A 38-year-old woman with adult-onset Still disease (AOSD) presented with a 3-year history of eyelid discoloration (Figure 1). The changes developed gradually following hospitalization for septic shock related to long-term immunosuppressive therapy for AOSD. After onset, the patches became more noticeable with arthritic flares. She had no other skin changes and no prior treatment of eyelid eruption. Her previous AOSD symptoms included fever, arthritis, pleuritis, lacy dermatitis, and dermatographism. Previous treatments for her AOSD included prednisone, leukovorin, methotrexate, infliximab, hydroxychloroquine, etanercept, and anakinra. Her medications at the time of presentation were aspirin, omeprazole, potassium chloride, and prednisone, 4 mg/d. Her medical history included factor V Leiden deficiency and deep-vein thrombosis.
Moraites E, Myers DJ, Lloyd R, Longley BJ. A 38-Year-Old Woman With Eyelid Discoloration—Quiz Case. Arch Dermatol. 2012;148(8):947–952. doi:10.1001/archderm.148.8.947-b
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: