每日一题_2022.12.17

A 58-year-old woman with a history of metastatic uterine leiomyosarcoma presented with a 1-month history of a nonpruritic rash on her arms. On examination, hyperpigmented plaques were observed on the dorsa of both hands at the sites of previous intravenous access. The darkened skin extended up the arms in a linear pattern along the network of superficial veins; the lesions were palpable but non-tender. What is the most likely diagnosis?

1例58岁女性患者，有转移性子宫平滑肌肉瘤病史，因手臂非瘙痒性皮疹1个月就诊。查体：既往静脉通路部位双手背可见色素沉着斑块。变暗的皮肤沿浅静脉网呈线状向上延伸手臂；皮损可触及但无压痛。最可能的诊断是什么？

A. Bleomycin-induced flagellate erythema博来霉素诱导的鞭毛状红斑

B. Erythema ab igne轻微红斑

C. Phlegmasia cerulea dolens深蓝芽生菌

D. Serpentine supravenous hyperpigmentation蛇形静脉上色素沉着

E. Superficial thrombophlebitis浅表性血栓性静脉炎

答案解析：

诊断为多西他赛相关蛇形静脉上色素沉着。皮肤色素沉着的机制仍不清楚，但反应是良性的；下面的静脉保持通畅。放置中心静脉导管用于随后的化疗给药。2个月后随访时，皮疹减轻。

正确答案：D