リポソーム化ドキソルビシン塩酸塩が奏功したHIV陰性カポジ肉腫の1例  [in Japanese] A first case report of HIV negative Kaposi's sarcoma treatment with liposomal doxorubicin hydrochloride in Japan  [in Japanese]

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Abstract

15年前に日本に移住したペルー出身の70歳女性。2010年10月,38度台の発熱と四肢の結節性紅斑,口唇のアフタを認め,当院を受診した。プレドニゾロン内服により加療した。同年12月頃より両下腿から足にかけて紫斑,血疱が出現した。皮疹は徐々に増加し,結節を伴っていた。HIV抗体は陰性。結節部の病理組織所見は異型性を伴う紡錘形細胞の増殖を示し,human herpesvirus-8(HHV-8)が陽性であった。皮膚生検組織からのPCR法でHHV-8の特異的なバンドの増幅を認めた。炭酸ガスレーザーによる結節部の焼灼と,弾性ストッキングによる下腿の圧迫に加え,リポソーム化ドキソルビシン塩酸塩(Doxil)による化学療法を計6クール行い皮疹は軽快した。DoxilによるHIV抗体陰性カポジ肉腫の治療について,考察を加え報告する。

The patient was a 70-years-old Peruvian woman whose HIV antibody was negative. She immigrated to Japan 15 years ago. The patient had prednisone therapy due to erythema nodosum and then she was referred to our department due to multiple purple spots and nodules developing from edema of both legs. Skin biopsy specimens were obtained from the nodules. The histopathologic findings included abnormally proliferated and dilated vessels, vascular slits, numerous red blood cells, and spindle-shaped cells in the dermis. PCR examination by using skin tissue was positive for the specific band of HHV-8. The patient received treatment with liposomal doxorubicin hydrochloride (Doxil) at a dose of 20 mg/m<sup>2</sup> intravenously every 3 weeks for six cycles. HIV negative Kaposi sarcoma is particularly rare in Japan, because of the very small population ratios of HHP8-positive in Japanese. Liposomal doxorubicin hydrochloride is usually used in disseminated HIV-related Kaposi's sarcoma, while there have still been no reports of cases of Doxil for HIV negative Kaposi's sarcoma in Japan. We first report the HIV negative Kaposi's sarcoma treatment with Doxil with good tolerance and remission of the lesion. [<i>Skin Cancer (Japan)</i> 2015 ; 30 : 10-15]

Journal

  • Skin Cancer

    Skin Cancer 30(1), 10-15, 2015

    The Japanese Skin Cancer Society

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