妊娠に伴い発症する多形滲出性紅斑様皮疹について

ON AN ERYTHEMA MULTIFORME-LIKE ERUPTION ASSOCIATED WITH PREGNANCY

Ⅰ．緒言

　多形滲出性紅斑（以下EEMと略す）には大別してHebraが記載した若年者の四肢に季節的に再発性に生じ，2週間程度で自然に消褪する古典的な特発性EEMと，個疹は之に似ているが種々雑多な原因によつて躯幹や顔面にもしばしば発生をみる症候性EEMの2つがある。このうち症候性EEMについては，現在これを1独立疾患とするよりはむしろ1症候名とみなしても差つかえない程様々な原因^{1）2）10）}が挙げられている。

　明らかに妊娠によるものは勿論症候性EEMに属するが，古来その詳しい記載に乏しく，成書でもその一部^1）〜5）にEEMの原因として妊娠の記載がわづかになされているものの，最近の日本，米国，ドイツ，フランス，ソ連の多くの成書^6）〜13）にはこれをみない。

A housewife, aged 24, when she became pregnant, developed an extensive erythema multi-forme-like eruption on her extremities with a fever and oliguria, and these skin lesions clearedup spontaneously after a child was delivered. The patient had had a relaqsing nail-sized exu-dative erythema on the left cheek and when she became pregnant first time about nine months ago, the skin lesion became more exudative and increased in size and number but spontaneously disappeared when she miscarried at the end of the second month of her pregnancy.

The baby, when one month old, developed erythematous skin lesions similar to those of his mother, on the trunk and extremities and about one month later when he stopped taking breast feedings, the skin lesions cleared up.

In discussing the world literatures on the case reported herein, this skin disease can be classified into two types according to the clinical courses: the first type in which the skin lesion returns whenever the patient becomes pregnant like that of herpes gestationes and the second type in which during pregnancy the lesion is brought about by ingestion of a drug, frequently associated with muco-ocular affectios and thereby led to a severe condition. The erythema multiforme-like lesions in this case may belong to the first type and have become more conspicuous by estrogen or gonadtropin.

As one of the causes of this eruption in the inbant, focal allergy might be involved. The antibody may have been transferred throngh the placenta to the baby and have caused the skin lesions by the antigen contained in the mother's milk.