Progress and prognosis in juvenile dermatomyositis

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.