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Although both naevus sebaceus systematicus (naevus sebaceus of Jadassohn) and adenoma sebaceum are regarded as belonging the "organ nevi" of the same kind, the farmer is rarer than the latter. So far as the author knows, only thirteen cases of naevus sebaceus systematicus have been recorded in our country to date. It seems, therefore, desirable to put every fresh instance on record. Here will be reported three cases of this disorder which the author was fortunate enough to observe successively within a short period. Case 1: T., a girl aged 8 years, is the only child of healthy parents. First seen on March 19, 1938. There is no history of any other cases having occured in her family. Shortly after birth, a linear bald area was found on the left temporo-parietal region by the parents, which caused no subjective symptoms. The area enlarged with the enlargement of the head, and was never independent of it. General physical examination showed nothing abnormal. The Wassermann and Murata tests and the examination of urine gave negative result. The blood count normal. An examination of area showed a sharply defined, elevated, brownish-yellow, spindle shaped plaque, 15cm in length and 6cm in width. The plaque was composed of four parallel patches, 3 by 0,5cm, 2,5 by 0,5cm, 2,5 by 0,5cm and 2 by 0,5cm each divided by the furrowing. Each patch was located in the same direction of the hair whorl. There were a few atrophic hairs in each furrow. The surface of the plaque was smooth and the plaque was formed by poppyseed-sized rather firm papules. No pain was caused under pressure and there was no trace of inflammation. Histologie examination revealed that in the epidermis were widened and deep seated follicle openings filled with horn and sebum. The cutis contained numerous hyperplastic sebaceous glands. Their structure was not abnormal. The sweat glands were also a little hypertrophic and hyperplastic, and they were surrounded by very loose inflammatory infiltrate of round cells. No nevus celas were found. A diagnosis of nevus sebaceus systematicus and nevus sudoriparus was made. Case II: S., a girl aged 3 months, is the only baby of healthy parents. First seen on May 19, 1938. The baby has had an eruption on the right malar region since birth, which has remained stationary and caused no subjective symptoms. Physical examination of the heart, circulation, lungs and abdomen was entirely negative. The infant appeared to be sound and healthy. An examination of the right malar region showed circumscribed, flat, firm, yellowish plaque with smooth, furrowed surfaces, arranged partly angularly and partly linearly; it measured 3,5 by 0,3cm. The tumor was composed of small round papules ranging in size from that of a millet seed to that of a pin-head. Biopsy revealed that the epidermis was slightly akanthotic and showed dilated follicle openings filled with horn scales. The greater part of the cutis was filled with hyperplastic sebaceous glands, and the sweat glands seemed rather atrophic. The sebaceous glands showed normal structure. There was no trace of inflammation and there were allo no nevus cells in the cutis. A diagnosis of nevus sebaceus systematicus was made. Case III: O., a boy aged 18 years, is the third child of healthy parents. First seen on May 24, 1938. There are six other children, all of whom are healthy. He has had the present eruption since birth. The disorder was not familial, and there were no associated subjective symptoms. He was a healthy well developed boy and general physical examination showed negative results. At the occiput was a triangular bald area, measuring 2 by 2cm, and was sharply demarcated. The skin of the area was dusky brown and was nat uniform The superior half was papillomatous and hard, while the inferior half was smooth and furrowed. There were three paralleled longitudinal furrows across the area, each provided with a few atrophic hairs. Microscopie examination of the superior part showed a hypertrophy of the horny layer, a thikening and elongation of the interpapillary processes, and an increase of the pigment granules of basal cells, while that of the inferior part showed hyperplasia of the sebaceus glands, some of which showed an inclination of cystic degeneration. The folliele openings were widened and filled with horn and sebum. A loose inflammatory infiltrate of round cells surrounded the tumor tissue. No nevus cells were visible. As for the sweat glands there was nothing abnormal. A diagnosis of nevus sebaceus sytematicus et naevus papillomatosus was made. This case was removed by a surgical excision, while the other two cases received an application of radium and are now under way. There is no wonder that a mixed nevus should occur as stated above, as the aetiology of nevus is regarded as a circumscribed cutaneous deformity of embryonic origin. It was of interest to note that the arrangement of the eruptions agreed either with the convergent line or with the divergent line of the embryonic hair whorl in the three cases and backed Blaschko's opinion.
京都府立医科大学の論文

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