Cracking the code: high ferritin load with Salmon-Colored skin episodes

Abstract

A 37-year-old previously healthy male presented to the Emergency Department with a two-week history of intermittent fevers, joint pain, sore throat, and a diffuse salmon-colored rash. Examination revealed a pruritic rash with joint swelling and red spots in the oropharynx. Initial sepsis management was instituted, but subsequent investigations, including infectious, hematologic, and autoimmune workups, were inconclusive. Notably, elevated ferritin levels prompted consideration of life-threatening conditions like Hemophagocytic Lymphohistiocytosis, which was ultimately ruled out. Adult-onset Still’s Disease (AOSD) emerged as the leading diagnosis following the exclusion of other potential causes. A skin biopsy was performed with non-specific findings and corticosteroid treatment led to significant improvement. This case illustrates the clinical decision-making process of diagnosing AOSD and highlights the potential utility of novel AI technology in dermatologic assessments.