予後からみた尋常性白斑の治療成績

STUDIES ON TREATMENT OF VITILIGO FOR 14 YEARS' FOLLOW-UP

I．はじめに

　従来尋常性白斑の治療成績についての報告は数多いが長期経過を追求観察した報告は少ない。我々は昭和26年から昭和39年迄の14年間に福島医大皮膚科を訪れた尋常性白斑患者362名について，主としてアンケートにより，又一部は直接患者に接して予後調査を行ない，治療成績および予後との関連事項について種々検討を加えて見た。

　予後の判明したものは362例中242例で，便宜上予後を治癒，改善，不変，悪化の4段階に，又病巣の程度を大，中，小の3段階に分けて検討した。なお治癒は全治および略治例を含み，又昭和41年12月の時点で再発のないもの，即ち最低2年以上再発のないものを治癒と見做した。又病巣の程度は大勢を見るのに支障はないと考え，おおよそ次の基準に従つた。病巣が多発性，汎発性であるか或いは又単発性でも客観的に極めて大きいものを大とし，手拳大以下の病巣が1乃至数コに止まり比較的限局性のものを小とし，大小の中間にあたるものを中とした。

Two hundred and forty two cases of vitiligo were observed for 14 years, from 1926 to 1940.

The results were as follows :

(1) About 20% of patients was completely cured, and about 50% of cases gave satisfactory results.

(2) Rather many patients visited at first in their youth, but their prognosis was not always good.

(3) Patients with smaller lesions and with their history of less than 6 months had rather beneficial prognosis.

(4) The results of treatment of lesions on the face were better than those on the trunk or extremities.

(5) Treatment should be started within 6 months after onset of the disease and continued at least for 3 months.

(6) No significant relationships between the results of the treatment and familiar occurrence, canities, or allergic disorders were proved.

(7) Rather good therapeutic effect was noted in cases without itching, and in cases accompanied with bullae formation by oxypsoralen treatment.

Dermabrasion, oxypsoralen treatment, iontophoresis of iron sulfate or local intracutaneous injection of hematoporphyrin showed excellent results. No significant differences on the thera-peutic effect were determined among them.