臨牀消化器内科 Vol.14 No.13(4)


特集名 消化器疾患と皮膚病変
題名 潰瘍性大腸炎と皮膚・粘膜病変
発刊年月 1999年 12月
著者 丹羽 寛文 帝京大学医学部第三内科客員教授
【 要旨 】 潰瘍性大腸炎の合併症としての皮膚病変の頻度は,欧米例ではかなり高いが,わが国では従来かなりまれであった.しかし注意してみるとかなりの頻度で認められ,防衛医科大学校で9年間に経験された潰瘍性大腸炎症例140例中,皮膚病変は16例に認められた.その内訳は結節性紅斑6例,壊疽性膿皮症2例,大型血疱症2例,アトピー性皮膚炎4例,その他2例であった.これらの病変は原疾患の潰瘍性大腸炎の増悪時に出現し,治療による原疾患の好転とともに皮膚病変も軽快した.原疾患の再燃に際し,皮膚病変も再燃した症例も認められた.症例を提示し,合併症としての皮膚病変の詳細について説明した.大型血疱は特異な病像を示すが,本症と壊疽性膿皮症との異同をめぐって考察を加えた.
Theme Gastrointestinal Tract Disease and Skin Manifestation
Title Skin Complications in Association with Ulcerative Colitis
Author Hirohumi Niwa 3rd Department of Internal Medicine, Teikyo University School of Medicine
[ Summary ] Skin lesions are frequently seen as complications associated with ulcerative colitis in Western countries, but have been thought to be rare in Japan. However, on close observation, this condition has been frequently found, in recent cases. Skin lesions were found in sixteen out of one hundred forty ulcerative colitis cases observed over nine years at the second Dept. of Medicine, National Defense Medical College Hospital. These included six cases of erythema nodosum, two cases of pyoderma gangrenosum, two cases of macro hemato-bullous dermatosis and six other cases. These lesions appeared when ulcerative colitis was exacerbated. When ulcerative colitis improved with treatment, the condition of the skin lesions also improved. Cases were observed where skin lesions worsened upon exacerbation of ulcerative colitis, during the long-term course. Some cases are presented to explain the details of skin lesion as a complication of ulcerative colitis. The two cases of macro hemato-bullous dermatosis lesions were seen in a peculiar image that was never reported in previous literature. Consideration is given as to whether macro hemato-bullous dermatosis and pyoderma gangrenosum are different in nature.
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