每日一题_2024.11.23

A 40-year-old man presented with a 2-day history of a burning rash on both hands. Physical examination was notable for a confluent region of erythema extending from the dorsal aspect of the thumbs to the medial aspect of the second finger. Scattered patches of erythema were observed on the knuckles and other fingers, and a small blister was noted on the base of the left thumb. What is the most likely diagnosis?一名40岁男性患者出现双手烧灼感皮疹已有2天。体格检查发现，从拇指背侧到第二指内侧的区域有融合性红斑。在指关节和其他手指上观察到散在的红斑，左拇指基部有一个小水疱。最可能的诊断是什么？

A. Atopic dermatitis异位性皮炎

B. Hand, foot, and mouth disease手足口病

C. Irritant contact dermatitis刺激性接触性皮炎

D. Phytophotodermatitis植物光敏性皮炎

E. Porphyria cutanea tarda迟发性皮肤卟啉病

答案解析:

在进一步的病史询问中，患者报告说在皮疹出现前一天，他手动榨了12个青柠汁，然后参加了户外足球比赛，没有在手上涂抹防晒霜。根据这一报告和他的临床表现，诊断为植物光敏性皮炎。植物光敏性皮炎是一种光毒性的非免疫性皮肤反应，由暴露于呋喃香豆素——一种在青柠、柠檬、芹菜和欧芹中发现的植物物质——和紫外线引起。处方了三氟氯氟龙软膏和润肤剂进行治疗。

正确答案：D