A 33-year-old man with systemic lupus erythematosus presented with a 1-week history of pruritic, burning plaques. Examination showed pink, edematous plaques on the hands, elbows, knees, and feet. Laboratory testing showed elevated antinuclear and anti–double-stranded DNA antibody levels and low complement levels. Skin biopsy showed leukocytoclastic vasculitis. Treatment with oral and topical glucocorticoids was started. One week later, the lesions evolved into fixed, urticarial, annular, and targetoid plaques with rims of purpura on the thighs, chest, abdomen, and back. Which of the following is the most likely diagnosis?
一名33岁男性系统性红斑狼疮患者，因瘙痒、烧灼感的斑块就诊，病程1周。查体可见手部、肘部、膝部和足部出现粉红色水肿性斑块。实验室检查显示抗核抗体和抗双链DNA抗体水平升高，补体水平降低。皮肤活检显示为白细胞碎裂性血管炎。开始口服和局部糖皮质激素治疗。一周后，皮损演变为固定性、荨麻疹样、环状及靶形斑块，伴有紫癜边缘，分布于大腿、胸部、腹部和背部。以下哪项是最可能的诊断？
A. Chronic spontaneous urticaria慢性自发性荨麻疹
B. Erythema multiforme多形红斑
C. Secondary syphilis二期梅毒
D. Subacute cutaneous lupus erythematosus亚急性皮肤型红斑狼疮
E. Urticarial vasculitis荨麻疹性血管炎
答案解析：
荨麻疹性血管炎的特征是荨麻疹样皮损持续超过24小时，且组织病理学证实为白细胞碎裂性血管炎。皮损可能伴有烧灼感、紫癜及炎症后色素沉着。荨麻疹性血管炎可与系统性红斑狼疮（SLE）并发，尤其在血清补体水平降低时。
正确答案：E
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