activity that does not stop as it should, but the cause is almost certainly not the cause in most cases. Common triggers embrace immunizations, infections, injuries, and sunburn. The symptoms of juvenile dermatomyositis frequently seem slowly. Symptoms may comprise weakness and discomforts develop in the muscles over a period of days. Children also become uncharacteristically miserable and fractious and they may nag of tummy pain.
They grow skin changes which vary from an clear reddening over the cheeks, eyelids, upper chest, knuckles, elbows and knees to a very weak 'violet' discoloration over the eyelids, which may not be obvious even to the most discerning parent. There may be some swelling around the eyes and sometimes the skin looks thin and shiny. The weakness mainly affects the large muscles around the hips and shoulders resulting in increasing difficulty with walking, climbing stairs, getting up from the floor and lifting the arms. Many children complain of difficulty in swallowing and their voice may become 'nasal' in quality.
Juvenile dermatomyositis cannot be cured. However, with helpful therapy and a multidisciplinary team advance to treatment, remission of the disease may be possible in time. Treatment may comprise medications such as glucocorticosteroids and methotrexate (to treat the inflammatory process) and hydroxychloroquine (to assist treat the skin disease of dermatomyositis). To treat the skin rash, anti-malarial drugs, such as hydroxychloroquine are generally given. Topical steroid creams (hydrocortisone) may help some patients, and anti-inflammatory creams (such as tacrolimus) are proving to be very effective.
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