{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:21:05Z","timestamp":1791973265153,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T00:00:00Z","timestamp":1478217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric patients can present with skin manifestations of dermatomyositis without overt weakness (clinically amyopathic juvenile dermatomyositis [<jats:styled-content style=\"fixed-case\">JDM<\/jats:styled-content>]), but it is unclear how often this happens and how often they have subclinical muscle inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Our goal was to determine the frequency of clinically amyopathic <jats:styled-content style=\"fixed-case\">JDM<\/jats:styled-content> and the frequency with which a thorough evaluation uncovers subclinical myositis at a single institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was performed of 46 patients diagnosed with <jats:styled-content style=\"fixed-case\">JDM<\/jats:styled-content> at Children's Hospital of Wisconsin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 46 patients presenting with skin findings consistent with dermatomyositis, 10 patients (21.7%) did not have evidence of muscle involvement on history or exam, and these tended to be the younger patients. Of these 10, only 2 (4% of all the <jats:styled-content style=\"fixed-case\">JDM<\/jats:styled-content> patients) were truly amyopathic upon further evaluation (all five muscle enzymes [aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, creatine kinase and aldolase], magnetic resonance imaging [<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>], muscle biopsy). In our series, muscle biopsy was not helpful in identifying subclinical myositis. In contrast, <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> did uncover subclinical muscle disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data suggest that truly amyopathic <jats:styled-content style=\"fixed-case\">JDM<\/jats:styled-content> is rare and that a thorough workup that includes all five muscle enzymes and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> may uncover occult myositis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.13013","type":"journal-article","created":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T07:32:07Z","timestamp":1478244727000},"page":"50-57","source":"Crossref","is-referenced-by-count":16,"title":["How Often are Pediatric Patients with Clinically Amyopathic Dermatomyositis Truly Amyopathic?"],"prefix":"10.1111","volume":"34","author":[{"given":"Edward J.","family":"Oberle","sequence":"first","affiliation":[{"name":"Department of Pediatrics Section of Pediatric Rheumatology Nationwide Children's Hospital Ohio State University Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Bayer","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2869-2718","authenticated-orcid":false,"given":"Yvonne E.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Dermatology Section of Pediatric Dermatology Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7760-2411","authenticated-orcid":false,"given":"Dominic O.","family":"Co","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Section of Pediatric Rheumatology Medical College of Wisconsin Milwaukee 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