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A Clinical Observation of Childhood Dermatomyositis.

Journal of the Korean Pediatric Society 1986;29(4):401-410.
Published online April 30, 1986.
A Clinical Observation of Childhood Dermatomyositis.
Dug Ha Kim, Young Yull Koh, Yong Seung Hwang
Dept, of Pediatrics, College of Medicine、Seoul National University
소아 피부근염의 임상적 관찰
김덕하, 고영률, 황용승
서울대학교 의과대 학 소아과학교실
Abstract
A clinical observation has been made on 10 cases of dermatomyositis who were admitted to the Department of Pediatrics, Seoul National University Hospital from January 1980 through December 1985. The results are as follows; 1) The ratio of female to male cases was 2.3 : 1, and the age at onset varied from 4 years of age to 14 years of age, the mean being 7.8 years of age. 2) The mode of onset was insidious in all 10 cases, and initial presentations were skin. rash(7 cases), muscle weakness(2 cases) and arthralgia/1 case). 3) Skin manifestation was present in all cases and showed Gottron’s papule(6 cases) edema and violaceous discoloration of upper eyelid(5 cases), facial erythema(4 cases) and fine telangiectasia(2 cases). 4) All 10 patients had some degree of muscle weakness. In 2 cases it was so severe that swallowing or respiratory difficulty occurred. The muscles most frequently affected were those of shoulder and hip. 5) Serum muscle enzyme level(LDH) was raised in all 10 cases and SGOT & CPK were elevated in 8 cases. 6) EMG showed myopathy in all patients and muscle biopsy revealed nonspecific myositis in all 10 cases. 7) Prednisone was given at a daily dose of 1 to 2 mg/kg in 10 patients. Clinical improvement was obtained between one week and two weeks after steroid therapy in nine cases Muscle enzymes were normalized within one month after steroid therapy 8) The relapse rate was 62.5% by 5 cases among 8 cases and relapse developed between 18 days and 1 year after initial treatment. There was one death from bronchopneumonia.
Key Words: Childhood dermatomyositis.


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