Kayoko Matsunaga

The patient was a 23-year-old female with a history of atopic dermatitis, allergic rhinitis, and allergic conjunctivitis. In her fourth year of primary school, she ate macadamia nuts and developed oral discomfort and generalized uticaria. In her second year of junior high school, she ate macadamia nuts and developed oral and pharyngeal discomfort, followed by generalized uticaria and dyspnea. At the age of 20 years, she also developed oral discomfort after eating vegetables in a Chinese dish containing macadamia nuts and visited our department for close examination. A scratch test of extract oil (concentration, as is) was positive, and a diagnosis of immediate allergy due to macadamia nuts was made. Thereafter, she avoided macadamia nuts completely and had no further recurrence. This patient developed oral allergy syndrome (OAS) after eating macadamia nuts. However, she was negative for Bet vl and Bet v2 as allergens in white birch pollinosis, in which OAS has been most frequently reported. She had Japanese cedar pollinosis, but its onset was when she was in her second year of high school. Therefore, it is unlikely that Japanese cedar pollen is a sensitization antigen for macadamia nut allergy.

1歳6ヵ月男児.生後2ヵ月ごろより,顔面〜体幹に湿疹があり,乳児期の脂漏性湿疹としてステロイドや非ステロイド外用薬などで治療していた.生後5ヵ月時になっても湿疹が持続するため血液検査を施行した.特異的IgE抗体がMast法で卵白80.8LC(class 3),ミルク5.43LC(class 1)で,鶏卵の完全除去食を指導された.生後5ヵ月ゴム風船をなめて遊んでいたところ,口周囲から顔面に蕁麻疹が広がった.生後6ヵ月時,バナナ,市販の野菜果物ジュース(リンゴ,オレンジ,レモン,ニンジン,ホウレンソウ,レタス,キャベツ,トマト,パセリ,ハチミツ)を摂取して口周囲に蕁麻疹が出現した.生後10ヵ月に,カキ(柿)を摂食している最中にアナフィラキシー様症状を起こした.乳児期発症のラテックスフルーツ症候群と診断した.バナナ果実抗原と柿果実抗原はお互いにIgE結合能を強く抑制し,ラテックス抗原でも30〜40%の抑制がかかった.よって3者間での交差抗原性の存在を認めた

28歳男.数年前から後頭部に毛包炎様の皮疹が出現し,1年前から後頸部の疼痛,腫脹,排膿があった.初診時,後頭部から項部にかけては,多数の毛包炎と圧痛を伴う板状の浸潤局面を呈し,3ヶ所の互いに交通する皮下瘻孔を形成していた.病理組織所見は毛包嚢腫様の表皮陥入・瘻孔形成,膿瘍と広範囲の線維化像であった.持続的に排膿する皮下瘻孔を形成した難治性慢性炎症病変であったため,外科的に筋膜上で広範囲に切除した.糖尿病と肥満が本症の発症要因の1つと考えられた