title: Persistent pruritic papules and plaques: a characteristic histopathologic presentation seen in a subset of patients with adult-onset and juvenile Still's disease.
abstract: BACKGROUND
  'Persistent pruritic papules and plaques' of Still's disease represents a recently described eruption seen in a subset of patients. Most cases reported in the literature to date have been associated with adult-onset Still's disease.
  
  
  METHODS
  We present the clinical and histopathologic examinations of three female patients ranging in age from 15 to 54 years.
  
  
  RESULTS
  Our three patients each presented with clinical findings consistent with Still's disease. The youngest patient suffered from the juvenile form of Still's disease (systemic-onset juvenile rheumatoid arthritis). Each patient had a persistent, pruritic eruption with histopathologic findings of dyskeratosis confined to the upper layers of the epidermis as well as a sparse superficial dermal infiltrate containing scattered neutrophils.
  
  
  CONCLUSIONS
  These cases confirm the characteristic clinical and histopathologic findings of 'persistent papules and plaques of Still's disease' and show the potential for this eruption in both the adult and juvenile age groups.
authors.affiliation: Department of Pathology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
authors.forename: Ryan R
authors.initials: RR
authors.lastname: Fortna
authors.forename: Johann E
authors.initials: JE
authors.lastname: Gudjonsson
authors.forename: Gregory
authors.initials: G
authors.lastname: Seidel
authors.forename: Damian
authors.initials: D
authors.lastname: Dicostanzo
authors.forename: Mark
authors.initials: M
authors.lastname: Jacobson
authors.forename: Margaret
authors.initials: M
authors.lastname: Kopelman
authors.forename: Rajiv M
authors.initials: RM
authors.lastname: Patel
mesh_terms: D000293:Adolescent; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D017444:Skin Diseases, Papulosquamous / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016706:Still's Disease, Adult-Onset / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein; D011241:Prednisone; D008775:Methylprednisolone; D008727:Methotrexate