下腿硬結症における細菌性抗体

ROLE OF INFECTIOUS ALLERGY IN NODULAR INFLAMMATORY LESIONS OF THE LEGS

I．はじめに

　下腿は炎症性結節ないし硬結の好発部位であり，それらの病変の主体をなすものは臨床的には著しい多形性を示す散在性の比較的小さな発疹を特徴とするものと，比較的単一な形態をとり，1個ないし少数の盆状皮疹を特徴とするものとに大別できる。しかし，それらを組織学的にみる時には前者が多数の吻合を持つ表在性血管を反応の場とし，後者が真皮・皮下境界部ないし終末動脈に貫流される脂肪織内の血管変化を前景に示すという差こそあれ，いづれの場合も本質的には白血球の迷走および崩壊，血管壁の腫脹ないし破壊に特徴づけられた血管炎である。このような皮膚および皮下脂肪織の血管炎は異つた原因因子によつても同じ臨床像と組織像とを示すいわゆるréactioncutanéeとされており，原因因子としては内因的諸因子の役割を無視できないとはいえ，薬剤アレルギー性血管炎と結核菌を含めた細菌その他の微生物感染の意義とが強調されて来た（Schnei—der^1））ことはいうまでもなく，著者に課せられた命題は下腿の炎症性硬結を示す患者における細菌性抗体の検討である。

Analytical studies on infectious allergy in erythema nodosum, erythema induratum, Behçet's disease, and anaphylactoid purpura were performed.

1) No significant results on kinds of microorganisms from the mouth and pharyngeal cavity in 24 cases of the above-mentioned diseases were obtained except in two cases of Behçet's disease.

2) Fifteen to twenty Percent of the cases showed the positive immediate reactions to the intra-cutaneous tests with 10 kinds of bacterial antigens. They especially gave the strong positive reactions to Pneumococcus, Streptococcus viridans, and Streptococcus faecalis.

3) Eight percent of the cases showed positive results of the delayed type reaction to pyogenic streptococcus.

4) Almost all cases of erythema induratum showed the strong positive tuberculine reaction, while many cases of erythema nodosum gave negative results.

5) Majority of the cases of erythema nodosum and anaphylactoid purpura had the abnormally high titer of ASL.

6) Few cases of erythema induratum showed the abnormally low titer of Middlebrook-Dubos' reaction, while Behçet's disease had the abnormally high titer.

7) Ability of production of humoral immunity for tetanus toxoid measured by radioimmuno-electrophoresis and radioimmunodiffusion technique was rather low in one or two examined cases of Behçet's disease.