乾癬様皮疹を呈した川崎病

・川崎病の際に出現する発疹は不定型発疹として知られ，さまざまな皮疹が報告されている．・自験例では不定型発疹が消褪したのち角化を伴う紅斑を呈し，乾癬様皮疹と考えた．・難治であり，シクロスポリンAを使用し改善した．（「症例のポイント」より）

A case of Kawasaki disease presenting with psoriasis-like eruptions

Watanabe, Aiko1）Fujiwara, Midori1）Saruban, Hiroko1） 1）Department of Dermatology, Higashiosaka City Medical Center

Abstract A 4-month-old male infant was hospitalized after being diagnosed with Kawasaki disease. He was treated with gamma-globulin and steroid-pulse therapy； however, aspirin was ineffective. Infliximab was administered and steroid-pulse therapy was repeated which reduced the fever. During the course of treatment, punctate papules appeared on his face, limbs, groin, and gluteal region. It was suspected that these pompholyx-like eruptions were due to the gamma-globulin. An external steroid was applied, but the eruptions worsened and became erythema keratodes. The histopathological image of a gluteal region skin biopsy showed hyperkeratosis accompanied by parakeratosis, neutrophil infiltration of the stratum corneum, disappearance of the stratum granulosum, and thickening of the epidermis, which led to a diagnosis of psoriasis-like eruptions. The eruptions permanently disappeared approximately 3 months after applying a tacalcitol ointment in combination with an internal course of cyclosporine A. We surmise that inflammatory cytokines contributed to the cause of the psoriasis-like eruptions.