Crohn病と合併したerosive pustular dermatosis of the scalp

・Crohn病に合併したerosive pustular dermatosis of the scalp（EPD）を経験した．

・妊娠のため中断していた抗TNF-α抗体製剤を出産後に再開することで皮膚症状は改善した．

・インフリキシマブとアダリムマブのいずれも皮膚症状の抑制効果はみられた．

・経過中，消化器症状の再燃はなかった．

（「症例のポイント」より）

　

Erosive pustular dermatosis of the scalp

　

Aki, Ryoichi1）Amoh, Yasuyuki1） 1）Department of Dermatology, Kitasato Universty Hospital

　

A woman developed Crohn’s disease at the age of 23 years, for which she was treated with infliximab. At the age of 25 years, she became pregnant and discontinued treatment. At 4 months of pregnancy, she developed pustules and erosions on her scalp, for which she was referred to our hospital. Pathology evaluation of scalp tissue indicated infiltration of various inflammatory cells in the upper to middle layer of the dermis, and destruction of some hair follicles. The patient was diagnosed with erosive pustular dermatosis of the scalp. After giving birth, she resumed infliximab therapy, which resulted in quick improvement in her symptoms. Erosive pustular dermatosis did not worsen as a result of switching from infliximab to adalimumab during the subsequent course of treatment of Crohn’s disease. Her gastrointestinal symptoms remained stable over the course of the disease.