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

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.