DERMATOMYOSITIS & POLYMYOSITIS MANAGEMENT

SUMMARY

1. Treated with a high-dose prednisone that is slowly tapered while a steroid sparing agent is added (azathioprine or MTX).

2. 80% begin to respond to the steroid within a few days to 6 weeks.

3. Patients with life-threatening manifestations receive IV pulse glucocorticoids.

4. Antimalarials, such as hydroxychloroquine, are helpful for the rash in dermatomyositis.

5. Think about superimposed steroid myopathy in a patient with PM/DM who initially improves but then develops progressive weakness despite improvement in CK levels.

6. Screen for cancer!

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].