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More than a century ago, George Still described a pediatric arthritis different from rheumatoid arthritis. Still disease (SD) can have adult onset; it is characterized by an evanescent rash associated with fever and joint pain. The histopathology of the cutaneous rash is not well described.
In a review of 10 patients with adult SD, lesions ranged from erythematous macules to papules and plaques (median duration, 3.7 weeks), sited predominantly on the extremities and trunk. All patients had systemic symptoms, including fever and arthralgia; 30% had adenopathy and 30%, sore throat. All were negative for rheumatoid factor; 90% were negative on ANA testing. The clinical differential diagnoses included lupus erythematosus, dermatomyositis, drug r…