Classical Ayurvedic Therapy in Juvenile Dermatomyositis: A Case Report

Juvenile Dermatomyositis (JDM) is an extremely rare idiopathic inflammatory myopathy occurring in childhood characterised by proximal muscle weakness, pathological skin manifestations, and systemic presentation. A 12-year-old boy presented with a history of bilateral hypopigmented patches over the palms and face, pain in the groin region and progressive generalised weakness for five years following an episode of high-grade fever. Investigations revealed elevated muscle enzymes which were consistently associated with JDM. This case is noteworthy for its unusually prolonged disease course prior to presentation, its atypical predominance of pigmentary skin changes over Gottron’s papules or heliotrope rash, and the absence of any prior immunosuppressive therapy. It thereby offers a rare opportunity to observe the isolated effect of Ayurvedic intervention on disease progression. He was treated with a Panchakarma protocol that included Sarvanga Abhyanga with Tila Taila, Shashtika Shali Pind Sweda (SSPS), and Matra Basti with Ashwagandha Ghrita, along with oral medications comprising Rasapachak vati, Mamsapachak vati, and Arogyavardhini Vati supplemented with Shatadhouta Ghrita for topical local application. Post a treatment course of 22 days, significant improvement was observed in muscle strength grading, skin pigmentation, pain scores, and biochemical parameters. This case thereby highlights the potential of Ayurvedic interventions in managing the degenerative pathology fundamental to JDM and also proposes further opportunities for research and awareness of alternative medical approaches.