Tacrolimus in refractory juvenile dermatomyositis: Case report and review of literature

Abstract

Juvenile dermatomyositis (JDM) is the most common type of inflammatory myositis in childhood, characterized by proximal muscle weakness and rash. The standard treatment of JDM involves steroids and methotrexate (MTX). A small proportion of patients do not respond to steroids and MTX. We present a couple of patients with refractory JDM who had failed to respond to steroids and MTX. Introduction of tacrolimus led to complete remission of the disease in a patient and partial control in the other. Literature review was done which revealed ten patients with JDM who were treated with tacrolimus with encouraging results in the form of significant reduction in the cutaneous and muscle disease activity. Tacrolimus is an useful drug in the management of refractory JDM.