Hepatitis B-assocciated adult-onset Still's disease presenting with neutrophilic urticaria.
Adult-onset Still's disease (AOSD) is an uncommon systemic inflammatory disorder that is characterized by quotidian fever, articular manifestations, neutrophilic leukocytosis, and maculopapular rash. The aetiology of the disease is unknown, however, an infectious cause has been suggested. Here we describe a patient in whom neutrophilic urticaria was the cutaneous manifestation of AOSD. In addition, the patient suffered from chronic hepatitis B infection that may be a potential trigger factor of AOSD. In patients with AOSD, serological investigations for detection of infection should include hepatitis serology. Further, we suggest that urticarial lesions may be a more common cutaneous manifestation of AOSD than has been recognized previously. Thus it is important to include AOSD in the differential diagnosis of urticaria.
Gambichler
T
T
Dermatology Out-Patient Clinic, Oldchurch Hospital, Romford (Greater East London), United Kingdom. thilo@gambichler.freeserve.co.uk
Paech
V
V
Rotterdam
S
S
Stücker
M
M
Boms
S
S
Altmeyer
P
P
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005335:Fever of Unknown Origin / Q000188:drug therapy; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D016706:Still's Disease, Adult-Onset / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D013997:Time Factors; D014581:Urticaria / Q000175:diagnosis* / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D011239:Prednisolone; D007213:Indomethacin