A Clinicopathological Study on Skin Manifestations of Adult-onset Still's Disease (AOSD)

Han, Sung Hyub; Choi, Gwang Seong; Shin, Jeonghyun

Abstract

BACKGROUND
Adult-onset Still's disease (AOSD), one of the causes of fever of unknown origin, is accompanied by skin rash. This is the reason why the clinical significance of skin lesions has been of interest. However, its skin manifestations and the histopathological findings are not clearly documented.
OBJECTIVE
This study aimed to identify characteristic clinical and histopathological features of skin manifestation of AOSD.
METHODS
We evaluated the medical records and histopathologic slides of five patients who had been diagnosed with AOSD in the rheumatology department and referred to our department between 1996 and 2009.
RESULTS
An asymptomatic evanescent salmon colored macular rash was seen in three patients (60%). A persistent brown plaque was seen in two patients (40%). Histopathologically, superficial perivascular infiltrates of neutrophils and lymphocytes were observed in all patients (100%) and necrotic keratinocytes were observed in the upper epidermis in three patients (60%).
CONCLUSION
In addition to typical Still's rash, atypical cutaneous findings such as persistent plaque lesions were found in AOSD patients. The results of this study may help clinicians to diagnose this rare disease more easily.