A Case of Reticular Erythematous Mucinosis with Systemic Lupus Erythematosus

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  • SATO Seisho
    Department of Dermatology, Graduate School of Medical Sciences, Kyushu University Division of Skin Surface Sensing, Graduate School of Medical Sciences, Kyushu University
  • FUYUNO Yoko
    Department of Dermatology, Graduate School of Medical Sciences, Kyushu University
  • KAWANO Shotaro
    Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University
  • FURUE Masutaka
    Department of Dermatology, Graduate School of Medical Sciences, Kyushu University Division of Skin Surface Sensing, Graduate School of Medical Sciences, Kyushu University

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  • 全身性エリテマトーデス患者に生じた Reticular Erythematous Mucinosis

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Abstract

<p>患者：45 歳，女性</p><p>主訴：胸背部の紅斑</p><p>現病歴：初診の 25 年前に全身性エリテマトーデス（systemic lupus erythematosus：SLE）と診断され，20 年前に背部に網状の紅斑が出現した。1 カ月前に皮疹が増悪し，SLE の増悪や薬疹が疑われ当科紹介となった。</p><p>既往歴：SLE</p><p>現症：前胸部，背部中央に軽度瘙痒を伴う網状浮腫性紅斑を認めた（図 1 ）。</p><p>臨床検査所見（異常値に下線）：WBC 7990/μl（Neut 83.5％，Lymp 8.5％，Mono 5.1％，Eos 0.7％，Baso 0.5％），Hb 13.3 g/dl，PLT 25.3×104 /μl，抗核抗体 160 倍，抗 ds-DNA 抗体（－），抗 Sm 抗体（＋），C3 71 mg/dl，C4 7 mg/dl，CH-50 32.1 U/ml</p><p>病理組織学的所見：角層は正常角化，表皮に部分的に軽度の空胞変性を認め，真皮浅層血管周囲・付属器周囲にリンパ球を中心とした炎症性細胞浸潤を認めた（図 2 ）。Alcian blue 染色にて真皮全層性にムチン沈着を認め，特に真皮浅層で豊富に沈着していた（図 3 ）。</p><p>診断：Reticular erythematous mucinosis（REM）</p>

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 82 (6), 401-402, 2020-12-01

    Western Division of Japanese Dermatological Association

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