Rapidly Worsening Subcutaneous Edema in a Young Boy: A Case of Juvenile Dermatomyositis

    April 2022 in “ Rheumatology ”
    Shalini Janagan, W. A. E Udeshika, Pasindu M Samarasinghe, Jayatri Jagoda
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    TLDR Juvenile dermatomyositis can worsen quickly and needs strong treatment.
    A 4-year-old boy in Sri Lanka presented with generalized rash, facial puffiness, hair loss, and muscle weakness, leading to a diagnosis of juvenile dermatomyositis (JDM). Despite initial treatment with high-dose steroids, his condition worsened with severe subcutaneous edema and muscle power deterioration. Further treatment with IV Methylprednisolone, plasmapheresis, and cyclophosphamide led to improvement, though he remains steroid-dependent and awaits Rituximab treatment. The case highlights the severe, rapidly progressive nature of JDM-associated subcutaneous edema and the need for aggressive immunosuppression for better outcomes.
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