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KMID : 0378019850280010102
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New Medical Journal
1985 Volume.28 No. 1 p.102 ~ p.107
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A Case of Dermatomyositis was improved by Combined Corticosteroid and Chloroquine Therapy
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Abstract
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Dermatomyositis (DM) is a collagen vascular disorder with prominent cutaneous features and an inflammatory muscle disease.
A 31 year-old male had symmetrical proximal muscle weakness on his shoulder girdle and anterior thigh muscle and purplish red patches & edema on the face, neck, "V"-area of chest and scapular areas. The patient noted that the rash worsened after sun exposure. There was no history of arthritis, periungual telangiectasia, Gottron´s papules and Raynaud´s phenomenon. Diagnosis of DM was established by clinical manifestations, electromyogram, histologic findings of the skin & muscle.
Most physicians treat DM with corticosteroids in high doses (l mg/kg/day) initially. Patients who are refractory to corticosteroids usually require a second drug. The best results have been reported with methotrexate. Azathioprine, cyclophosphamide and chlorambucil have also been used in this disease with variable success. Woo et al concluded that anti-malarials appear to be effective in treating the cutaneous lesions of DM at recently. Furthermore, instititution of antimalarials allowed the dosage of steroids to be reduced, and a steroid-sparing effect due to antimalarials was present.
The patient was initially started on 60 mg of prednisolone every day, and placed on chloroquine, 200mg twice daily, which resulted in good control of his cutaneous lesions and muscle weakness within 7 weeks. Following improvement, the dose of corticosteroid & chloroquine were tapered and eventually discontinued. Eye examinations conducted on a monthly basis have been normal.
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