Toxic epidermal necrolysis（Lyell）剖検所見について—自験例を中心とする本症の概観

TOXIC EPIDERMAL NECROLYSIS (LYELL): AN AUTOPSIED CASE

I．はじめに

　我々は今回Toxic epidermal necrolysisと診定される1症例に遭遇した。入院3日目に死の転帰をとり，剖検の機会を得たので以下にこれを記載し，既報の剖検例と比較検討した上，本症の概要を記してみたい。

　A 50-year-old man was hospitalized with diffuse erythema and erosion over the entire body surface and serious general conditions. Three days after admission he died, and autopsy was performed.

　Three cases of autopsy in Japan and eleven from abroad have been reported. Many of them showed decreased lipid or necrosis of the adrenal cortex, and necrosis of the epidermis. Its on-set is quite abrupt.

　The pathomechanism of this disease might be autoimmunity to the epidermis or anaphylaxis on the epidermis as a shock organ. Dysproteinemia, beneficial effect of steroid hormone, LE phenomenon-like reaction, and findings suggesting allergic reaction might support this view.