ROMANIAN JOURNAL of CLINICAL and EXPERIMENTAL DERMATOLOGY 64 Up to date Diagnostic value of cutaneous findings in Adult Still Disease, a rare autoinflammatory disease DIAGNOSTIC VALUE OF CUTANEOUS FINDINGS IN ADULT STILL DISEASE, A RARE AUTOINFLAMMATORY DISEASE Cite this article: R.S. Bumbacea, L. Vasile, L.G. Popa, I. Tudose, C. Giurcaneanu Diagnostic value of cutane- ous findings in Adult Still Disease, a rare autoinflam- matory disease. RoJCED 2014; 1(1):64-68. Keywords: Still disease, adult onset, rash, cutaneous manifestations Abstract Adult onset Still disease (AOSD) is a rare autoinflammatory syndrome of unknown etiology, characterized by fever, arthralgia or arthritis, evanescent rash and systemic involvement. AOSD has variable clinical pictures, from mild symptoms to life-threatening complications, and variable disease course (self-limited, intermittent or chronic). The heterogeneous clinical presentation often makes the diagnosis difficult for an inexperienced clinician. Therefore, cutaneous manifestations are considered important clues for correct diagnosis. Besides the typical salmon-pink, macular or maculo-papular rash, which represents one of the major diagnosis criteria, AOSD can be associated with various types of skin lesions (e.g. persistent, erythematous, slightly scaly or crusted papules with linear configuration) with characteristic histological features. In this short review, we present a series of important diagnostic aspects in AOSD, insisting on cutaneous manifestations, according to available literature data. R.S. Bumbacea 1,2, L. Vasile 2 , L.G. Popa 2 , I. Tudose 3 , C. Giurcaneanu 1,2 1. Carol Davila University of Medicine and Pharmacy, Bucharest; 2. Elias Emergency University Hospital, Department of Dermatology and Allergology; 3. Elias Emergency University Hospital, Department of Pathology Corresponding author: Roxana Bumbacea, 17 bd Marasti Street, Sector 1, Bucharest, Phone 021 / 3161600 – 190 / 224, fax 021 / 3173052, E-mail roxana.bumbacea@gmail.com Open Access Article Autoinflammatory diseases: clues for diag- nosis in patients with urticarial rashes Urticarial skin reactions are one of the most frequent problems seen by dermatologists and allergists in daily practice. The most common reason for recurrent wheals is chronic spontaneous urticaria. Although it is much less common than acute urticaria, it is still a frequent condition, with a point prevalence of 0.5-1% in the European population (1) . The underlying mechanisms of chronic urticaria are largely unknown, but being mast-cell mediator-mediated, the first line symptomatic treatment is based on non- sedating antihistamines. Importantly, there are some much less common diseases that present with urticarial rash and thus mimic urticaria, such as autoinflammatory disorders. In contrast to autoimmune diseases (mediated by T and B cells and other key players of adaptive immunity), autoinflammatory diseases are disorders of the innate immune system (2) . They include cryopirin-associated periodic syndrome (CAPS), Schnitzler’s syndrome and others disorders like Adult-onset Still’s disease (AOSD) (Table 1). They are characterized by episodic fever and chronic inflammation of the skin, joints and various other organs. Thus, the list of symptoms can also include inflammation of the anterior eye or uveitis