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Oral mucosa lesions as atypical manifestation of adult-onset Still´s disease* * Work performed at the Rheumatology Centre, Bone Biology Laboratory, School of Medicine, Universidad Nacional de Rosario, National Council of Scientific and Technical Research (CONICET), Rosario, Argentina; and Pathological Anatomy Department, Pergamino, Argentina.

Abstract:

Adult-onset Still's disease is a systemic inflammatory disorder of unknown etiology, characterized by skin rash, spiking fever, arthralgias or arthritis, and leukocytosis. The typical skin rash is evanescent, salmon-pink, nonpruritic and maculopapular, predominantly on the extremities. It is considered one of the major Yamaguchi's criteria in adult-onset Still's disease. However, atypical skin lesions are also described. Here, a 61-year-old woman with sore throat, spiking fever, polyarthritis and evanescent salmon-pink nonpruritic maculopapular skin rash on the extremities was diagnosed with adult-onset Still's disease. In addition, atypical brown macules on oral mucosa, localized on the inner lips and tongue were also observed. Biopsy revealed a neutrophilic infiltrate. Despite treatment and improvement of the adult-onset Still's disease, the atypical oral mucosal lesions persisted.

Keywords:
Mouth mucosa; Skin manifestations; Still's disease, adult-onset

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