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Polymyositis ManagementAka: Dermatomyositis Management

See Also
1. Dermatomyositis
2. Polymyositis
Management: General Measures
1. Prevent atrophy and contractures in Myositis
  1. Passive Stretching and splinting
  2. Strength-building after inflammation decreases
2. Dermatomyositis
  1. Skin Lesions
    1. See Pruritus Management
    2. Consider high potency Topical Corticosteroid
  2. Avoid Sun Exposure (especially in photosensitivity)
    1. Sunscreen
    2. Protective clothing
Management: Systemic Medications
1. Prednisone
  1. Dose
    1. Adults: 40-60 mg/day
    2. Children: 1 to 2 mg/kg/day
  2. Protocol
    1. Administer bid until serum Creatine Kinase normal
    2. Convert to single daily dose
    3. Reduce dose by 25% every 4 weeks down to 10 mg/day
    4. Continue low dose (5-10 mg in adults) for 1 year
2. Other Immunosuppressants
  1. Indications
    1. Strength refractory to Prednisone after 3 months
    2. No improvement in objective muscle strength
    3. Differentiate from steroid Myopathy
      1. Neck flexor strength unchanged steroid Myopathy
  2. Immunosuppressant Options
    1. Methotrexate
    2. Azathioprine (Imuran)
References

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.