抗セントロメア抗体陽性の全身性強皮症を合併した爪扁平苔癬

・爪の萎縮を主訴として来院し，臨床所見と病理組織学的所見をもとに爪扁平苔癬と診断した1例を報告した．

・両手指の冷感と腫脹を伴い，抗セントロメア抗体陽性の所見を手がかりとして全身性強皮症早期病変を見出した．

・全身性強皮症による末梢循環不全が，爪扁平苔癬の増悪因子の1つになっている可能性が推測された．

（「症例のポイント」より）

　

Nail lichen planus associated with systemic scleroderma

　

Endo, Miki1）Matsuura, Daisuke1）Onoe, Asuka1）Suzuki, Hirotake2）Terui, Tadashi3）Ochiai, Toyoko1） 1）Department of Dermatology, Nihon University Hospital 2）Kajicho-Suzuki Dermatology Clinic 3）Department of Dermatology, Nihon University Itabashi Hospital, Nihon University, School of Medicine

　

A 61 year-old man presented with malformed nails of both hands and feet of 3 years duration. All finger and toenails except the thumbs showed thinning, atrophy, onychorrhexis, and pterygium. His fingers were cold and swollen, with redness and capillary dilation in the paronychium. Histopathology of the nail matrix revealed epidermal hypergranulosis, dermo-epidermal junction liquefaction degeneration, and band-like lymphocyte infiltration in the upper dermal layer. Antinuclear antibody was increased 160-fold, he was anticentromere antibody-positive, and had an ACR/EULAR score of 10. He was diagnosed with lichen planus and systemic scleroderma. Scleroderma-related peripheral circulation disorders may worsen nail lichen planus.