Extracorporeal Photochemotherapy as Adjunctive Treatment in Juvenile Dermatomyositis: A Case Report

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Abstract
To the Editor. —Juvenile dermatomyositis (JDMS) is an inflammatory myopathy characterized by a classic heliotrope rash, proximal muscle weakness, and elevated muscle enzyme levels. Autoimmunity, both humoral and cellular, is implicated in the pathogenesis. High doses of steroids and ag Months After Start of Photopheresis Patient's enzyme studies throughout the course of combined therapy with methotrexate and photopheresis. ALT indicates alanine aminotransferase; AST, aspartate aminotransferase[ill] and ULN, upper limit of normal. gressive physical therapy are the mainstay of treatment. In patients unresponsive to or intolerant of steroid [ill] therapeutic modalities such as methotrexate, cytotoxic drugs, total body irradiation, and plasmapheresis are used.1Extracorporeal photochemotherapy has been reported for the treatment of autoimmune diseases.2,3We describe a patient with JDMS whose disease progressed on treatment with methotrexate alone and who appears to respond to adjunctive therapy with extracorporeal photopheresis. Report of a Case .—Our patient, an 18-year-old woman, developed

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