Progress and prognosis in juvenile dermatomyositis

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Future Medicine Ltd. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMAPRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at www.medscape.org/journal/ijcr; (4) view/print certificate. With the advent of corticosteroids as a treatment option for autoimmune disease in the early 1960s, the course of juvenile dermatomyositis was altered from one of high mortality to one with various degrees of morbidity. Prior to treatment with corticosteroids, juvenile dermatomyositis resulted in recovery, recovery with chronic disability or death. Corticosteroids significantly decreased mortality and by modifying disease course, morbidity but introduced additional complications. Biomarkers of disease activity, as well as predictors of disease course and severity, are lacking but are a focus of current investigation. Improved understanding of pathogenesis has expanded medication choices to treat both new-onset and refractory disease. Published consensus treatment plans are being implemented, facilitating studies of comparative effectiveness and toxicity.