22才女子で, 生後まもなく頭髪の異常, 躯幹の環状, 蛇行状の皮疹を生じた, いわゆるNetherton’s syndromeについて種々の検討を加えて報告した。本症例の毛髪はbamboo like node, pili torti, cup like formを呈し, 皮疹は病理組織学的には湿疹様および尋常乾癬様の変化を示した。また本例ではMEDの延長が認められ, 皮疹にたいしてPUVA療法を行ない, ほぼ満足すべき結果を得た。
The patients of drug eruptions who attended the Department of Dermatology, Branch Hospital, University of Tokyo, from 1966 to 1968, were 113 persons or 1.08% of the total outpatients. The number of drug eruption patients in their twenties was the largest—31 persons, and those in their thirties was the next largest—28 persons. The sum of both groups was slightly more than half of the total drug eruption patients. Cutaneous eruptions were classified according to the list of American Medical Association. Fixed eruption with 45.1% was the largest, followed by exanthematic eruption with 25.7%, erythematous eruptions with 11.5%, papulovesicular eruption with 8%, urticarial eruption with 2.7%, erythroderma with 0.9%, acne form with 0.9%, toxic epidermal necrolysis with 0.9%, photosensitive eruption with 0.9%. Causative drugs of 10 cases were ascertained by a provocation test and the ones of another 21 cases were suspected by determing that the patient had used one drug only. The largest group of causative drugs was antibiotics with 12 cases, followed by sulfonamide with 8 cases, sedativa with 2 cases and so on. Of the drugs used, chloramphenicol in 5 cases, sulfisomezole in 3 cases and carbamazepine in 2 cases were outstanding. Both in exanthematic and in papulovesicular eruptions, trunk and extremities were frequently involved but the face was seldom affected. In erythematous eruption, extremities most were frequently involved; secondarily, the face and trunk were affected. The dosage of drug, used in the provocation tests of exanthematic, papulovesicular and erythematous eruptions, was about one fifth of the normal single dose and when no reactions were observed in the following 24 hours, an additional dosage was used. If the distribution of exanthems in the provocation test was compared with that in the previous reaction, areas which were at an early stage and severely involved were unchanged. The tendency was observed that exanthems appeared earlier in the arms than legs. In 3 of 6 provocation tests, leukocytosis was observed. In other 3, leukopenia was observed. A decrease in the number of platelet was observed in both cases.