Atypical Persistent Pruritic Hyperpigmented Plaques in Adult-Onset Still's Disease: A Case Report From Uganda.

We report a case of adult-onset Still's disease (AOSD) in a 30-year-old Ugandan man presenting with migratory polyarthralgia, intermittent fever, lymphadenopathy, and atypical persistent pruritic hyperpigmented plaques. Laboratory evaluation showed neutrophilic leukocytosis, markedly elevated C-reactive protein, and hyperferritinemia. Infectious and autoimmune causes were excluded. A diagnosis of moderate systemic AOSD was established based on the Yamaguchi criteria. Treatment with corticosteroids and nonsteroidal anti-inflammatory drugs led to rapid clinical improvement and progressive regression of the cutaneous lesions on follow-up. This case highlights the need for considering atypical persistent dermatologic manifestations of AOSD, especially in low-resource settings.