每日一题_2026.03.12

A 33-year-old pregnant woman with previously well-controlled atopic dermatitis presented to the emergency department at 34 weeks’ gestation with a 3-day history of fever and an itchy, painful rash. A lesion had first developed on her lip, after which skin lesions had appeared across her face and body, sparing the ocular, oral, and genital mucosa. Similar lesions were scattered across the chest, arms, and palms. Which of the following is the most likely diagnosis?一位33岁孕妇，既往特应性皮炎控制良好，于妊娠34周时因发热3天伴瘙痒性疼痛性皮疹就诊急诊科。最初皮损出现在其唇部，随后面部及全身出现皮肤损害，但眼、口腔及生殖器黏膜未受累。胸部、手臂及手掌可见散在类似皮损。以下哪项是最可能的诊断？

A. Atopic dermatitis flare特应性皮炎加重

B. Atopic eruption of pregnancy妊娠期特应性皮疹

C. Eczema herpeticum疱疹性湿疹

D. Impetiginized atopic dermatitis继发感染的特应性皮炎

E. Primary varicella (chickenpox)原发性水痘（水痘）

答案解析：

疱疹性湿疹是由单纯疱疹病毒1型（HSV‑1）引起的湿疹样皮肤继发性感染，最常见于特应性皮炎患者。

对颈部水疱内液体的聚合酶链反应（PCR）检测显示单纯疱疹病毒1型（HSV‑1）阳性，血清样本也检出HSV‑1 IgG抗体。治疗需采用系统性抗病毒药物。

该病通常发生于原有皮肤病（如特应性皮炎）累及的皮肤区域，而播散性单纯疱疹则常表现为皮肤受累轻微，且病变不局限于湿疹样区域。

正确答案：C