多形紅斑と角層下膿疱を呈した非典型手足口病

・掌蹠外に分布する皮疹．

・全身性の小水疱・膿疱から多形滲出性紅斑に移行した特異な臨床経過．

・経過中に多形紅斑様皮疹を呈し，ステロイド投与で軽快．

（「症例のポイント」より）

　

A case of atypical hand-foot-and-mouth disease with erythema exsudativum multiforme and subcorneal pustule

　

Kawakita, Haruka1）Niijima, Yasuko1）Ishitsuka, Yousuke1）Fujisawa, Yasuhiro1）Fujimoto, Manabu1） 1）University of Tsukuba, Department of Dermatology

　

A 74 years-old man presented with fever, sore throat, erythema and multiple small vesicles that were scattered around the body. Initial differential diagnoses involved vericella and Sweet’s disease, and tentative treatment with acyclovir in combination with potassium iodide was initiated, which was not successful. After that, he developed erythema exudativum multiforme that responded promptly to systemic corticosteroid administration. Skin biopsy revealed the presence of subcorneal pustule and inflammatory cell infiltration in the upper dermis. Serological tests using paired serum revealed that he had been contracted Enterovirus 71, yielding the definitive diagnosis of hand-foot-and-mouth disease.