Juvenile dermatomyositis (JDM) is a disease in children that causes skin rash (dermato) and muscle inflammation (myositis) resulting in weak muscles.
 
JDM is a type of autoimmune disease. The immune system is a group of cells that function to protect the body from infections. In autoimmune diseases like JDM, these cells fight the body's own tissues and cells, resulting in inflammation and tissue damage.  Blood vessel involvement is frequent and often severe, and since blood vessels run throughout the body, JDM can affect all areas of the including the digestive tract.  Calcium deposits (calcinosis) are also common, especially in the recovery phase. 
 

Symptoms:

There are three main symptoms of JDMS:
  • skin rash
  • slow onset of weak muscles
  • fever
 
Other symptoms might include:
  • sore or swollen joints
  • low energy
  • Visible, reddish-purple rash over the eyelids or joints
  • Swelling or redness in the skin around the fingernails
  • Hardened lumps or sheets of calcium (calcinosis) under the skin
  • Muscle contractures
  • Trouble swallowing (dysphagia)
  • Hoarse-sounding voice
  • Stomach problem
 

Evaluation:

Your physician may refer your child to see a physical therapy (PT), Occupational therapy (OT) and/or a speech language pathologist (SLP).  At the evaluation visit the therapist will talk with you about your child’s medical history, current function and your concerns.   They may do a physical examination of your child, complete standardized testing, observe your child perform several activities.  The therapist will discuss with you if treatment is recommended.
 

Treatment:

Physical therapy: A physical therapist can teach exercises to maintain and improve strength and flexibility and advise an appropriate level of activity. Physical activity is thought to be important in JDM. Physical therapy is directed at preventing muscle wasting and stiffness, and is particularly necessary in patients with calcium deposits (calcinosis) and muscle involvement. Therapy should focus initially on stretching and splinting and include more aggressive strength-building therapy once inflammation is controlled.
 
Occupational Therapy:  An occupational therapist can teach new ways to do daily activities such as eating, combing hair, and dressing, which may be more difficult for a child with JDMS. These activities strengthen smaller muscles (such as those in the hand) and help the child feel more independent.
 
Speech therapy: If the swallowing muscles are weakened by dermatomyositis, speech therapy can help the patient learn how to compensate for those changes.
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