間質性肺炎を併発した皮膚の水疱性類天庖瘡の2例

Two Cases of Bullous Pemphigoid of the Skin Associated with Interstitial Pneumonia

　当科で経験した水疱性類天疱瘡と間質性肺炎を併発した2症例について報告した．症例1は水疱性類天疱瘡の発症以前に認められた間質性肺炎が皮膚病変治療のための経口ステロイド減量中に増悪し当科に入院．症例2は皮膚科でステロイド外用による経過観察中に胸部X線写真上間質性陰影を指摘され当科入院となった．経気管支肺生検では間質性肺炎の所見が得られたが，同じ標本による蛍光抗体性による免疫組織学的検討ではIgG,C₃の肺胞壁，細気管支基底膜部への沈着は認められず，両疾患が同一の機序で起こっている証左は得られなかった．

We present two cases of bullous pemphigoid of the skin associated with interstitial pneumonia. Intersitial pneumonia of case 1 worsened during tapering off of systemic corticosteroids for the treatment of bullous pemphigoid. Case 2, who had been treated for bullous pemphigoid with topical corticosteroids. was show as having linear and reticular opacities on the chest roent-genogram. The CT scan of case 2 showed interstitial shadows especially in the subpleural region. Transbron-chial lung biopsy specimens revealed remarkably thick-ened alveolar wall and mononuclear cell infiltration in both cases.