SHM Converge Scientific Abstract ePoster Gallery-A Case of Juvenile Dermatomyositis Associated With Epstein-Barr Virus Infection

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This case describes a 17-year-old male with no significant past medical history who presented with diffuse rash and proximal shoulder weakness. On exam, he had 3/5 shoulder girdle strength and characteristic skin findings of dermatomyositis, including Gottron papules and erythematous scaly plaques on the hands, elbows, knees, ankles, and feet.<br /><br />Despite the clinical picture, initial laboratory studies were not strongly supportive: serum aldolase was normal, ANA was negative, and ESR was normal. Imaging did not show hip girdle muscle inflammation. However, a punch biopsy of the hand showed interface dermatitis with superficial and periadnexal lymphocytic infiltrate, findings consistent with dermatomyositis in the appropriate clinical context. Additional testing revealed positive Epstein-Barr virus IgG and IgM, positive parvovirus B19 IgG, and an elevated CRP.<br /><br />The case highlights that juvenile dermatomyositis can still be diagnosed even when labs and imaging are unrevealing, especially if the patient has already received steroids that may have reduced inflammation and masked abnormal results. The authors emphasize the importance of a careful history, detailed physical examination, and clinical judgment in complex presentations. In this patient, those elements were key to making the correct diagnosis and guiding appropriate management.

Asset Subtitle

Alaina Mui

Meta Tag

Author List Alaina Mui

Category Clinical Vignettes

Concept Juvenile Dermatomyositis

Concept Proximal Weakness

Concept Gottron Papules

Concept Erythematous Scaly Plaques

Concept Interface Dermatitis

Distinguished Non-Finalist

Presenter Organization University of South Florida

Presenting Author Alaina Mui

Track Pediatric

Keywords

juvenile dermatomyositis

Gottron papules

proximal muscle weakness

skin biopsy

interface dermatitis

ANA negative

normal aldolase

elevated CRP

steroid treatment

clinical diagnosis

Juvenile Dermatomyositis

Proximal Weakness

Gottron Papules

Erythematous Scaly Plaques

Interface Dermatitis