ぶどう膜炎, 白毛を伴った転移性悪性黒色腫の1例 A Case of Uveitis and Poliosis with Metastatic Malignant Melanoma

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55歳女性。1998年夏頃,左鼠径部の腫瘤に気づいた。生検で悪性黒色腫と診断され,近医病院皮膚科で腫瘤を摘出。精査するも原発巣は不明。左鼠径部腫瘤とほぼ同時期に頭部の白毛に気づいた。その後右眼の視力障害出現し,陳旧性ぶどう膜炎·視神経炎と診断。頭部の白毛は認めるものの白斑は認められなかった。悪性黒色腫に伴う白毛,ぶどう膜炎について悪性黒色腫に対する自己免疫的機序の関与を考えた。

A 55-year-old woman presented with a subcutaneous tumor in her left inguinal region in 1998. An aspiration biopsy of the mass demonstrated tissue consistent with metastatic malignant melanoma. A surgical excision of the tumor was performed in 1999. An extensive search failed to identify the primary lesion. At the time of the initial tumor developement, the patient had poliosis of the scalp. Approximately 3 months after the developing the tumor, she noticed a visual disturbance in her right eye. Uveitis and optic neuritis were diagnosed, and the patient was followed up without any treatment. Vitiligo may thus be an immunologically mediated by melanocyte destruction. Circulating antibodies to the melanocytes have been found in some patient with vitiligo. Ocular abnormalities occurring in depigmented patients have been reported to be especially common when leukoderma is associated with cutaneous melanoma. Therefore, our present report suggests that the autoimmune system plays an important role in the occurence of poliosis and uveitis associated with malignant melanoma. In addition, the presence of hypopigmentation and uveitis has a positive influence on the prognosis of patients with malignant melanoma.

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  • 西日本皮膚科 = The Nishinihon journal of dermatology  

    西日本皮膚科 = The Nishinihon journal of dermatology 64(2), 203-206, 2002-04-01 

    Western Division of Japanese Dermatological Association

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