褐色色素斑が先行したボーエン病の1例

BOWEN'S DISEASE STARTING FROM A PIGMENTED SPOT

はじめに

　前癌症ないし前癌性変化の1つとして，皮膚腫瘍群中特異な位置をしめるボーエン病も，最近は単にその悪性化に関してのみならず，内臓悪性腫瘍の合併^1）や砒素との関係^2）において注目され，その早期診断のため，臨床的，組織学的にいかなる初期病変を示すかを知ることが重要となつてきた。最近われわれは，10年前に先行皮疹として褐色色素斑を生じ，3〜4年前よりその1部に疣贅様変化，痂皮形成をみた42歳男子のボーエン病症例を経験したので報告する。

A 42-year-old man noticed a brown spot without any subjective sensations in the occipital region 10 years ago, which has been left with no medical care. It has become verrucous with a crust in a part of the fleck since several years.

Past history revealed no intake of arsenicals.

Histologic specimen from the verrucous lesion disclosed a typical picture of Bowen's disease, while the brown spot showed partial hyperkeratosis, partial bud-like elongation of the epidermis, vacuolization of squamous cells, and increased melanin in the basal layer. The changes of the pigmented spot were identical with those in the early stage of Bowen's disease. Destruction of the basal membrane, metastasis to the regional lymph nodes and to other organs, and as-sociated internal malignancies were not proved.

Clinical and histologic findings suggested that this pigmented spot might represent an early or preceeding condition of Bowen's disease.