Atypical Still disease with necrotic keratinocytes: A histologic mimicker of erythema multiforme.

Still disease, or systemic juvenile idiopathic arthritis (sJIA), and its adult form, adult-onset Still disease (AOSD), are illnesses characterizefd by daily fever, evanescent rash, and arthritis.1 Typical rash is nonpruritic, salmon-pink, transient, and maculopapular. Typical histology shows dermal edema and perivascular neutrophils. Atypical Still disease is a variant characterized by persistent pruritic papules and plaques1 with histologic necrotic keratinocytes.2 We report 2 unique cases of atypical Still disease, one in an adult and the other in an adolescent.