Persistent pruritic papules and plaques: a characteristic histopathologic presentation seen in a subset of patients with adult-onset and juvenile Still's disease.
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.
Fortna
Ryan R
RR
Department of Pathology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
Gudjonsson
Johann E
JE
Seidel
Gregory
G
Dicostanzo
Damian
D
Jacobson
Mark
M
Kopelman
Margaret
M
Patel
Rajiv M
RM
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
D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein; D011241:Prednisone; D008775:Methylprednisolone; D008727:Methotrexate