每日一题_2026.02.27

A 47-year-old woman presented to the dermatology clinic with a 1-year history of a crawling sensation on her chin that caused her to scratch the area. The right corneal reflex was decreased, and pinprick and temperature sensation around the mouth, lip, and chin on the right side was reduced. With occlusive dressings, the ulcer healed, but it later recurred after being left uncovered. What is the diagnosis?

一名47岁女性因下巴部位持续1年的爬行感前来皮肤科就诊，这种感觉促使她反复抓挠该区域。检查发现其右侧角膜反射减弱，右侧口周、唇部及下巴区域的针刺觉和温度觉减退。使用封闭敷料后溃疡愈合，但去除敷料后又复发。请问最可能的诊断是什么？

A. Cutaneous lupus erythematosus皮肤红斑狼疮

B. Cutaneous malignancy皮肤恶性肿瘤

C. Herpes simplex virus infection单纯疱疹病毒感染

D. Sarcoidosis结节病

E. Trigeminal trophic syndrome三叉神经营养综合征

答案解析：

患者接受了头部磁共振成像检查，结果显示三叉神经有一增强病灶，部分填充了梅克尔腔（Meckel’s cave）。据此诊断为三叉神经营养综合征（Trigeminal trophic syndrome）。

三叉神经营养综合征是三叉神经损伤后的罕见并发症，表现为相应三叉神经皮节区域的感觉异常（dysesthesia）及由患者自身行为引起的皮肤溃疡。随后，患者接受了脑部病变的

正确答案：E