Adult-Onset Still’s Disease with an Atypical Cutaneous Manifestation

Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder, characterized by daily fevers, arthralgias, and rash without evidence of infection. Recently there has been growing number cases reported with atypical cutaneous manifestations. We present 37-year-old type VI Fitzpatrick skin female who was seen in the hospital for pruritic on her chest, back, legs. Skin examination significant hyperpigmented papules coalescing into plaques linear patches excoriated back Punch biopsy showed acanthosis numerous apoptotic keratinocytes upper layers epidermis, which characteristic AOSD. As recently, body describing an eruption persistent, typical histologic findings Further, these features may be associated more severe symptoms, higher incidence macrophage activation syndrome, possible delayed malignancy. Due to scarcity manifestations literature, eruptions have not included diagnostic criteria can therefore overlooked misdiagnosed. Prompt recognition imperative prevent worsening prognosis serious adverse effects.