Atypical cutaneous and histological presentation of adult-onset Still's disease.

Adult-onset Still's disease (AOSD), the adult variant of systemic juvenile idiopathic arthritis, is a rare auto-inflammatory condition that presents with characteristic skin findings. There is no specific test available; diagnosis is usually based on the symptoms and evanescent rash found in patients. More recently, however, descriptions of atypical cutaneous and histological manifestations of AOSD have been published. We describe a case of atypical AOSD and discuss recent literature on this different cutaneous and histological presentation. Our results add to the growing discussion on atypical AOSD and suggest that this presentation may have been underreported and more common than previously thought.

The impact of biologic agents on health-related quality of life outcomes in patients with psoriasis.

INTRODUCTION: Psoriasis is a common, immune-mediated skin disease often associated with significant physical and psychosocial impairment. Antipsoriatic biologic agents offer patients unparalleled treatment potential in regard to greater skin clearance and overall improved quality of life. Evaluation of the therapeutic efficacy of biologic agents on the full psoriasis disease burden must account for their impact on both physical symptoms, as well as patient-reported, health-related quality of life (HRQoL) measurements. Areas covered: Results from numerous clinical trials demonstrate the significant clinical efficacy of biological agents targeting tumor necrosis factor-α (TNF-α) and the interleukin (IL)-12/23 and IL-17 immune pathways. However, relatively limited data is available evaluating their full effect on quality of life outcomes. This review will discuss the most relevant and up-to-date clinical data on HRQoL measurements related to treatment with these aforementioned biologic agents. Expert commentary: Patient-reported outcomes (i.e. Dermatology Life Quality Index) are being used with increasing frequency in clinical trials, and provide valuable information on the impact of psoriasis on numerous aspects of day-to-day living. These outcomes must also be incorporated in clinical practice, in addition to physical assessment of disease severity, treatment decisions, and therapeutic response in the psoriasis patient population.