title: Adult-onset Still's disease with vesiculopustules on the hands and feet.
abstract: 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.
authors.affiliation: Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea. schul@chonnam.ac.kr
authors.forename: Jee Bum
authors.initials: JB
authors.lastname: Lee
authors.forename: Jae Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Shin Seok
authors.initials: SS
authors.lastname: Lee
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Won
authors.forename: Seung Chul
authors.initials: SC
authors.lastname: Lee
mesh_terms: 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
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal