PUVA後の lentigo maligna : 乾癬治療中に lentigo maligna を含む多彩な色素斑を生じた尋常性乾癬の1例

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A 44-year-old male had been suffered from psoriasis for 12 years. He had been treated with tar and topical steroid. In addition, he received PUVA and UVB therapy for 12 years since 1979. The total irradiated amount of UVA and UVB was 831 joules/cm2 and 102 joules/cm2, respectively. He had also taken etretinate in 1984 and methotrexate in 1987. When he was admitted to our hospital for the exacerbation of psoriasis, a lot of pigmented frecles were found. Forty-eight pigmented lesions could be classified into 5 different types; type A to E. Type A is lentigo simplex which shows an increased production of melanin. Type B is a lentigo simplex with atypical melanocytic hyperplasia. Type C shows a lentigo simplex with atypical melanocytic hyperplasia and remarkable pigment blockade. Type D is a junction nevus with nests of atypical melanocytes. Type E is a lentigo maligna with the nests of atypical spindle- shaped melanocytes that extents along epidermal-dermal junction. Type E pigmented lesions are distributed in intermittently sun-exposed skin. In this case, there were 2 nevus cell nevus, 12 type A, 20 type B, 5 type C, 5 type D, and 4 type E in 48 pigmented lesions. There was no correlation between the size and the type of pigmented lesions.
日本皮膚悪性腫瘍学会の論文