炭鉱爆発外傷部位に生じた多発性瘢痕浸潤型サルコイドーシスの1例  [in Japanese] A Case of Sarcoidosis Manifesting Multiple Subcutaneous Nodules and Indurated Plaques at the Sites of Posttraumatic Scars  [in Japanese]

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Author(s)

    • 鍵本 香子 KAGIMOTO Yoshiko
    • 九州大学大学院医学研究院皮膚科学分野 Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
    • 古賀 哲也 KOGA Tetsuya
    • 九州大学大学院医学研究院皮膚科学分野 Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
    • 古江 増隆 FURUE Masutaka
    • 九州大学大学院医学研究院皮膚科学分野 Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
    • 池上 聡子 IKEGAMI Satoko
    • 九州大学大学院医学研究院胸部疾患研究施設内科部門 Department of Respirology, Graduate School of Medical Sciences, Kyushu University
    • 原 信之 HARA Nobuyuki
    • 九州大学大学院医学研究院胸部疾患研究施設内科部門 Department of Respirology, Graduate School of Medical Sciences, Kyushu University

Abstract

66歳,男性。40年前に炭鉱爆発事故で外傷を受けた部位に一致して,多発性の皮下~皮内結節が出現。その臨床像は,右前腕においては皮下~皮内結節を呈し,下肢においては瘢痕を形成。病理組織学的診断では,異物硝子体を含む非乾酪性類上皮細胞肉芽腫を呈していた。他の全身症状としては,血清ACEおよびリゾチームの上昇,ブドウ膜炎,軽度の両側肺門部リンパ節腫脹(以下BHL)および筋サルコイドーシスを認め,瘢痕浸潤を初発症状としたサルコイドーシスと診断した。

A 66-year-old man, who had been injured in a coalmine explosion 40years earlier, was found to have multiple subcutaneous nodules and indurated plaques at the sites of disseminated posttraumatic scars on his right arm and leg. A biopsy specimen obtained from the multiple subcutaneous nodules on his right dorsal hand showed noncaseating epithelioid cell granulomas, including foreign bodies which were mainly composed of SiO<SUB>2</SUB>. Furthermore, an elevated level of angiotensin-converting enzyme and the presence of bilateral hilar lymphadenopathy and uveitis were also found. We diagnosed this patient to have intra- and subcutaneous multiple scar sarcoidosis.

Journal

  • The Nishinihon Jourrnal of Dermatology  

    The Nishinihon Jourrnal of Dermatology 64(5), 563-566, 2002-10-01 

    Western Division of Japanese Dermatological Association

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