Encapsulated Fat Necrosis の1例  [in Japanese] A Case of Encapsulated Fat Necrosis  [in Japanese]

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Abstract

63歳の女性。尋常性天疱瘡に対して1984年より, ベタメサゾン最大量6mg/日, 通算約7g, 現在3mg/日内服にて経過を観察していた。1996年9月頃より両下腿を中心として直径2~5mmの可動性のある, 軽度圧痛のある皮下結節に気づいた。徐々に増数し, 80個以上認められるようになった。1997年5月外来受診時数個を摘出。組織学的に, 結合織の線維に包まれた蜂巣状の変性脂肪組織が認められ, encapsulated fat necrosisと診断した。長期のステロイド大量全身投与が関係している可能性が示唆された。

A 63-year-old Japanese female complained of a 9-month history of multiple subcutaneous nodules on her lower legs. She had been treated with oral betamethasone (3mg/day, total dose 7g, maximum dose 6 mg/day) for pemphigus vulgaris. Physical examination revealed multiple mobile subcutaneous nodules, 46 on the right leg and 38 on the left leg. The nodules were less than 5 mm in diameter. Several nodules were extirpated under local anesthesia. Histopathologically, the nodules were composed of mature fat tissue with various degrees of degeneration and membranocystic fat necrosis, and they were encapsulated by thick collagen. To our knowledge, 23 cases (including the present case) of multiple encapsulated fat necrosis have been reported. Fourteen cases had serious complications, seven cases received oral glucocorticoids, and one suffered from Cushing's syndrome. These reports implicate glucocorticoids in the pathogenesis of the development of multiple encapsulated fat necrosis.

Journal

  • The Nishinihon Jourrnal of Dermatology  

    The Nishinihon Jourrnal of Dermatology 66(5), 451-453, 2004-10-01 

    Western Division of Japanese Dermatological Association

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