论文部分内容阅读
临床资料患者,男,66岁。主因双耳郭、手背及足跟部紫红色斑片、反复破溃伴疼痛10年余,于2012年1月13日就诊。患者10年前无明显诱因双耳郭、双手背及足底出现多个紫红色皮损,每于冬季发生破溃,伴明显疼痛,夏季症状可缓解。曾多次在当地医院治疗,注射抗生素等药物,病情时好时坏。近2年来患者皮损增多、发作频繁。患者既往体健,否认有食物、药物过敏史及光敏史。皮肤科检查:双耳郭、双手指背均可见散在紫红色斑片,皮损中央萎缩,可见浅表溃疡、色素减退及脱失;多个指、趾甲甲板变薄、萎缩、脱落;双手指关节僵直,活动受限。双足跟及足跖外侧缘皮损角化增生明显,足跟处可见浅溃疡(图1a-1c);双唇可见紫红色斑片,上附粘着性鳞屑,口腔黏膜正常。实验室及辅助
Patients with clinical data, male, 66 years old. Mainly due to the double ear Guo, hand back and heel purple patches, repeatedly ruptured with pain more than 10 years, on January 13, 2012 treatment. 10 years ago, there was no obvious incentive for patients with both ears Guo, both hands and feet appear multiple purple skin lesions, ulceration occurs in winter, with significant pain, summer symptoms can be alleviated. Has repeatedly in the local hospital for treatment, injection of antibiotics and other drugs, the condition of good times and bad. In recent 2 years, patients with increased skin lesions, seizures frequent. Past patient health, denied food, drug allergy history and photosensitive history. Dermatology examination: both ears Guo, both fingers back are scattered purple patches, the central lesion atrophy, visible superficial ulcers, hypopigmentation and loss; multiple fingers, toenail deck thinning, atrophy, loss; two fingers Joint stiffness, limited activity. Paw pedicled and lateral plantar skin lesions were hyperkeratotic lesions were visible at the heel at shallow ulcers (Figure 1a-1c); lips visible purple patches, attached to the adhesive scales, normal oral mucosa. Laboratory and support