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Reminder of important clinical lesson
CASE REPORT
Fever with persistent flagellate erythema in a primigravida: a rare presentation of adult-onset Still’s disease
  1. Riti Bhatia1,
  2. Nidhi Kaeley2,
  3. Ravi Kant3 and
  4. Ankith Basi3
  1. 1 Dermatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  2. 2 Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  3. 3 Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  1. Correspondence to Dr Nidhi Kaeley, drnidhi_kaeley{at}yahoo.com

Abstract

We describe a case of a 25-year-old primigravida, who presented to the emergency department with fever, arthralgia and erythematous maculopapular eruption. There was confluent violaceous macular erythema on the arms, v-area of the neck and upper back with periorbital oedema, mimicking dermatomyositis. There was flagellate erythema on the back. Skin biopsy and systemic investigations helped to rule out dermatomyositis. A final diagnosis of adult-onset Still’s disease with atypical cutaneous manifestations was made. This atypical variant is associated with a worse prognosis. Early recognition of this clinical variant can be life-saving for the patient.

  • musculoskeletal syndromes
  • vasculitis

https://doi.org/10.1136/bcr-2019-229332

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    Footnotes

    • Contributors NK: conception and design, acquisition of data or analysis and interpretation of data and drafting the article or revising it critically for important intellectual content. RB: conception and design, acquisition of data or analysis and interpretation of data. Drafting the article or revising it critically for important intellectual content. Final approval of the version published. RK: conception and design, acquisition of data or analysis and interpretation of data. AB: conception and design, acquisition of data or analysis and interpretation of data.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. There are no funding sources to declare.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.