하지에 발생한 결절 홍반양 병변의 임상 및 병리조직학적 특징 = Clinical and Histopathologic Caracteristics of the Erythema Nodosum-like Lesions on the Legs

국문 초록 (Abstract)

저자들은 임상적으로 하지에 뚜렷한 결절 홍반양 병변을 보인 66례(남자 13례, 여자 53례)를 대상으로 임상 및 병리조직학적 소견을 비교 관찰하였으며 최종 진단은 결절 홍반 30례(45.5%), 베체트 증후군 14례(21.2% ; 불완전형 12례, 추정형 2례), 경결 홍반 11례(16.7%), 결절성 혈관염 7례(10.6%), 결절성 다발 동맥염 1례(1.5%), 표재성 이행성 혈전 정맥염 1례(1.5%), 비특이성 지방층염 2례(3.0%)였다. 하지에 발생한 결절 홍반양 병변들은 임상 증상이 서로 유사하기 때문에 서로의 감별 진단에 있어서 임상적인 특징 이외에 검사실 소견 및 병리조직학적인 소견을 분석, 검토함이 보다 정확한 진단을 도출하는 길이라 하겠다.

다국어 초록 (Multilingual Abstract)

There is a group of diseases manifesting themselves as erythema nodosum-like lesions primarily on the lege. These diseases have been classified such several distinctive disease entities as erythema nodosum(EN), erythema induratum(EI), nodular vasculitis(NV), Weber-Christian disease and Behcet's syndrome(BS), etc, on the ground of minor clinical & histopathological variations. However, they have many common clinical features which often make the differential diagnosis from one another very difficult or sometimes impossible even by histopathological studies. This study was performed to evaluate the correlation between clinical and histopathological findings in 66 patients with erythema nodosum-like lesions on the legs. The results obtained were as follows ;
1.Among the 66 patients were 30 cases of EN(45.5%), 14 cases of BS(21.2%) comprising 12 incomplete types & 2 suspected types, 11 cases of EI(16.7%), 7 cases of NV(10.6%), each one case of polyarteritis nodosa(1.5%) & superficial migratory thrombophlebitis(1.5%), and 2 cases of non-specific panniculitis(3%).
2.There were 13 males(19.7%) & 53 females(80.3%) in this series with four times more common in female than in male.
3.The peak incidence of age at onset were between twenties & thirties of age in the female group and the peak of seasonal distribution were during spring and summer.
4.Coexistant rate with tuberculosis in EI(27.3%) was rather than higher.
5.Significant pathologic foci were mainly in subcutis and major type of panniculitis observed were ; 23 cases of septal type(76.7%) in EN, 8 cases of lobular tripe(72.7%) in EI, each 3 cases of lobulr & mixed type(42.9%) and each 6 cases of septal & mixed type(42.9%) in NV and BS, respectively.
6.Fat necrosis were observed In 8 cases of EI(72.7%) & 4 cases of BS(28.6%) and caseation necrosis were in 6 cases of EI & one case of BS while no necrosis were found In both EN & NV.
7.Epithelioid granuloma & histiocytic granuloma were most prominent features in EN, EI, BS & NV and lipophagic granuloma were coexistent in 2 cases of EI. Touton grant cell was seen in one case of EN.
8.Necrotizing vasculitis was not shown in EN while small & large vessels were involved both in EI & NV. In BS, smll vessels were involved in 4 cases(28.6%), which were localized in only severely inflamed areas, and necrosis & granuloma were observed in areas of severe vasculitis.

목차 (Table of Contents)

• Ⅰ.서론
• Ⅱ.연구대상 및 방법
• Ⅲ.결과
• A.임상적 소견
• B.병리조직학적 소견
• Ⅳ.고찰
• Ⅴ.결론