Urticaria as a cutaneous sign of adult-onset Still's disease

• Published in: Journal of cutaneous medicine and surgery Vol. 10; no. 2; p. 99
• Main Authors: Criado, Roberta F J, Criado, Paulo Ricardo, Vasconcellos, Cidia, Szajubok, José Carlos M, Michalany, Nilceo S, Kadunc, Bogdana Victoria, Costa Martins, Jose Eduardo
• Format: Journal Article
• Language: English
• Published: United States 01.03.2006
• Subjects: Diagnosis, Differential; Female; Humans; Middle Aged; Still's Disease, Adult-Onset - complications; Still's Disease, Adult-Onset - diagnosis; Urticaria - diagnosis; Urticaria - etiology
• ISSN: 1203-4754
• DOI: 10.2310/7750.2006.00017

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. To alert clinicians and dermatologists to internal diseases such as AOSD when assisting patients with urticarial eruptions and systemic symptoms. 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. 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. Urticarial rash is an uncommon presentation of AOSD, and clinicians must be alert to the possibility of a misdiagnosis in these cases.