However, other organs such as the lung and heart may be involved. A systemic vasculopathy, which can produce disease in other organs such as the gastrointestinal tract, is frequently present in children with dermatomiositis. The active cutaneous manifestations of dermatomyositis can Recommendations Treatment Dosage recommendations in this document are for an average-sized, otherwise healthy adult and should be appropriately adjusted when treating children or adults with renal or hepatic dysfunction. Medical Topical corticosteroids Topical corticosteroids usually in an ointment base are occasionally helpful, but care should be taken to avoid producing atrophy. Other forms of topical and systemic anti-pruritic therapy, including oral antihistamines, may be considered when topical corticosteroids are not successful.
Partial improvement is more common than complete control.
Baseline and periodic follow-up ophthalmologic screening for antimalarial retinopathy should be performed for all patients being treated with chloroquine and hydroxychloroquine. Baseline and intermittent tests to evaluate for hematologic and hepatic toxicity with any of these drugs are recommended. In cases involving disabling skin disease such therapy may be warranted. In some patients treated with systemic corticosteroids, pruritic skin disease activity can persist long after full resolution of muscle weakness. Patients should be monitored carefully while taking systemic corticosteroids.