非水疱型先天性魚鱗癬様紅皮症の悪性黒色腫 (ALM) とボーエン病の併発

同側Plantar prema1igmant melanosis切除, 対側前腕のSCCによる切断後の症例

抄録

In a female patient with non-bullous type, congenital ichthyosiform erythroderma, who was 55 years old at first examination, pseudocarcinomatous hyperplasia was noted in the refractory ulcer portion of the right toe and Mishima et al.'s plantar premalignant melanosis in the right sole, and both lesions were resected. Four years later, squamous cell carcinoma resulting from Bowen's disease developed on her right forearm, of which amputation was performed. Furthermore, 13 years later, this patient developed ALM on her right heel and Bowen's disease on her left forearm. This is a very rare case. The sequential onset of Bowen's disease is not uncommon, but there has been no report on the sequential onset of ALM on the same side of body. There also seems to be no case report on malignant tumor of the skin secondary to non-bullous type, congenital ichthyosiform erythroderma. Duplication and sequelae of two kinds of cutaneous malignant tumors seem to be very rare. The possible involvement of trauma (physical stimuli) in the development of malignant tumor has been accepted. In this case, the involvement of trauma such as desquamation repeated on hyperkeratotic skin was suspected for the development of ALM and SCC. Additionally, it was considered that an abnormal immunity of the host was involved in plural sequelae of cutaneous malignant tumors. Retinoids could not inhibit the development of these cutaneous malignant tumors, but may have inhibitory effects on metastasis.