TY - JOUR T1 - Lichen Planus in Association with Adult-onset Still’s Disease Successfully Treated with Mycophenolate Mofetil JF - The Journal of Rheumatology JO - J Rheumatol SP - 1305 LP - 1306 DO - 10.3899/jrheum.120032 VL - 39 IS - 6 AU - YASSER EMAD AU - YASSER RAGAB AU - NASHWA EL-SHAARAWY Y1 - 2012/06/01 UR - http://www.jrheum.org/content/39/6/1305.abstract N2 - To the Editor:A 55-year-old woman presented with acute onset of spiking fever, symmetric polyarthritis with intense myalgia, and sore throat. Onset was associated with diffusely itchy purple papules involving the trunk, anterior chest wall, and upper and lower limbs. Initial laboratory investigation showed elevated erythrocyte sedimentation rate (90 mm/h), elevated C-reactive protein (17.8 mg/dl), negative rheumatoid factor (RF), negative anti-citrullinated protein antibody, and negative antinuclear antibody (ANA). Complete blood count showed leukocytosis with white blood cell count 14.7 × 103/μl, anemia with hemoglobin 9.6 g/dl, thrombocytosis with platelet count 802 × 103/μl, and 2-fold increase in serum ferritin levels (350 ng/ml, normal values up to 150 ng/ml). Other laboratory investigations showed elevated liver enzymes [aspartate transaminase 69 IU/l, alanine transaminase 125 IU/l, and elevated creatine phosphokinase (CPK) levels 320 IU/l, normal 40–120 IU/l] with negative virology screening for viral hepatitis. Skin biopsy showed focal thinning of the epidermis with focal destruction of basal layers and focal dermal mononuclear infiltrate, features consistent with the diagnosis of lichen planus … Address correspondence to Dr. Emad; E-mail: yasseremad68{at}yahoo.com ER -