Abstract
We present a case of a 24 year-old woman with high fever, pruritic erythematous plaques and papules on the trunk and extremities, inflammatory peripheral joint symptoms and sore throat for two weeks. The patient had neutrophilic leucocytosis, elevated acute phase proteins (erythrocyte sedimentation rate, C-reactive protein and ferritin) and increased liver enzymes. Abdominal ultrasonography revealed mild splenomegaly. After the exclusion of infection, malignancy and other rheumatic inflammatory diseases, the patient was diagnosed with adult-onset Still's disease (AOSD) meeting to Yamaguchi criteria. Clinical symptoms and abnormal laboratory tests rapidly improved within days of starting glucocorticoid treatment. The presence of typical evanescent skin rash (salmon-pink) is one of the major criteria of disease, however different skin lesions such as persistent pruritic erythematous plaques and papules have been occasionally reported in association with AOSD on trunk and extremities, which may be confused with other diseases. Therefore, the recognition of the atypical skin lesions with AOSD is necessary for diagnosis and choice treatment of disease.
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