4)Sweet病

Sweet's Disease

　Sweet病は，発熱，多核好中球を主体とした白血球増多，隆起性有痛性皮疹，真皮への好中球浸潤を特徴とする皮膚科領域の独立した疾患であるが消化管病変を合併することが知られている．その主なものは，潰瘍性大腸炎やCrohn病である．しかし，報告は少ないが，非特異的な潰瘍を回盲部に伴う症例もある．この潰瘍は，単純性潰瘍やBehçet病に類似する略円形潰瘍で腸間膜反対側に分布するが，下掘れ傾向が乏しいこと，mucosal tag様の炎症性ポリープを伴うなどの特徴がみられる．また，術後の長期経過観察では，吻合部を中心に再発を認めたが成分栄養療法で瘢痕化を認め緩解維持に栄養療法が有効であった．

　Sweet's disease was known as acute febrile neutrophilic dermatitis, characterized by tender raised erythematous plaques and associated with predominantly neutrophilic infiltration in the dermis. It was well known that the disease was sometimes associated with gastrointestinal tract disorders such as ulcerative colitis and Crohn's disease. We encounterd non specific ulcers in the ileocecal area. These ulcers were characterized by discrete or punched-out-like ulcers, located at an anti-mesenteric site and which were often thought of as simple ulcers or Behçet's disease. However, the ulcers were neither deep nor and associated with mucosal tags like inflammatory polyps. In a case of long-term follow-up after resection, recurrent ulcers were noticed after 7 years and the ulcers were cured by an elementary diet. An elementary diet was effective for the treatment of nonspecific ulcers associated with Sweet's disease.