Urticaria as a cutaneous sign of adult-onset Still's disease.
BACKGROUND
The cardinal signs and symptoms of adult-onset Still's disease (AOSD) include periodic fever, arthralgia and arthritis, lymphadenopathy, hepatosplenomegaly, an evanescent rash accompanied by neutrophilic granulocytosis, and a negative rheumatoid factor and antinuclear antibody test.


OBJECTIVE
To alert clinicians and dermatologists to internal diseases such as AOSD when assisting patients with urticarial eruptions and systemic symptoms.


METHODS
A case report of a 52-year-old white woman who received conventional therapy for urticaria for 3 years, with no improvement. Following this period, a diagnosis of AOSD was performed based on the presence of systemic symptoms.


RESULTS
The inflammatory activity markers decreased by the second month of methotrexate therapy; however, the cutaneous lesions failed to disappear. Thalidomide was initiated, and total improvement of the cutaneous lesions was observed after 2 weeks.


CONCLUSIONS
Urticarial rash is an uncommon presentation of AOSD, and clinicians must be alert to the possibility of a misdiagnosis in these cases.
Criado
Roberta F J
RF
Allergy Unit, Dermatology Department of Faculdade de Medicina do ABC, Santo André, Brazil.
Criado
Paulo Ricardo
PR
Vasconcellos
Cidia
C
Szajubok
José Carlos M
JC
Michalany
Nilceo S
NS
Kadunc
Bogdana Victoria
BV
Costa Martins
Jose Eduardo
JE
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D016706:Still's Disease, Adult-Onset / Q000150:complications / Q000175:diagnosis*; D014581:Urticaria / Q000175:diagnosis* / Q000209:etiology