Successful Treatment of Refractory Dermatomyositis with Deucravacitinib (Sotyktu): A Case Report
Bibliographic record
Abstract
Introduction: Clinically amyopathic dermatomyositis (CADM) is a subtype of dermatomyositis (DM) characterized by cutaneous findings without clinically apparent muscle involvement. While immunosuppressive therapies such as methotrexate, mycophenolate mofetil, and hydroxychloroquine are commonly used, treatment-resistant cases remain a challenge. We present a case of refractory CADM successfully treated with deucravacitinib, a selective TYK2 inhibitor. Case Presentation: A 50-year-old woman with a 3-year history of CADM presented with persistent facial erythema, heliotrope rash, violaceous erythema on sun-exposed areas, and Gottron's sign. Despite multiple systemic treatments, including methotrexate, mycophenolate mofetil, hydroxychloroquine, and topical and oral roflumilast, she continued to experience skin involvement and associated pain. Deucravacitinib 6 mg daily was initiated, leading to near-complete resolution of cutaneous lesions and complete resolution of pain within 10 weeks. At 6 months, her response remained stable, and she continues treatment with ongoing monitoring. Conclusion: This case highlights deucravacitinib as a potential treatment option for refractory CADM. By selectively inhibiting TYK2, it targets key inflammatory pathways involved in DM pathogenesis while minimizing off-target effects. Further studies are needed to evaluate its long-term safety and efficacy in this patient population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".