每日一题_2024.01.05

A 26-year-old man presented to the dermatology clinic with a 1-week history of an asymptomatic rash on his hands and feet. He also reported having had a fever — which had resolved 6 days before presentation — but no joint pains or oral lesions. Physical examination was notable for scattered, partially blanchable macules around the wrists and ankles that merged into erythematous patches on both the ventral (left) and dorsal (right) surfaces of the hands and feet. Serum B19 IgM antibody test and polymerase-chain-reaction assay were positive for parvovirus, and a diagnosis of papular-purpuric “gloves and socks” syndrome in the context of parvovirus B19 infection was made. What is the more classic appearance and distribution of the rash associated with this virus?

一名26岁男性因手脚出现无症状皮疹1周到皮肤科门诊就诊。患者还自诉有发热(在就诊前6日消退)，但无关节痛或口腔病变。体格检查中值得注意的是手腕和脚踝周围散在的、部分可漂白的斑疹，并在手脚腹侧(左)和背侧(右)表面融合成红斑。血清B19 IgM抗体检测和聚合酶链反应检测微小病毒阳性，诊断为微小病毒B19感染背景下的丘疹性紫癜“手套和袜子”综合征。与这种病毒相关的皮疹的更典型的外观和分布是什么?

A. Purpura on the buttocks and lower extremities 臀部和下肢紫癜

B. “Sandpaper” rash that is accentuated in flexor creases 屈肌皱褶处突出的“砂纸状”皮疹

C. “Slapped cheek” pattern on the face 脸上有“扇耳光”的图案

D. Transient salmon-pink maculopapular rash on the trunk 躯干一过性橙红色斑丘疹

E. Vesicles on an erythematous base in a dermatomal distribution 皮区分布的红斑基础上的水疱

答案解析：

正确答案是“打脸”模式。丘疹-紫癜性“手套和袜子”综合征中出现的肢端皮疹最常见于青少年和成人。尽管称为综合征，皮肤损害可能是点状或黄斑。该病毒具有自限性，1周后，患者的皮疹消退。

正确答案：C