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Histopathological diagnosis of persistent pruritic eruptions associated with adult‐onset Still's disease
Author(s) -
Qiao Jianjun,
Zhou Sha,
Li Sheng,
Xue Ruzeng,
Pan Yunlei,
Tang Shunli,
Sun Qingmiao,
Wu Yanyan,
Wang Su,
Wu Yinhua,
Bai Juan,
Qu Tingting,
Zhang Xiuming,
Sun Chuanyin,
Fang Hong
Publication year - 2019
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13785
Subject(s) - adult onset still's disease , medicine , disease , pathology , dermatology
Aims Persistent pruritic eruptions ( PPE s), presenting with dyskeratotic keratinocytes histologically, are characteristic skin rash in patients with adult‐onset Still's disease ( AOSD ). The lesions may be histologically similar to other entities that present with dyskeratosis. In the present study, we compared the histopathological features between PPE s and other entities presenting with dyskeratosis. Methods and results To investigate whether histopathological findings can be used to discriminate among PPE s and other entities presenting with dyskeratotic keratinocytes, cutaneous histopathological changes of PPE s associated with AOSD ( n = 26) were compared with those of systemic lupus erythematosus ( SLE ) ( n = 16), dermatomyositis ( n = 19), and drug eruption ( n = 16). Dyskeratosis was observed in the upper one‐third of the epidermal layer in all 26 PPE s. The rate of dyskeratosis for PPE s was higher than that for SLE (18.8%) and dermatomyositis (15.8%). In drug eruptions, the dyskeratotic cells were distributed in all levels of the epidermis. Variable densities of neutrophils were found in the dermis in all PPE s. Conclusions Although this was a retrospective study conducted at a single centre, presentation of dyskeratotic keratinocytes in the upper one‐third of the epidermal layer is a distinctive histopathological reactive pattern of PPE s. This pattern may be a useful histopathological marker for early diagnosis of AOSD .