Case Number : CASE 4498 - 17 April 2024 Posted By: Admin_Dermpath

Difficult but I will give a try! High up necrotic keratinocytes within the stratum corneum and st granulosum with sparse neutrophils in the infiltrate. Upon clinicopathological correlation will think of Adult onset Still’s disease!

On 03/05/2024 at 13:45, Eman El-Nabarawy said:

Difficult but I will give a try! High up necrotic keratinocytes within the stratum corneum and st granulosum with sparse neutrophils in the infiltrate. Upon clinicopathological correlation will think of Adult onset Still’s disease!

This hypothesis hadn’t even crossed my mind. CPC is mandatory, to find possible lymphadenopathy, or epatosplenomegaly or fever and arthralgia...but my compliments for the happy intuition. AOSD could really be a possibility, agree!

Drug eruption

I think it is Lupus erythematosus

Still's disease, adult onset

2 minutes ago, Summaya Ahmed said:

Still's disease, adult onset

Yes agree

On 11/05/2024 at 17:50, Adam Ali said:

I think it is Lupus erythematosus

Agree

Thank you for your comments. 

The final diagnosis is:  Still's disease, adult onset

The differential diagnoses to consider are:
Drug eruption
Dermatomyositis
Lupus erythematosus
Rheumatic fever