Adult-onset Still's disease with vesiculopustules on the hands and feet.
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology characterized by an evanescent rash, intermittent spiking high fever, arthralgia, and a variety of systemic features. We describe a 46-yr-old woman with Still  s disease who presented with a 2-month history of a symmetrical vesiculopustular eruptions only on both hands and feet. Skin biopsy specimens of both vesicle and pustule revealed fibrin thrombi deposition in the small dermal vessels with little inflammation, subepidermal bulla, and ischemic necrosis of the overlying epidermis, which were consistent with a vasculopathic reaction. Her skin lesions gradually disappeared in response to conventional AOSD therapy, as elevated serum ferritin levels, an index of disease activity, decreased. To the best of our knowledge, this is the first case of vesiculopustular lesions as a skin manifestation of AOSD.
Lee
Jee Bum
JB
Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea. schul@chonnam.ac.kr
Kim
Jae Wook
JW
Lee
Shin Seok
SS
Kim
Seong Jin
SJ
Won
Young Ho
YH
Lee
Seung Chul
SC
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D005528:Foot; D006225:Hand; D006801:Humans; D008875:Middle Aged; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal