Here, we review IL-6 and tocilizumab, an IL-6 receptor blocker, and survey the literature on off-label tocilizumab use in pediatric patients with rheumatic diseases, such as juvenile-onset systemic lupus erythematosus (SLE), juvenile dermatomyositis (DM), vasculitis, and juvenile scleroderma. The gene discussed is IL6; the disease is dermatomyositis.