難治性臀部潰瘍を呈した抗リン脂質抗体症候群

・抗リン脂質抗体症候群は皮膚に初発症状が出現することが多く，網状皮斑が最多で，次いで皮膚潰瘍が多い． ・皮膚潰瘍は下肢，指尖・足趾が多く，自験例のような臀部に潰瘍を生じる例はまれであるが，上肢や体幹の報告もあり，基礎疾患のない症例も多いので，難治性の皮膚潰瘍の鑑別には抗リン脂質抗体症候群を念頭に置く必要がある． ・潰瘍周辺に網状皮斑がある場合，皮膚生検は網状皮斑でも行うべきである． （「症例のポイント」より）

A case of anti-phospholipid antibody syndrome presenting with refractory buttock ulcer

Matsuo, Yuji1）Miyagi, Takuya1）Yonamine, Shuhei1）Kariya, Yoshiyuki1）Yamamoto, Yu-ichi1）Takahashi, Kenzo1） 1）Department of dermatology, University of the Ryukyus

Abstract A 69-year-old Japanese woman, who had suffered from SLE and angina pectoris, presented with refractory buttock ulcer. Histopathological examination obtained from surrounding livedo reticularis showed the presence of multiple arterio-venous thrombus. Collectively with the results of head MRI and presence of anti-phospholipid antibody, she was diagnosed as skin ulcer due to antiphospholipid antibody syndrome. She was treated with warfarin, clopidogrel and aspirin, and ulcer was cured by 3 months.