2021 Volume 20 Issue 1 Pages 18-23
This report presents a 29-year-old man who had a fever 4days before the first visit. After taking acetaminopen for several days, a generalized rash appeared 1 day before the first visit. On the first visit, the body temperature was 39.5°C and red bean-sized erythema diffusely occurred on the trunk and extremities. The histopathologic examinations demonstrated individual cell necrosis of epidermal keratinocytes and vacuolar degeneration. The skin rash improved after treatment with topical steroids, but fever and high inflammatory reaction persisted. No viral infection could be proved from the serum virus antibody titer. He developed hyponatremia, myocarditis, and ileus. He was diagnosed with adult-onset Still’s disease due to fever of 39 degrees or higher that lasts for 1 week or longer, swollen lymph nodes, sore throat, and marked increase of serum ferritin. Systemic administration of steroids improved all of his symptoms. The skin eruption in our case was considered to be similar to drug eruption, but the skin histopathology was consistent with adult-onset Still’s disease. We considered the possibility that adult-onset Still’s disease and drug eruption were combined, and that the symptoms of adult-onset Still’s disease were enhanced by the drug. Skin Research, 20 : 18-23, 2021
