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<div class="Section1">
<p class="MsoNormal"><span style=
"font-size: 10pt; font-family: &quot;ＭＳ ゴシック&quot;;">網状皮斑</span>
<span style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;"><b style=
""><span lang="EN-US">livedo (reticularis)</span></b><span lang=
"EN-US">:</span></span> <span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">大きな網目状の紅色調の皮斑</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">真皮下血管層</span>
<span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">真皮と皮下脂肪組織の境界部</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">)</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">において</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">静脈網の緊張低下と動脈網の緊張亢進状態が生じることで網目状の皮斑を形成する</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">大理石様皮膚</span></b>
<b style=""><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(cutis
marmorata)</span></b> <span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">は圧迫によって消退し</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">色素沈着を残さない</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">寒冷によって生じる皮斑で</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">小児や若い女性では生理的にみられることがある</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">外気温の上昇により消失することが多い</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">網状皮斑</span></b>
<b style=""><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(livedo
reticularis)</span></b> <span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">は主として若い女性の膝に</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">淡紅色</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">網目状の持続性紅斑としてみられる</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">分枝状皮斑</span></b>
<b style=""><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(livedo
racemosa)</span></b> <span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">は四肢に樹枝状で</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">環の閉じていない紫紅色持続性紅斑として出現する</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">いずれも血管炎など全身性の器質的変化に伴って生じやすい</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span></p>
<p align="right" style="text-align: right;" class="MsoNormal"><span lang=
"EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">[</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">清水</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">:</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">あたらしい皮膚科学</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">中山書店</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">]</span></p>
<p class="MsoNormal"></p>
<p class="MsoNormal"><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">
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"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">大理石様皮膚</span>
<span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">細</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">)</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">網状皮膚</span></p>
<p class="MsoNormal"></p>
<p class="MsoNormal"><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">
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alt=""><!--[endif]--> </span><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">分枝状皮斑</span></p>
<p align="right" style="text-align: right;" class="MsoNormal"><span lang=
"EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">[</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">上野</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">:</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">皮膚科学</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">金芳堂</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">]</span></p>
<p class="MsoNormal"></p>
<p class="MsoNormal"><span style=
"font-size: 10pt; font-family: &quot;ＭＳ ゴシック&quot;;">神経炎</span><b style=""><span lang="FR"
style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">neuritis</span></b><span lang="FR"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">:</span>
<b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">ニューロパシー</span></b><b style=""><span lang="EN-US"
style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">neuropathy</span></b><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">ともいう</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">脊髄神経および脳神経の末梢神経における炎症で</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">感染</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">代謝異常</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">中毒</span>
<span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">中毒性神経炎</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">toxic
neuropathy),</span> <span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">外傷</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">膠原病など種々の原因に由来する神経病変をいう</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">神経炎は</span><span lang="EN-US"
style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">運動神経</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">知覚神経いずれでも起こり</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">単発性または多発性に起こる</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">病変が進行すると</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">罹患神経支配部に知覚障害</span>
<span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">痛み</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">鈍麻</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">消失</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">),</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">運動麻痺がみられ</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">深部反射は消失する</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span></p>
<p style="margin-left: 21pt; text-indent: -10.5pt;" class="MsoNormal">
<!--[if !supportLists]--><b style=""><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;"><span style="">1.
</span></span></b><!--[endif]--><b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">単神経炎</span></b><b style=""><span lang="EN-US"
style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">mononeuritis:</span></b>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">単一の末梢神経の障害により</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">その神経支配領域に限局性の運動麻痺と知覚障害を起こすもので</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">主なものとして顔面神経麻痺</span>
<span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(Bell</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">麻痺</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">),</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">橈骨神経麻痺</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">正中神経麻痺</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">尺骨神経麻痺</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">腓骨神経麻痺などがある</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span></p>
<p style="margin-left: 21pt; text-indent: -10.5pt;" class="MsoNormal">
<!--[if !supportLists]--><b style=""><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;"><span style="">2.
</span></span></b><!--[endif]--><b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">多発単神経炎</span></b><b style=""><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">mononeuritis
multiplex:</span></b> <span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">2</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">本以上の単神経が不規則におかされる場合で</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">結節性動脈周囲炎などの膠原病</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">糖尿病</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">マクログロブリン血症などがある</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span></p>
<p style="margin-left: 21pt; text-indent: -10.5pt;" class="MsoNormal">
<!--[if !supportLists]--><b style=""><span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;"><span style="">3.
</span></span></b><!--[endif]--><b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">多発神経炎</span></b>
<b style=""><span style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;"><span lang=
"EN-US">polyneuritis:</span></span></b> <span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">運動障害と知覚障害</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">ときには自律神経障害が</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">左右対称性に四肢末梢に強く起こり</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">四肢近位部に向かって軽くなる分布を示す病像を示すもので</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">多発ニューロパシー</span><span lang="EN-US"
style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">polyneuropathy</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">とも呼んでいる</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">病像の内容には</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">運動障害優位型</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">知覚障害優位型</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">運動失調型</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">多発脳神経炎型などの特徴を示す場合もあるが</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">一般には運動障害と知覚障害の両者を有する混合型が多く</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">四肢末端優位障害の分布を示す</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">.</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">多発神経炎の原因には各種のものがあり</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">大部分は原因不明であるが</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">なかには原因の明らかなものもある</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">; <b style=
"">1)</b></span> <b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">遺伝性</span></b><b style=""><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span></b>
<b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">家族性</span></b><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">のもの</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">; <b style=
"">2)</b></span> <b style=""><span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">非遺伝性</span></b><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">には</span><span lang="EN-US"
style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">,</span>
<span style=
"font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">急性特発性</span>
<span lang="EN-US" style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">(</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">ギラン・バレー症候群</span><span lang="EN-US"
style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">Guillain</span><span style="font-size: 10pt; font-family: &quot;ＭＳ 明朝&quot;;">‐</span><span lang="EN-US"
style=
"font-size: 10pt; font-family: &quot;Times New Roman&quot;;">Barr</span><span style="font-size: 10pt; font-family: &quot;Times New Roman&quot;;">