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		<h1 class="catchCopy">全ての皮膚科医必携！皮膚病理の基本とパターン分類から診断に迫る理論を解説！</h1>
		

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					編集：真鍋俊明（京都大学名誉教授）
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">皮膚の病理組織像をみるための基本的な知識から，パターン分類から診断に迫る理論を具体的かつ明確に解説した1冊．病理組織変化と臨床所見，ダーモスコピー像と病理組織像，生検の仕方と生検材料の扱い方，特殊染色と免疫染色，顕微鏡の取り扱い方など病理組織診断に必要な基本的な知識を余すことなく解説．従来の皮膚病理教科書の絵合わせ診断ではなく，診断に到達するためのパターン認識の考え方が基本から学べる．他の追随を許さない本格的な皮膚病理学教科書．</section><section class="preface">序　文<br><br>　京都大学皮膚科退任後奉職した滋賀県立総合病院院長時代，何よりの愉しみは，週一回の皮膚病理カンファレンスであった．病院経営や人事などに忙殺される日々の日常のなかで，大好きな皮膚科臨床に接することができるささやかな至福のひとときであった．そのカンファレンスには皮膚科医と病理医，形成外科医が数名ずつ参加し，症例提示に続いて，皮膚病理標本をともに鏡検し，診断に至るというものであったが，多くの場合，臨床所見から私が臨床診断を提示し，京都大学病理部名誉教授で当時病院の研究所長だった真鍋俊明先生が最終病理診断を下すというスキームであった．<br>　このカンファレンスで従来と最も異なっていたのは，まず担当病理医が粛々と病理所見を述べ，炎症にせよ腫瘍にせよ，どのパターンになるかを検討し，臨床情報を加味して「組織パターンから読み解く」という手法が一貫してとられていた点である．従来，ともすると皮膚科医はどうしても「絵合わせ」的に病理診断をしてきたが，それとは全く異なる斬新な経験であった．私が滔々と臨床診断を述べた直後に，真鍋先生が顕微鏡をみながら「違いますね」と一刀両断に斬られるのは，悔しくもあったが自虐的な悦びの瞬間でもあった．理詰めのパターン分類読み解き方式で導かれた結論には抵抗の術がなかったからである．<br>　私もこれまで臨床皮膚科医として皮膚病理の重要性を痛感し，自分の専門ではなかったが文光堂も含めていくつかの皮膚病理教本を編纂してきた．しかし，これまでの「絵合わせ方式」ではなかなか自分の皮膚病理診断力が向上しないもどかしさも実感していた．真鍋先生に学ぶなかで，いままで皮膚科医に欠けていたのはこの「組織パターンから読み解く」技法であったことを直感的に合点した．<br>　ちょうどその頃， 文光堂社長で皮膚科医でもある浅井麻紀氏が病院を訪ねてこられ，「自分も皮膚病理が苦手だったので，是非究極の皮膚病理書がほしい」といわれたことから，その場で刊行が即決されたのが本書「皮膚病理のすべて」である．三部作という大著になり，しかもその第一巻の「皮膚病理のすべて Ⅰ　基礎知識とパターン分類」はほぼ全編を真鍋先生が単独執筆されるという大胆な企画となった．続刊される炎症編，腫瘍編は，第一巻の刊行後，各執筆者に本書を熟読いただき，その趣旨を十分理解していただいてから執筆をお願いするという念の入れようである．私は皮膚科医としての希望をひたすら企画に反映させるためのファシリテーターとして編集に参加したが，皮膚病理を極めたいという皮膚科医や病理医の意図を十分に斟酌することができたと自負している．<br>　本書が，わが国における皮膚病理診断の新たなパラダイムシフトを誘起し，多くの皮膚病理に興味を持つ皮膚科医や病理医に「目からウロコ」の教書になることができれば編者としてこれに勝る喜びはない．<br><br>2019年5月<br>編者を代表して<br>宮地 良樹<br>京都大学名誉教授</section><section class="indexes">第I章　皮膚の構造と機能<br>　1　皮膚の発生<br>　2　皮膚の正常構造<br>第II章　皮膚組織の変化とその用語<br>　1　皮膚臨床所見を表現する用語<br>　2　皮膚病理組織変化を表現する用語<br>　付録①　代表的皮膚病変の臨床像<br>　付録②　間質細胞で特有の名称で呼ばれる細胞<br>第III章　皮膚臨床所見を説明する病理組織変化<br>　1　臨床所見が病理所見とどのように符合するのか<br>第IV章　ダーモスコピー像の病理学的説明<br>第V章　生検の仕方<br>　1　生検の目的と基本的な考え方<br>　2　炎症性疾患の生検時の注意点<br>　3　腫瘍性疾患の生検時の注意点<br>　4　生検時のその他の特殊な注意点<br>　5　生検前の準備〜写真撮影・消毒・局所麻酔〜<br>　6　皮膚生検の方法・種類<br>　7　病理検査依頼書の記載事項<br>第VI章　皮膚生検・摘出材料の取り扱い方，切り出し方法<br>　1　皮膚摘出材料の固定<br>　2　検体の切り出し<br>　3　標本作製上のコツなど<br>第VII章　組織切片の作製法，一般的組織染色法と免疫組織化学および蛍光抗体法<br>　1　組織切片の作製法<br>　2　一般的な組織染色法と特殊染色<br>　3　免疫組織化学染色<br>　4　蛍光抗体法<br>第VIII章　顕微鏡の取り扱い方<br>　1　顕微鏡の原理<br>　2　顕微鏡を上手に使う8つのポイント<br>　3　標本観察時の注意点<br>　4　組織写真の撮影法<br>　COLUMN　分解能の概念<br>第IX章　顕微鏡標本をみる前に知っておくべき基本<br>　1　顕微鏡を使う前に必ず確認すべきこと：患者の確認<br>　2　顕微鏡を使っての検索法<br>　3　疾患の定義や概念の把握と病理組織診断<br>　4　診断基準の把握<br>　5　病変の多彩性とその取り扱い方<br>　6　病理所見の目的別分類と診断者のとるべき態度<br>　7　診断困難な場合の対応<br>　8　技術の限界と能力の限界<br>　9　病理診断を行う者がとるべき態度<br>　10　臨床病理相関の重要性と臨床医とのキャッチボール<br>　11　病理診断の精度管理<br>第X章　顕微鏡による皮膚病理組織の診断<br>　1　皮膚病理組織診断への迫り方：総論<br>　2　炎症性皮膚疾患のパターン分類の構成<br>　3　炎症性皮膚疾患におけるパターン分類による診断へのアプローチ<br>　4　炎症性皮膚疾患におけるパターン分類表<br>　5　腫瘍性皮膚疾患のパターン分類の構成<br>　6　腫瘍性皮膚疾患におけるパターン分類による診断へのアプローチ<br>　7　腫瘍性皮膚疾患におけるパターン分類表<br>　8　組織診断の手順<br>　付録①　組織標本でみてわかる感染性病原微生物とみえない場合に感染症を推測させる所見<br>　付録②　組織標本でみえる外因性および内因性異物<br>　付録③　組織標本に現れるアーチファクトのいろいろ<br>索引</section></article>
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