RT Journal Article SR Electronic T1 Childhood Arthritis and Rheumatology Research Alliance Consensus Clinical Treatment Plans for Juvenile Dermatomyositis with Persistent Skin Rash JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP jrheum.160688 DO 10.3899/jrheum.160688 A1 Adam M. Huber A1 Susan Kim A1 Ann M. Reed A1 Ruy Carrasco A1 Brian M. Feldman A1 Sandy D. Hong A1 Philip Kahn A1 Homaira Rahimi A1 Angela Byun Robinson A1 Richard K. Vehe A1 Jennifer E. Weiss A1 Charles Spencer A1 and the Juvenile Dermatomyositis Research Committee of the Childhood Arthritis and Rheumatology Research Alliance YR 2016 UL http://www.jrheum.org/content/early/2016/10/26/jrheum.160688.abstract AB Objective Juvenile dermatomyositis (JDM) is the most common form of idiopathic inflammatory myopathy in children. While outcomes are generally thought to be good, persistence of skin rash is a common problem. The goal of this study was to describe the development of clinical treatment plans (CTP) for children with JDM characterized by persistent skin rash despite complete resolution of muscle involvement. Methods The Childhood Arthritis and Rheumatology Research Alliance, a North American consortium of pediatric rheumatologists and other healthcare providers, used a combination of Delphi surveys and nominal group consensus meetings to develop CTP that reflected consensus on typical treatments for patients with JDM with persistent skin rash. Results Consensus was reached on patient characteristics and outcome assessment. Patients should have previously received corticosteroids and methotrexate (MTX). Three consensus treatment plans were developed. Plan A added intravenous immunoglobulin (IVIG) if it was not already being used. Plan B added mycophenolate mofetil, while Plan C added cyclosporine. Continuation of previous treatments, including corticosteroids, MTX, and IVIG, was permitted in plans B and C. Conclusion Three consensus CTP were developed for use in children with JDM and persistent skin rash despite complete resolution of muscle disease. These CTP reflect typical treatment approaches and are not to be considered treatment recommendations or standard of care. Using prospective data collection and statistical methods to account for nonrandom treatment assignment, it is expected that these CTP will be used to allow treatment comparisons, and ultimately determine the best treatment for these patients.