Criado Roberta F J, Criado Paulo Ricardo, Vasconcellos Cidia, Szajubok José Carlos M, Michalany Nilceo S, Kadunc Bogdana Victoria, Costa Martins Jose Eduardo
Allergy Unit, Dermatology Department of Faculdade de Medicina do ABC, Santo André, Brazil.
J Cutan Med Surg. 2006 Mar-Apr;10(2):99-103. 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.
成人斯蒂尔病（AOSD）的主要体征和症状包括周期性发热、关节痛和关节炎、淋巴结病、肝脾肿大、伴有中性粒细胞增多的一过性皮疹，以及类风湿因子和抗核抗体检测阴性。
在协助患有荨麻疹样皮疹和全身症状的患者时，提醒临床医生和皮肤科医生注意诸如AOSD等内科疾病。
报告一例52岁白人女性病例，该患者接受了3年的常规荨麻疹治疗，但无改善。在此之后，基于全身症状诊断为AOSD。
甲氨蝶呤治疗的第二个月，炎症活动标志物下降；然而，皮肤损害并未消失。开始使用沙利度胺，2周后观察到皮肤损害完全改善。
荨麻疹样皮疹是AOSD的一种不常见表现，临床医生必须警惕这些病例中误诊的可能性。
