線状萎縮症の1例—特に成因についての考察

LINEAR ATROPHY ON THE BREASTS : WITH REFERENCE TO THE PATHOGENESIS

I．はじめに

　線状萎縮症は妊娠，肥満症，成長期，クッシング症候群，副腎皮質ホルモン長期大量内服，感染症等に際して生ずるとされている。その成因に関しては，従来皮膚の過度伸展という機械的な因子が第一義的に考えられていたが，近年では下垂体一副腎皮質系ホルモンの真皮結合組織に対する影響を重要視するものが多い。

　我々は最近，両側乳房部に放射状に太く長い，赤色線状萎縮を生じた20歳未婚女子の1例を経験した。しかも臨床検査で軽度の副腎皮質機能亢進を認めることが出来たので，本症の成因についての考察を中心にこれを報告したい。

Biochemical and histopathological studies of linear atrophy on the breasts in a 20-year-old unmarried woman were performed.

Increased urinary excretion of 17-ketosteroids and of 17-hydroxycorticoids and a slight enlargement of the left adrenal were proved, although she had no clinical signs and symptoms suggesting Cushing's disease.

Pregnancy, obesity, severe infectious disease or diabetes mellitus were not found in her past history or in physical examinations and laboratory tests.

These clinical findings and laboratory results suggest the following three pathomechanisms in this case.

1) It is due to an oligosymptomatic Cushing's syndrome (Hauser) which may develop into typical Cushing's disease.

2) She has had an episode of transitional adrenocortical hyperf unction. Furthermore, topical application of the triamcinolone ointment might have accelerated the development of the skin manifestation.

3) She has had an episode of a high increase in the adrenocortical function which formed the striae, but now the adrenal cortex is functioning normally.

As a conclusion the third mechanism may be the most possible factor and the second acted as an accelerating factor.