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・播種状黄色腫はまれな疾患であるが,アトピー性皮膚炎と同様に間擦部に対称性に皮疹が出現するという特徴がある.しかしその病理組織学的所見は肉芽腫で特異的である.
・発症機序は不明で,海外では抗IL-1受容体抗体が奏効した症例が報告されているが,本邦では適応がなく,承認されている有効な全身療法はない.
・自験例はCO2レーザーとルビーレーザーを用いて整容的な改善を得ることができた.対症療法的な治療であるが患者の満足度は比較的高い.
(「症例のポイント」より)
Xanthoma disseminatum in a young adult female : A case cosmetically ameliorated by laser therapy
Kogame, Toshiaki1)Shibuya, Mami1)Okamoto, Natsuko1)Kumakiri, Masanori2)Arata, Jun2)Toichi, Eiko1) 1)Department of Dermatology, National Hospital Organization Kyoto Medical Center 2)Department of Plastic Surgery, National Hospital Organization Kyoto Medical Center
A woman in the third decade suffered from diabetes insipidus and yellow-brown, granulomatous papules. The papules symmetrically appeared on the intertriginous areas such as the axillary fossa, the upper eye lids and the neck. Histopathological analysis revealed that the granulomas were composed of CD68+/CD1a−/S100− cells, which suggested the non-Langerhans cell origin. Coupled with the unique distribution of the skin lesions, the diagnosis was finally concluded as xanthoma disseminatum. Application of a CO2 laser and a ruby laser cosmetically ameliorated her cutaneous symptoms.
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