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Typical evanescent and atypical persistent polymorphic cutaneous rash in an adult Brazilian with Still's disease: a case report and review of the literature.

Michailidou D, Shin J, Forde I, Gopalratnam K, Cohen P, DeGirolamo A - Auto Immun Highlights (2015)

Bottom Line: Adult onset Still's disease (AOSD) is a systemic auto-inflammatory condition of unknown etiology, characterized by high fever, an evanescent, salmon-pink maculopapular skin rash, arthralgia or arthritis and leukocytosis.AOSD can also present with atypical cutaneous manifestations, such as persistent pruritic coalescent papules or plaques and linear lesions that have highly distinctive pathological features and are usually associated with severe disease.Herein, we present a 31-year-old Brazilian man with both typical Still's rash and atypical persistent polymorphic cutaneous manifestations associated with severe systemic inflammatory response syndrome.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Bridgeport Hospital, Yale-New Haven Health System, Bridgeport, CT, USA. de.michailidou@gmail.com.

ABSTRACT
Adult onset Still's disease (AOSD) is a systemic auto-inflammatory condition of unknown etiology, characterized by high fever, an evanescent, salmon-pink maculopapular skin rash, arthralgia or arthritis and leukocytosis. AOSD can also present with atypical cutaneous manifestations, such as persistent pruritic coalescent papules or plaques and linear lesions that have highly distinctive pathological features and are usually associated with severe disease. Herein, we present a 31-year-old Brazilian man with both typical Still's rash and atypical persistent polymorphic cutaneous manifestations associated with severe systemic inflammatory response syndrome. Eosinophils that are consistently lacking in the AOSD-associated skin lesions were evident in the skin biopsy of the persistent atypical cutaneous manifestations and were either drug-related or AOSD-associated.

No MeSH data available.


Related in: MedlinePlus

Atypical urticarial rash: a linear urticarial eruption on the flexor surface of arms. b Multiple intensely pruritic linear urticarial streaks on the upper and lower trunk
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Fig2: Atypical urticarial rash: a linear urticarial eruption on the flexor surface of arms. b Multiple intensely pruritic linear urticarial streaks on the upper and lower trunk

Mentions: A 31-year-old Brazilian male presented with high quotidian fever and night sweats, non-productive cough, lower back pain and erythematous rash for two weeks. The fever occurred almost daily and ranged from 39 to 40 °C. The rash started from both hands and was characterized by multiple erythematous confluent roundish macules and papules that coalesced to form large, irregular erythematous plaques (Fig. 1). The rash lasted for a few days and then appeared with a different morphology on the flexor surfaces of his arms as an extensive erythematous linear urticarial eruption (Fig. 2a). Subsequently the rash appeared on his upper and lower trunk as multiple intensely pruritic linear urticarial streaks (Fig. 2b). Ibuprofen has been used intermittently to alleviate back pain as well as the fever with minimal relief. He denied any contacts with sick individuals, insect or animal bites and his last trip was to Brazil 10 months ago. He has been sexually active in a monogamous relationship.Fig. 1


Typical evanescent and atypical persistent polymorphic cutaneous rash in an adult Brazilian with Still's disease: a case report and review of the literature.

Michailidou D, Shin J, Forde I, Gopalratnam K, Cohen P, DeGirolamo A - Auto Immun Highlights (2015)

Atypical urticarial rash: a linear urticarial eruption on the flexor surface of arms. b Multiple intensely pruritic linear urticarial streaks on the upper and lower trunk
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4633415&req=5

Fig2: Atypical urticarial rash: a linear urticarial eruption on the flexor surface of arms. b Multiple intensely pruritic linear urticarial streaks on the upper and lower trunk
Mentions: A 31-year-old Brazilian male presented with high quotidian fever and night sweats, non-productive cough, lower back pain and erythematous rash for two weeks. The fever occurred almost daily and ranged from 39 to 40 °C. The rash started from both hands and was characterized by multiple erythematous confluent roundish macules and papules that coalesced to form large, irregular erythematous plaques (Fig. 1). The rash lasted for a few days and then appeared with a different morphology on the flexor surfaces of his arms as an extensive erythematous linear urticarial eruption (Fig. 2a). Subsequently the rash appeared on his upper and lower trunk as multiple intensely pruritic linear urticarial streaks (Fig. 2b). Ibuprofen has been used intermittently to alleviate back pain as well as the fever with minimal relief. He denied any contacts with sick individuals, insect or animal bites and his last trip was to Brazil 10 months ago. He has been sexually active in a monogamous relationship.Fig. 1

Bottom Line: Adult onset Still's disease (AOSD) is a systemic auto-inflammatory condition of unknown etiology, characterized by high fever, an evanescent, salmon-pink maculopapular skin rash, arthralgia or arthritis and leukocytosis.AOSD can also present with atypical cutaneous manifestations, such as persistent pruritic coalescent papules or plaques and linear lesions that have highly distinctive pathological features and are usually associated with severe disease.Herein, we present a 31-year-old Brazilian man with both typical Still's rash and atypical persistent polymorphic cutaneous manifestations associated with severe systemic inflammatory response syndrome.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Bridgeport Hospital, Yale-New Haven Health System, Bridgeport, CT, USA. de.michailidou@gmail.com.

ABSTRACT
Adult onset Still's disease (AOSD) is a systemic auto-inflammatory condition of unknown etiology, characterized by high fever, an evanescent, salmon-pink maculopapular skin rash, arthralgia or arthritis and leukocytosis. AOSD can also present with atypical cutaneous manifestations, such as persistent pruritic coalescent papules or plaques and linear lesions that have highly distinctive pathological features and are usually associated with severe disease. Herein, we present a 31-year-old Brazilian man with both typical Still's rash and atypical persistent polymorphic cutaneous manifestations associated with severe systemic inflammatory response syndrome. Eosinophils that are consistently lacking in the AOSD-associated skin lesions were evident in the skin biopsy of the persistent atypical cutaneous manifestations and were either drug-related or AOSD-associated.

No MeSH data available.


Related in: MedlinePlus