除草剤による接触性皮膚炎（死亡例）

CONTACT DERMATITIS DUE TO HERBICIDE (PCP AND MCPB):A FATAL CASE

　最近における農薬の開発はめざましく，そのため農産物は飛躍的に増産をみるようになつた。しかしながら反面，農薬は多くの併害をもたらすようになり大きな社会問題となつてきている。皮膚科領域においても農薬による皮膚炎は今後増加するものと思おれ，したがつてこの方面の知識が皮膚科医にも要求されるようになつてきた。

　最近，われわれは農薬の一種である除草剤の使用後，発熱，倦怠感などの全身症状とともに，四肢，顔，口唇，口腔粘膜などに紅斑，紫斑，血痂などを生じ入院20日後に不幸にして死亡した例を経験したので報告するとともに，改めて農薬使用にさいしての注意を喚起したいと考えるものである。

Although the fatal cases due to herbicides-PCP or 2, 4-dichlorophenoxy acetic acid have been reported in Japan, this is the first report by the mixture of PCP and MCPB. The herbicide is a mixture granule of PCP, MCPB and bentnite etc. and named "Manokku granule".

A 46-year-old farmwoman, after handling 16.5 kg of the drug for 6 hours without any protec-tion, was affected by the erythematopurpuric eruptions with bullae on the exposed skin, oral mucosa and conjunctiva accompanied by pains in the eye, throat and head, attacks of chills and fevers from 38 to 39℃.

She was hospitalized after 5 days, when she had a severe malaise, showing SLE-like skin manifestations. In spite of the therapy with adrenocortical hormone and antibiotics, she died the 30 th day after the contact with the herbicide.

While the histologic findings in the epidermis showed the necrosis, reticular degeneration of the epidermis, formation of the bulla and civatte body, the dermal damage was rather mild.

These histopathologic findings were analogous to those of the toxic epidermal necrolysis (Lyell).

Autopsy proved the damage of the heart muscle which might be due to the toxic effect of the herbicide.