PDF
ePub
Citation
Print
Abstract
Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology that is characterized by high-spiking fever, arthralgia, sore throat, and skin rash. The typical rash of AOSD is an evanescent, sal-mon-colored erythema, which is considered to be the major diagnostic criterion. Recently, other cutaneous manifestations of AOSD, such as persistent plaque and urticaria, have been reported. Here, we report a rare case of AOSD presenting with periorbital swelling and erythema. A 47-year-old woman was presented with periorbital swelling, erythema, high fever, arthritis, and a sore throat. One year prior to admission, she was diagnosed with AOSD based on the diagnostic criteria of Yamaguchi. The patient's periorbital swelling and erythema may not have been associated with periorbital cellulitis because they did not respond to antibiotics but did improve after treatment with steroids. Considering all of her signs and symptoms with a history of AOSD, periorbital lesion was suspected as atypical cutaneous manifestation of AOSD.
References
1. Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H, et al. Preliminary criteria for classification of adult Still's disease. J Rheumatol. 1992; 19:424–30.
2. Yamamoto T. Cutaneous manifestations associated with adult-onset Still's disease: important diagnostic values. Rheumatol Int. 2012; 32:2233–7.
3. Cush JJ, Medsger TA Jr, Christy WC, Herbert DC, Cooperstein LA. Adult-onset Still's disease. Clinical course and outcome. Arthritis Rheum. 1987; 30:186–94.
4. Reginato AJ, Schumacher HR Jr, Baker DG, O'Connor CR, Ferreiros J. Adult onset Still's disease: experience in 23 patients and literature review with emphasis on organ failure. Semin Arthritis Rheum. 1987; 17:39–57.
5. Fautrel B, Le Moël G, Saint-Marcoux B, Taupin P, Vignes S, Rozenberg S, et al. Diagnostic value of ferritin and glycosylated ferritin in adult onset Still's disease. J Rheumatol. 2001; 28:322–9.
6. Bagnari V, Colina M, Ciancio G, Govoni M, Trotta F. Adult-onset Still's disease. Rheumatol Int. 2010; 30:855–62.
7. Ohta A, Yamaguchi M, Kaneoka H, Nagayoshi T, Hiida M. Adult Still's disease: review of 228 cases from the literature. J Rheumatol. 1987; 14:1139–46.
8. Wolgamot G, Yoo J, Hurst S, Gardner G, Olerud J, Argenyi Z. Unique histopathologic findings in a patient with adult-onset Still disease. Am J Dermatopathol. 2007; 29:194–6.
9. Han SH, Choi GS, Shin J. A clinicopathological study on skin manifestations of adult-onset still's disease (AOSD). Korean J Dermatol. 2010; 48:283–9.
10. Affleck AG, Littlewood SM. Adult-onset Still's disease with atypical cutaneous features. J Eur Acad Dermatol Venereol. 2005; 19:360–3.
11. Inaoki M, Nishijima C, Kumada S, Kawabata C, Yachie A. Adult-onset Stills disease with a cellulitis-like eruption. Eur J Dermatol. 2009; 19:80–1.
12. Soy M. A case of adult-onset Still's disease presenting with angioedema. Clin Rheumatol. 2004; 23:92.
13. Jeon YK, Paik JH, Park SS, Park SO, Kim YA, Kim JE, et al. Spectrum of lymph node pathology in adult onset Still's disease; analysis of 12 patients with one follow up biopsy. J Clin Pathol. 2004; 57:1052–6.
14. Trotta F, Dovigo L, Scapoli G, Cavazzini L, Castoldi G. Immunoblastic malignant lymphoma in adult onset Still's disease. J Rheumatol. 1993; 20:1788–92.
15. Hot A, Toh ML, Coppéré B, Perard L, Madoux MH, Mausservey C, et al. Reactive hemophagocytic syndrome in adult-onset Still disease: clinical features and longterm outcome: a case-control study of 8 patients. Medicine (Baltimore). 2010; 89:37–46.
XML Download