A 60-year-old man with a 30-pack-year smoking history presented to the dermatology clinic for a 2-year history of a painful rash on his palms and soles. Previous treatment with various antibacterial agents had been ineffective. Laboratory studies revealed neutrophilic leukocytosis and an elevated C-reactive protein level. What is the diagnosis?
一名有30包年吸烟史的60岁男性因手掌和足底疼痛性皮疹持续2年来皮肤科门诊就诊。此前使用多种抗菌药物治疗无效。实验室检查显示中性粒细胞增多及C反应蛋白水平升高。诊断是什么？
A. Contact dermatitis接触性皮炎
B. Dyshidrotic eczema汗疱疹（出汗不良性湿疹）
C. Palmoplantar plaque psoriasis掌跖斑块型银屑病
D. Palmoplantar pustulosis掌跖脓疱病
E. Secondary syphilis二期梅毒
答案解析：
诊断为原发性掌跖脓疱病——这是一种以无菌性脓疱为特征的慢性炎症性皮肤病。该疾病与吸烟高度相关。开始给予外用曲安奈德和口服环孢素治疗，并建议戒烟。
正确答案：D
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