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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".