耳介のみにみられた環状肉芽腫—とくに皮下環状肉芽腫と単一症候性リウマチ結節の問題について

A CASE OF GRANULOMA ANNULARE SEEN ON THE EARS ALONE

　環状肉芽腫は，発症病理，組織鑑別などで問題になることのきわめて多い疾患であるが，それらの問題点を除いては，臨床像，組織像などに特有のものがあり，また報告例も多く，まれなものとはいいがたい疾患である．ちなみに，藤沢^1）によると，昭和43年までに，本邦で120例の報告をかぞえるという．

　著者らは，最近，両耳介のみに小結節を多発した小児例に遭遇し，紅織学的に環状肉芽腫と診断した．きわめてまれな例と考えるのでここに報告しておおかたの批判を仰ぎたい．

An 11-year-old boy first visited us on Jan. 7, 1971, complaining of asymptomatic small nodules on both auricules, which started to appear half a year ago without any attributable cause. On examina-tion, rice-corn-sized, whitish, hard nodules, 12 on the right side and 9 on the left in number, were seen. The nodules were not movable. Laboratory examinations revealed negative serological test for rheumatic disease, and marked increase in peripheral cosinophil count was observed. Histological picture was a typical palisading granuloma adherent to the periostiurn. Alcian Blue positive substances were found in the necrobiotic center.

Clinical and histological differential diagnosis was attempted amoung granuloma annulare, sub-cutaneous granuloma annulare and rheumatic nodules only in vain.

The authors believe that the cases without any serological evidence of rheumatic disease must'nt bear the diagnosis as an "isolated rheumatic nodules".

Granuloma annulare seen on the cars alone has never been reported in Japan.