持久性隆起性紅斑の1例

ERYTHEMA ELEVATUM DIUTINUM

I．はじめに

　Erythema elevatum diutinum　（E．e．d．と略す）は比較的稀な疾患とされ，慢性に経過し，あまり自覚症状のない持異な紅斑である。1878年Hutchinson^1）は58歳男子の下肢，手指背，前腕にやや隆起した紫紅色の慢性紅斑症を発表し，1889年Bury^2）は12歳女子で足趾，膝蓋，肘頭，さらに指におよんだ境界鮮明な結節性肥厚と硬結紅斑の症例を発表した。

　1894年Radcliffe-Crocker　＆　Williams^3）は6歳女子の肘頭，手，膝蓋，臀部に紫紅色結節の生じた症例を発表し，類似症例を集めて検討し，経過が長く，隆起性の紅斑を主症状とすることから，一括してE．e．d．なる名称を与えたのである。

A 51-year-old man have had slightly elevated, well margined erythema on the extensor sur-faces of fingers, hands, feet, palms, soles, cubital regions and earlobes for 2 years. The similar lesion was found on the tongue.

It is a very rare case with mucosal lesion.

Histologic specimen showed i nfiltration mainly composed of ncutrophils and lymphocytes throughout the dermis. Perivascular infiltration, proliferation and dilatation of capillaries, thickn-ing of vascular walls, onion skin-like proliferation of fibers around the vessels and perivascular fibrinoid degeneration were noted.

It was resistant to all kinds of treatment, though administration of chloroquinc and O.D.T. steroid ointment were slightly effective.