Ha Dae-Lyong, Ha Gi Ung, Han Man-Hoon, Lee Seok-Jong
Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Pathology, School of Medicine, Kyungpook National University, Daegu, Korea.
Ann Dermatol. 2023 May;35(Suppl 1):S84-S87. 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.
鉴别躯干和四肢广泛持续存在的紫红色至暗红色丘疹和斑块很重要，因为有些皮肤病可能是致命的，如红斑狼疮、皮肌炎、药疹和移植物抗宿主病。仅在上表皮和角质层出现的角化不良细胞并不为人熟知，但它是成人斯蒂尔病（AOSD）非典型皮疹的一种独特组织病理学模式。AOSD皮疹是一种随发热出现和消失的短暂性鲑鱼色皮疹；然而，也有报道称存在一种非典型皮疹，称为“持续性皮肤斑块”或“持续性瘙痒性皮疹”。它在发热消退后仍会出现并持续存在。在此，我们描述一例在上表皮和角质层有坏死性角化不良细胞且无AOSD症状持续五年的病例。
