A Case of Multiple Necrotic Dyskeratotic Cells within the Upper Epidermis and Horny Layer Revealing Persistent Papules and Plaques of Adult-Onset Still's Disease

• Published in: Annals of dermatology Vol. 35; no. Suppl 1; pp. S84 - S87
• Main Authors: Ha, Dae-Lyong, Ha, Gi Ung, Han, Man-Hoon, Lee, Seok-Jong
• Format: Journal Article
• Language: English
• Published: The Korean Dermatological Association; The Korean Society for Investigative Dermatology 01.05.2023; 대한피부과학회
• Subjects: Case Report; 피부과학
• ISSN: 2005-3894; 1013-9087; 2005-3894
• DOI: 10.5021/ad.21.163

It is important to differentiate violaceous to dusky red papules and plaques that widely persist on the trunk and extremities because there are dermatoses that could be fatal, such as lupus erythematosus, dermatomyositis, drug eruptions, and graft-versus-host disease. Dyskeratotic cells only in the upper epidermis and horny layer are not well known, but it is a distinctive histopathological pattern of atypical type of rash of adult-onset Still's disease (AOSD). AOSD rash is a transient salmon-colored rash that occurs and disappears with fever; however, an atypical type of rash called "persistent dermal plaque" or "persistent pruritic eruptions" has also been reported. It occurs and persists even after fever subsides. Herein, we describe a case with necrotic dyskeratotic cells in the upper epidermis and horny layer without AOSD symptoms lasting for five years.It is important to differentiate violaceous to dusky red papules and plaques that widely persist on the trunk and extremities because there are dermatoses that could be fatal, such as lupus erythematosus, dermatomyositis, drug eruptions, and graft-versus-host disease. Dyskeratotic cells only in the upper epidermis and horny layer are not well known, but it is a distinctive histopathological pattern of atypical type of rash of adult-onset Still's disease (AOSD). AOSD rash is a transient salmon-colored rash that occurs and disappears with fever; however, an atypical type of rash called "persistent dermal plaque" or "persistent pruritic eruptions" has also been reported. It occurs and persists even after fever subsides. Herein, we describe a case with necrotic dyskeratotic cells in the upper epidermis and horny layer without AOSD symptoms lasting for five years.