アブストラクト
| Title | 壊疽性膿皮症の診断と治療 |
|---|---|
| Subtitle | 特集 / 皮膚科らしい傷の治しかた |
| Authors | 葉山惟大* |
| Authors (kana) | |
| Organization | *日本大学医学部皮膚科学系皮膚科学分野, 准教授 |
| Journal | MB Derma |
| Volume | |
| Number | 344 |
| Page | 84-92 |
| Year/Month | 2024 / 2 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」壊疽性膿皮症とは急速に拡大する増殖性・壊死性の潰瘍であり, 主に下腿に生じる. 潰瘍型, 膿疱型, 水疱型, 増殖型, ストーマ周囲型の5型が, 主たるサブタイプとして分類される. 炎症性腸疾患や血液腫瘍の合併症として有名ではあるが, 3〜10名/100万人という低い有病率である. その希少性のため診断基準や治療アルゴリズムが整備されていなかった. 病変部位には好中球の浸潤が著明であり, 病変部位では好中球の活性化に関与するサイトカインやケモカインの発現が目立つ. そのため好中球の活動を抑えることが重要である. 近年, TNF-α阻害薬であるアダリムマブの有効性が報告され, 治療抵抗性の壊疽性膿皮症に保険適用となった. 本稿では壊疽性膿皮症の診断, 分類, 診断, 治療について解説する. |
| Practice | 臨床医学：内科系 |
| Keywords | 壊疽性膿皮症(pyoderma gangrenosum), 好中球性皮膚症(neutrophilic dermatosis), 好中球(neutrophil), TNF-α, アダリムマブ(adalimumab) |
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