Turkyilmaz Aysegul Kucukali, Devrimsel Gul, Topaloglu Mehmet Serhat, Erturk Ayse, Capkin Arzu Aydın, Yildirim Murat
Department of Physical Medicine and Rehabilitation, Recep Tayyip Erdogan University Medical School, 53100 Rize, Turkey.
Department of Infectious Diseases, Recep Tayyip Erdogan University Medical School, 53100 Rize, Turkey.
Oman Med J. 2013 Jul;28(4):e052. doi: 10.5001/omj.2013.86.
Adult-onset Still's disease (AOSD) is an uncommon idiopathic disorder with various clinical manifestations. The absence of specific serological and pathological findings often makes the disease difficult to diagnose. The presence of skin lesions is important to the correct diagnosis of the disease. Various atypical skin lesions have been reported in association with Adult-onset Still's disease. We present a 52-year-old male who had atypical cutaneous manifestations of Adult-onset Still's disease. The rash manifested as persistent, pruritic, dark reddish, confluent, erythematous maculopapules and plaques on his chest, abdomen, upper back and proximal extremities. He suffered high, spiking fevers and had marked elevations of ferritin, C-reactive protein, and the erythrocyte sedimentation rate, which are characteristic of Adult-onset Still's disease. The fever and systemic symptoms improved after the administration of intravenous pulse methylprednisolone therapy. The skin lesions improved after prednisolone and methotrexate combination therapy. Therefore, to make the correct diagnosis, it is important to understand that patients with Adult-onset Still's disease may present with various types of skin lesions.
成人斯蒂尔病（AOSD）是一种临床表现多样的罕见特发性疾病。缺乏特异性血清学和病理学表现常常使该病难以诊断。皮肤病变的存在对该病的正确诊断很重要。已有多种非典型皮肤病变与成人斯蒂尔病相关的报道。我们报告一名52岁男性，他患有成人斯蒂尔病的非典型皮肤表现。皮疹表现为胸部、腹部、上背部和近端肢体持续存在的、瘙痒的、暗红色的、融合性的红斑丘疹和斑块。他反复高热，铁蛋白、C反应蛋白和红细胞沉降率显著升高，这是成人斯蒂尔病的特征。静脉注射甲基强的松龙脉冲治疗后，发热和全身症状有所改善。泼尼松龙和甲氨蝶呤联合治疗后，皮肤病变有所改善。因此，为了做出正确诊断，重要的是要认识到成人斯蒂尔病患者可能会出现各种类型的皮肤病变。
