This case report highlights an unusual presentation of Adult Still’s Disease (ASD), a rare systemic inflammatory disorder, in a 26-year-old woman who exhibited atypical skin symptoms without classical febrile patterns. ASD is typically characterized by spiking fevers, arthritis, and an evanescent salmon-pink rash, but the patient instead presented with widespread urticarial and erythematous plaques accompanied by pruritus and angioedema. These lesions initially led to misdiagnosis and ineffective treatments for conditions like scabies and infectious diseases. Laboratory tests revealed hallmark features of ASD, including leukocytosis with neutrophilia, elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), hyperferritinemia, and negative rheumatoid factor (RF) and antinuclear antibodies (ANA). Despite the absence of classical skin findings, the patient fulfilled Yamaguchi’s diagnostic criteria for ASD. The diagnosis was ultimately confirmed based on clinical features and lab results, without requiring skin biopsy. Treatment with corticosteroids and methotrexate led to significant clinical improvement. This case emphasizes the diagnostic challenges posed by atypical cutaneous manifestations of ASD and highlights the importance of considering ASD in the differential diagnosis of persistent systemic symptoms with non-specific dermatologic signs. Early recognition and appropriate management are crucial to prevent complications and improve outcomes. The report underscores the need for heightened clinical awareness of ASD’s diverse presentations, particularly in dermatological settings, and supports the use of Yamaguchi’s criteria in guiding diagnosis even in atypical cases. It also reinforces the effectiveness of methotrexate as a steroid-sparing agent in managing persistent ASD symptoms.

During the Covid-19 pandemic, the federal government enabled schools to provide all children, regardless of need, with free meals to address nutrition and food insecurity. While program participation increased, many students declined the free meals, missing out on potential health and academic benefits.

A new study by nutrition researchers identifies several barriers cited by foodservice directors—the leaders who run school food programs—to student participation, including student preferences for home-cooked meals or fast food, and concerns about how healthy the meals are.