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CASE REPORT
Extensive skin ulcers in a child with juvenile dermatomyositis
  1. Aman Gupta,
  2. Rakesh Kumar Pilania,
  3. Venkata Durga Prasad,
  4. Sandesh Guleria
  1. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Aman Gupta, drgupta_aman{at}yahoo.com

Summary

Juvenile dermatomyositis (JDM) is a multisystemic disorder. Vasculitic ulcers in JDM have been reported to involve axilla, elbow or extensor surfaces of other joints. We report a young boy with JDM who presented with extensive cutaneous ulcers involving scrotum, prepuce, gluteal region, neck, bilateral axilla, periumbilical area and bilateral elbows and popliteal fossa. His disease course was marked by several relapses and he required immunosuppression with prednisolone, subcutaneous methotrexate and intravenous cyclophosphamide. His muscle weakness improved and skin ulcers healed after 6 months of intensive immunosuppressive therapy. Children with JDM and ulcers often show increased resistance to immunosuppressive therapy. Extensive cutaneous ulcers in JDM, especially those involving the scrotum, have never been described. Awareness regarding the uncommon manifestations is important to guide appropriate therapy.

  • musculoskeletal and joint disorders
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Footnotes

  • Contributors AG prepared the manuscript and was involved in patient care, RKP reviewed the literature on the subject, VDP reviewed the literature on the subject and was involved in patient care and SG was involved in patient care and reviewed the literature. All authors had read and approved the final manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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