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. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
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].