口腔に限局している尋常性天疱瘡の1例

PEMPHIGUS VULGARIS LOCALIZED IN THE ORAL CAVITY

はじめに

　尋常性天疱瘡がしばしば口腔粘膜に初発し，かなり長期間口腔内に限局することは欧米の文献には記載が多いが本邦での記載は比較的少ない。

　尋常性天疱瘡が口腔に先行限局している場合は皮疹の生じないかぎり診断がときに困難であり，難治性の不明の口内炎もしくは2次的にcandidaが寄生し易いことからcandida性口内炎としてみすごされている場合が多いと思われる。

A 51-year-old woman of this disease with repeated formation of bullae, erosion, bleeding and white pellicle on the oral mucous membrane after extraction of a tooth was reported.

Candida albicans was positive in the white pellicle on the erosion. Suprabasal acantholytic bullae on histologic section and acantholytic cells by Tzank's method were proved.

There was no abnormality in the laboratory tests, except elevated erythrocyte sedimentation rate, positive RA tests, CRP (++), increased α₂-globulin in serum, and decreased basal metabo-lism (-15%).

Oral lesion disappeared after β-methazone treatment (4mg/day, parenterally), but disturbance of standing, weakness, muscular atrophy of peripheral parts of extremities were developed. Then the amount of β-methazone was diminished to daily dosage of 2mg, and accompanied with anabolic steroid. There was no recurrence of lesion in the course of 1 year and 4 months.