鼻粘膜病変を伴った瘢痕性類天疱瘡の2症例

Cicatrical Pemphigoid with Nasal Mucosa Lesion: Report of Two Cases

　はじめに

　瘢痕性類天疱瘡は病理組織学的に区別される皮膚・粘膜疾患で，報告例が少ない疾患である。病変は皮膚・粘膜に水疱を形成するのが特徴で，のちに瘢痕化をきたす自己免疫性水疱症の1つと考えられている^1）。

　組織学的には表皮下にみられる水疱が特徴で，免疫組織学的には基底膜に一致して免疫グロブリンや補体の線状沈着を認め，末期には線維化が認められるようになる^2）。症状は咽頭，外陰部，肛門などの粘膜に水疱を形成することが多く，従来からの報告を通覧しても鼻粘膜病変を記載した論文は少ない。

　最近，われわれは鼻粘膜にも病変が認められた瘢痕性類天疱瘡の症例を2例経験したので報告する。

Two cases of cicatrical pemphigoid in nasal mucosa were reported. A 73-year-old male com-plained of nasal bleeding. Dry hyperemic nasal mucosa with slight bleeding, crusting and erosion was observed. Immunohistopathologically, linear deposit of IgG was recognized in basement mem-brane of buccal mucosa. The second case was a 45-year-old female who complained of nasal bleeding. Nasal mucosa was dry hyperemic, and crusting and erosion of mucosa with slight bleeding were seen. There was flush in tooth roots. In this case, linear deposit of IgG and C3 were recognized in basement membrane of nasal mucosa and skin of lower extremity.

Both case had rhinenchysis and aerosol treatment by DSCG. Erythromycin was gave orally in the first case and in the second case steroid ointment was topically used in the nasal cavity. Their nasal symp-tom was remarkably improved by these treatments.