Juvenile dermatomyositis is a chronic inflammatory myopathy that commonly manifests systemically. what is the treatment of choice for this myopathy?

The treatment for this myopathy includes the use of corticosteroids,methotrexate intravenous immunoglobulins,anti-TNF therapy & additional treatments include speech therapy,physiotherapy & skin protection.

Explanation:

Juvenile dermatomyositis is an inflammatory disease which results in muscle weakness & skin rashes. It affects all ethnic groups as well as ages. Mostly it occurs in the children at the age group between 5 to 10.Immune system abnormality results in the inflammation and damage to blood vessels & muscles in the skin's muscles & cells.It is characterised by the appearance of reddish or purplish rash on the skin of eyelids & cheeks. A patchy rash may appear around elbows, knees,chest or back.Muscle weakness may began at the same time as the skin rash or it may take place days or months after. This weakness usually affects neck,shoulder, back & stomach muscles. Running, climbing stairs, standing from  seated position & lie to sit position becomes very difficult.Diagnostic test used for the detection of this myopathy includes EMG, Blood tests, MRI, Muscle biopsy & Nail Capillaroscopy.

TREATMENT:

Corticosteroids: They work very faster & they are very powerful anti inflammatory. But because of their side effects, they can't be used for longer duration.Methotrexate: Works very slowly to reduce the inflammation, but it have very few side effects as compared to corticosteroids.Intravenous immunoglobulins (IVIGs): It consists of the healthy antibodies which were taken from healthy donor.  They block the antibodies which affects muscles & skin.Other drugs : Other  medicines include Tacrolimus,cyclosporine, anti-TNF therapy & Azathioprine.

In addition to the above treatments:

Physical Therapy: Exercises are told by therapist to patient in order to maintain strength,flexibility. Physiotherapy is directed to prevent the chronic stiffness,wasting & contractures.Speech Therapy :  Throat muscles also become weak.  Speech Therapy can help improve the speech as well as swallowing.Skin Protection : Skin protection from sun plays very important role in the control of skin as well as muscle disease. Sunscreen, protective clothing  & wide brimmed hats & prevention from sun exposure during the peak hours are very important.

Iwould put 'think' in the blank

Olfactory epithelium i believe