La dermatomiositis juvenil (DMJ) es una enfermedad autoinmune rara que representa la miopatía inflamatoria idiopática más frecuente en la edad pediátrica. Se caracteriza principalmente por debilidad muscular proximal de inicio insidioso y lesiones cutáneas patognomónicas, como el exantema heliotropo y las pápulas de Gottrón. Su incidencia anual se estima entre 2 y 4 casos por millón de niños, con un predominio en el sexo femenino. La etiología de esta condición es multifactorial, combinando predisposición genética y factores ambientales, principalmente infecciosos, que desencadenan una respuesta inmune aberrante dirigida al endotelio vascular y al tejido muscular. A nivel clínico, además del compromiso musculocutáneo, pueden observarse manifestaciones sistémicas, como afecciones pulmonares, gastrointestinales o cardíacas, lo que convierte a esta entidad en un desafío diagnóstico y terapéutico en reumatología pediátrica. En este reporte de caso, se presenta una paciente femenina con DMJ, quien acude inicialmente por debilidad generalizada, lesiones cutáneas y dolor articular, presentando una evolución que amerita ingreso hospitalario para tratamiento con inmunoglobulina intravenosa y manejo del dolor. Este caso resalta la importancia de una evaluación clínica oportuna y un enfoque terapéutico integral para evitar complicaciones a largo plazo y mejorar la calidad de vida del paciente.
Juvenile dermatomyositis (JDM) is a rare autoimmune disease and the most common idiopathic inflammatory myopathy in the pediatric population. It is primarily characterized by insidious-onset proximal muscle weakness and pathognomonic cutaneous lesions, such as heliotrope rash and Gottron’s papules. Its annual incidence is estimated at 2 to 4 cases per million children, with a higher prevalence in females. Etiology is multifactorial, involving a combination of genetic predisposition and environmental factors, mainly infectious triggers, that lead to an aberrant immune response targeting vascular endothelium and muscle tissue. Clinically, in addition to the characteristic skin and muscle involvement, systemic manifestations may occur, including pulmonary, gastrointestinal, or cardiac complications, making JDM a diagnostic and therapeutic challenge in pediatric rheumatology. This case report presents a female patient with JDM who initially presented with generalized weakness, cutaneous lesions, and joint pain, progressing to require hospital admission for intravenous immunoglobulin therapy and pain management. This case highlights the importance of timely clinical evaluation and a comprehensive therapeutic approach to prevent long-term complications and improve the patient’s quality of life.
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