Introduction:The diagnosis of adult-onset Still's disease (AOSD) can be very difficult. There are no specific tests and reliance is usually placed on a symptom complex and the well described typical rash seen in most patients. In recent years, however, other cutaneous manifestations of AOSD have been reported but these are not so well known. Observations:We report a patient with urticaria and fixed plaques and review the other ‘atypical’cutaneous findings associated with AOSD. Conclusions:The diagnosis of AOSD can be made in the absence of the typical Still's rash but in the presence of other atypical cutaneous features.