針反応陽性であった Sweet 病の1例  [in Japanese] Pathergy Reaction in Sweet's Disease  [in Japanese]

Access this Article

Search this Article

Author(s)

Abstract

53歳,女性。1999年3月中旬,発熱,再発性口内炎,咽頭痛,関節痛出現。顔面と手背,下肢に境界鮮明な暗赤色,有痛性,浮腫性紅斑を認める。病理では血管周囲性に好中球を主体とする密な細胞浸潤が認められた。末梢血好中球増多,CRP上昇。針反応陽性,フィブリノーゲン高値,シアル酸高値が認められるものの,診断基準よりSweet病と診断。 Behçet病の診断は臨床症状に頼っているところが大きいが,最近の文献では,針反応がBehçet病に特異性が高いとしてあるものが多い。針反応を重視すると,今回の症例は,症状が足りなく,診断基準を満足していないものの,Sweet病にBehçet病を合併している可能性もある。Sweet病をみた場合は針反応にも注目すべきである。

We report a case of Sweet’s disease which showed a pathergy reaction in a 53-year-old woman. We noted the occurrence of multiple, painful, sharply demarcated, raised erythematous plaques on the face, hands and legs, accompanied by fever, arthralgia and a sore throat. The histology of the plaques on the hands showed neutrophilic infiltration in the dermis, but no leukocytoclastic vasculitis. Cutaneous pathergy, which is well-known to occur in Behçet’s disease or pyoderma gangrenosum, also occurred on the forearm skin which had previously been used for intracutaneus injections. Recent studies have reconfirmed the marked specificity of a positive skin pathergy in Behçet’s disease. This case of Sweet’s disease may have also been complicated with Behçet’s disease. Therefore, when encountering Sweet’s disease, it is important to look for the possibility of a pathergy reaction.

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 63(5), 505-508, 2001-10-01

    Western Division of Japanese Dermatological Association

References:  17

Codes

Page Top