掌蹠膿疱症—治療と予後

PUSTULOSIS PALMARIS ET PLANTARIS

　掌蹠膿疱症はわれわれが日常しばしば経験する疾患で，かつ難治である。われわれは昭和34年以降同45年までの11年2ヵ月間に金沢大学皮膚科において観察された本症263例を統計的に検討し，また予後についてのアンケート調査も行なつた。以下にその成績を述べる。

Statistic studies on this disease in the Department of Dermatology, Kanazawa University Hospital for 11 years and 2 months-from 1959, June to 1970, August-were performed.

Number of the patients was 263, which was 0.76% of all the patients of the Departmet. Male were 127 and female patients were 136. Most of the male patients started the disease in the forth decade, while the female patients started it from the fourth to sixth decade of life. 164 cases (62.4%) had bilateral lesions on the palms and soles, the lesions outside the palm and sole were found in 16% of the cases, and the nail changes were in 19.8%.

A few cases showed slight abnormality in the laboratory tests of ASLO, CRP, RA and ESR.

Nine cases were accompanied with tinea. Seventy-eight in 111 cases showed some abnormalities which couldbe focal infections otorhinologically or dentistrically.

Therapeutic effects of nonsteroid antiinflammatory drugs and antiplasmin agent were not so remarkable as those of systemic administration of glycocorticoids. As a external treatment, topical applications of steroid ointment in form of ODT, simple rubbing on the skin, or double applica-tion under the usual ointment were used most frequently.

Twenty-five cases received the treatment against focal infection. The results of this treatment were excellent.

The results of follow-up study of 134 cases were as follows ; cured, 26.9% ; improved, 40.3% ; unchanged or worse 30.6% ; and died 2.2%.

The rate of the cured patients over 5 years after the first visit was higher than that under 5 years.

This disease might cure after long course, and the removal of focus showed beneficial effect.