皮疹を伴つた伝染性単核球症の1例

INFECTIOUS MONONUCLEOSIS ASSOCIATED WITH SKIN LESIONS

Ⅰ．緒言

　伝染性単核球症（腺熱）は発熱，リンパ節腫張及び血液像の変化を3大徴候とする予後良好な伝染性疾患であり，従来主として内科領域で検索の対象となつていたが，近年前記Trias以外に種々の皮疹を併発せる事例の故に，皮膚科領域においても注目されるに至つた。筆者は東大分院皮膚科において，臨床的に本症を疑い，血液学的並びに血清学的検索により本症と確診した1例を経験したので，ここに報告したい。

Only 5 cases of infectious mononucleosis accompanied with skin manifestations have been reported in Japan, in which histologic picture of the skin lesions has not been described.

One typical case of this disease was reported by the author, and erythematous swelling of the face and papules, papules with a vesicle purpurae on the extremities were noticed from the onset of the disease.

Histologically, a small hemorrhagic papule on the lower leg showed a perivascular lympho-cytic infiltrate, infiltrate, edema with slight bleeding in the upper dermis, spongiosis and vesicle formation, under which destruction of the basement membrane was pronounced.

This case started with fever (39℃), swelling of the superficial lymph nodes of the entire body, leukocytosis (23,000) with atypical lymphocytes (32%), and positive Paul-Bunnel's reac-tion. Rickettsia sennetsu was failed to be proved. Liver functions revealed 18u. of jaundice index, 88u. of GOT and 220u. of GPT.