论文部分内容阅读
男,58岁。无明显诱因于左足内侧出现数块指头大小紫红色斑及黄豆大小结节,质硬有压痛。2月后波及右足并伴双足肿胀。4个月后皮疹发至双手背,手足皮疹渐增多对称.在当地医院经用“低右”、丹参注射液、口服强的松及中药治疗后,紫红斑及结节颜色减退,压痛减轻,双足水肿消退。因未坚持治疗,入院前半月皮损加剧,双足水肿、疼痛以致不能下床、遂至我院就诊。门诊疑“结节性血管炎”“结节性红斑”收入院。起病以来无任何不适,既往体健。否认同性恋史及冶游性病史。体查:系统检查无异常.双手背及尺侧、双足内外缘及足底、趾背可见10多个大小不等紫红色斑及结节,部份结节融合成斑块,有的呈环状。质硬有压痛.双足背凹陷性肿胀(见图片)。胸透主动脉舒展,双肺纹理增多。肝
Male, 58 years old. There is no obvious incentive to appear inside the left foot a few pieces of finger size purple spots and soybean size nodules, hard and tender. After February spread to the right foot and feet with swelling. 4 months after the rash was sent to both hands, hand-foot rash increased symmetry in the local hospital by the use of “low right”, Salvia injection, oral prednisone and Chinese medicine treatment, purple stains and nodules decreased color, tenderness, Edema of both feet subsided. Because they did not adhere to treatment, exacerbations of the first half of hospitalized lesions, bipedal edema, pain and can not get out of bed, then to our hospital. Outpatient suspected “nodular vasculitis” “nodular erythema” income hospital. Since the onset of any discomfort, previous physical health. Denied the history of homosexuality and the history of sexually transmitted diseases. Physical examination: No abnormalities were found in the system, with more than 10 fuchsia spots and nodules on the dorsal and ulnar edges, both inside and outside edges, and on the back of the toes, some of the nodules were fused into plaques and some were ring. Hard and tender tenderness. Bipedal pitting swelling (see picture). Thoracic aorta stretch, double lungs increased. liver