[Adult Kawasaki disease: A diagnostic case report]

Kawasaki disease (KD) is an acute systemic vasculitis mainly affecting medium-size blood vessels and primarily affecting children under five years old. The typical clinical presentation associates fever, skin rash, mucous membrane abnormalities, and lymphadenopathies. Occurrence in adults is rare, with fewer than 100 cases reported and limited histological descriptions available, particularly regarding the skin. We report herein the case of a 22-year-old man hospitalized for fever, odynophagia, and aphagia since five days. Clinical examination revealed enanthem with palatal ulcerations, maculopapular lesions with fine scaling on the limbs and extremities, painful scrotal ulcerations, bilateral non-exudative conjunctivitis, and bilateral lymphadenopathy. Laboratory tests showed an isolated inflammatory syndrome. Skin biopsy revealed lichenoid epidermal changes along with a polymorphic dermal inflammatory infiltrate exhibiting a granulomatous pattern and comprising abundant lymphocytes, accompanied by vascular changes. The diagnosis of KD was established by integrating clinical and histological data. Early recognition of this disease in adults is essential to prevent chronic complications; this report aims to describe its potential histological features.