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患者,男,53岁。左足掌长黑色斑53年,溃烂半年。患者出生几天后发现左足掌有一芝麻大黑色点,此后随年龄增长渐增大,色素加深,无不适感,未予治疗。2年前皮损面迅速增大,色素加深。1年前在该皮损中央出现多个米粒大丘疹,渐增大增多呈高低不平的斑块。半年前表面破损,有渗血渗水,行走时有疼痛感。体格检查:全身系统检查无异常发现。皮肤科情况:左足掌外侧第4趾掌关节处有一直径3.5cm大黑色斑,边界清楚,中央有2×1cm深黑色的隆起性斑块,边界不规则,呈锯齿状,表面似杨梅状,中央有小溃疡及渗出。双侧腹股沟淋巴结不肿大。
Patient, male, 53 years old. Left palm long black spot 53 years, ulcerated half year. A few days after the patient was born, he found a large black spot on his left paw, which gradually increased with age, pigmentation, no discomfort, and no treatment. Two years ago, the skin lesion surface rapidly increased and the pigment deepened. A large number of large rice papules appeared in the center of the lesion a year ago, and gradually increased in size. Six months ago, the surface was damaged, bleeding, and pain when walking. Physical examination: no abnormal systemic system findings. Department of Dermatology: There is a large dark spot with a diameter of 3.5cm at the 4th metatarsophalangeal joint of the left paw of the left palm. The boundary is clear. There is a 2×1cm deep black uplift plaque in the center. The boundary is irregular, jagged, and the surface resembles a myrica. There is a small ulcer and exudation in the center. Bilateral groin lymph nodes are not swollen.