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.