膿瘍性穿掘性頭部毛嚢周囲炎の1例

PERIFOLLICULITIS CAPITIS ABSCEDENS ET SUFFODIENS

はじめに

　現在一般に使用されているPerifolliculitis ca-pitis abscedens et suffodiensなる語は1907年Erich Hoffmannおよび1913年Reuteが提唱したものであるが，本邦では太田^1）はsuffodie-nsという言葉に対し潜蝕性なる訳語を採り，皆見^2）は穿掘性と訳し，現在膿瘍性穿掘性頭部毛嚢周囲炎として諸家が用いている。

　当疾患は慢性難治性膿皮症で，従来より外科的，理学的および保存的に種々の治療法が試みられ，容易に治療効果が上らなかつたが，われわれは保存的療法すなわち抗生物質，副腎皮質ホルモン併用投与を主体とし，これに一部電気焼灼術を加え比較的短期間に軽快せしめたのでここに報告する。

A 37-year-old business man had been suffering from infectious eruptions since 2 and half year and had no improvement with surgical treatment by a local doctor.

He was obese, and his face was slightly erythematous and showed seborrhoic glister. There were many acne and small scars on the chest and back.

Many nodules up to 2cm in diameter were grouped on the occipital region of the head and nape, with many fistulae discharging stinking pus-like fluids. There were marked loss of hairs of the scalp.

Histologic findings showed slight hyperkeratosis, acanthosis, elongation of rete ridges and horny plugging. Granulomatous infiltration composed of lymphocytes, histiocytes and plasma cells accompanied with irregularly aranged connective tisssue and hypertrophic sebaceous gland in the dermis was proved.

Laboratory tests were within normal limits except mild renal glycosuria.

Treatments with antibiotics and steroid hormone accompanied by electro-cauterization with moderate success were performed.