{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T07:40:07Z","timestamp":1759218007404,"version":"3.44.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 29-year-old woman presented with 3 weeks of fever, arthralgia and pruritic rashes on her trunk and limbs. She had no significant medical history and denied occurrence of muscle weakness, dysphagia, mouth ulcers, alopecia and sicca symptoms. Physical examination revealed erythematous, oedematous papules and plaques on the anterior sternum, upper to mid-back, arms, flanks and lateral aspect of the proximal thighs. Antinuclear antibody and anti-double-stranded DNA were negative. Complements, creatine kinase and myositis panel were normal. Her erythrocyte sediment rate and ferritin levels were elevated at 48\u2005mm h\u20131 and 580\u2005\u00b5g L\u20131, respectively. Histological examination of the plaque on her upper back revealed epidermal dyskeratosis, with a mixed perivascular infiltrate of neutrophils, lymphocytes and histiocytes within the superficial dermis. There was prominent nuclear dust, red cell extravasation and increased dermal mucin. Direct immunofluorescence was negative. She was eventually diagnosed with persistent pruritic eruption (PPE) of adult-onset Still disease (AOSD) and was treated with oral etoricoxib with resolution of her fever and symptoms. The entity of PPE in AOSD is associated with the striking histological feature of dyskeratotic keratinocytes in the upper one-third of the epidermis. This is in contrast to other conditions such as cutaneous lupus or dermatomyositis, where the dyskeratotic keratinocytes are found in the lower epidermis instead. This case highlights the importance of clinicopathological correlation and recognition of PPEs in AOSD in view of the associated poorer prognosis due to associated conditions such as secondary macrophage activation syndrome.<\/jats:p>","DOI":"10.1093\/skinhd\/vzaf039","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T07:51:44Z","timestamp":1749196304000},"page":"382-385","source":"Crossref","is-referenced-by-count":0,"title":["Pruritic eruption in a young woman with fever"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2894-4508","authenticated-orcid":false,"given":"Delwyn Zhi Jie","family":"Lim","sequence":"first","affiliation":[{"name":"National Skin Centre , Singapore ,","place":["Singapore"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5445-5698","authenticated-orcid":false,"given":"Valencia","family":"Long","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, National University Hospital, National University Health System , Singapore ,","place":["Singapore"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3084-8814","authenticated-orcid":false,"given":"Lester","family":"Juay","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, National University Hospital, National University Health System , Singapore ,","place":["Singapore"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"2025093003013617200_vzaf039-B1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s13317-015-0071-9","article-title":"Typical evanescent and atypical persistent polymorphic cutaneous rash in an adult Brazilian with Still\u2019s disease: a case report and review of the literature","volume":"6","author":"Michailidou","year":"2015","journal-title":"Auto Immun Highlights"},{"key":"2025093003013617200_vzaf039-B2","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1111\/ced.15294","article-title":"Still disease with persistent atypical dermatomyositis-like skin eruption: two cases associated with macrophage activation syndrome","volume":"47","author":"Fern\u00e1ndez Camporro","year":"2022","journal-title":"Clin Exp Dermatol"},{"key":"2025093003013617200_vzaf039-B3","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1309\/AJCPZE77UAPSMDCD","article-title":"The spectrum of histopathologic findings in cutaneous lesions in patients with still disease","volume":"144","author":"Larson","year":"2015","journal-title":"Am J Clin Pathol"},{"key":"2025093003013617200_vzaf039-B4","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1111\/his.13785","article-title":"Histopathological diagnosis of persistent pruritic eruptions associated with adult-onset Still\u2019s disease","volume":"74","author":"Qiao","year":"2019","journal-title":"Histopathology"},{"key":"2025093003013617200_vzaf039-B5","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1111\/ced.14250","article-title":"The systemic autoinflammatory disorders for dermatologists. Part 1: overview","volume":"45","author":"Oldham","year":"2020","journal-title":"Clin Exp Dermatol"},{"key":"2025093003013617200_vzaf039-B6","doi-asserted-by":"crossref","first-page":"904","DOI":"10.3892\/etm.2021.10336","article-title":"Macrophage activation syndrome: a diagnostic challenge (review)","volume":"22","author":"Bojan","year":"2021","journal-title":"Exp Ther Med"},{"key":"2025093003013617200_vzaf039-B7","first-page":"e62267","article-title":"Persistent pruritic linear streaks of adult-onset Still\u2019s disease: reconsidering the Yamaguchi criteria","volume":"16","author":"Iwanami","year":"2024","journal-title":"Cureus"}],"container-title":["Skin Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/5\/5\/382\/63845234\/vzaf039.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/5\/5\/382\/63845234\/vzaf039.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T07:18:28Z","timestamp":1759216708000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/skinhd\/article\/5\/5\/382\/8212290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,25]]},"references-count":7,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,7,25]]},"published-print":{"date-parts":[[2025,9,30]]}},"URL":"https:\/\/doi.org\/10.1093\/skinhd\/vzaf039","relation":{},"ISSN":["2690-442X"],"issn-type":[{"type":"electronic","value":"2690-442X"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,7,25]]}}}