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病例 女性,28岁,已婚。以“咽喉部不适,声音嘶哑1周”来我院就诊。在常规咽喉部检查后,诊断为“急性咽喉炎”。在交待疾病注意事项时,发现患者右手掌部有数个红斑,红斑中央色素减退并有脱屑,立即嘱病人伸出右手和脱掉鞋袜,见掌跖部呈对称性散在分部的绿豆大小的圆形或椭圆形、棕红色、边缘鲜明、互不融合、无疼无痒的斑疹,红斑中央有鳞屑,同时发现病员下唇内侧有直径约0.4cm、稍隆起、微红、椭圆形平滑的丘疹,表面糜烂,覆以灰白色薄膜的粘膜斑。追问病史,病员半年前在广州有不洁性交史。约半月后,大阴唇处出现隆起的硬结,表面糜烂,不疼不痒,未经任何治疗自愈。2月后出现掌跖部红斑,作RPR试验阳性。诊断为二期梅毒疹。给予苄星青霉素240万单位分两侧臀部肌肉注射,每周1次,共2次。其配偶给予同样治疗。随访3个月,掌跖部红斑消失。
Case female, 28 years old, married. To “throat discomfort, hoarse voice 1 week” to our hospital. After a routine throat examination, the diagnosis was “acute sore throat.” In confessed the disease precautions, found that the right palm of the patient has several erythema, central erythema and desquamation of the central pigment, immediately instruct the patient to extend his right hand and take off the shoes and socks, see palm-plantar symmetry scatter division mung bean size Round or oval, reddish brown, sharp edges, no fusion, no pain no itch spots, erythema central scaly, and found the patient inside the lower lip with a diameter of about 0.4cm, slightly raised, reddish, oval Smooth papules, surface erosion, covered with a gray film mucosal spots. Asked history, the patient six months ago in Guangzhou have a dirty history of sexual intercourse. About half a month after the labia majora protruding bulging induration, surface erosion, pain does not itch, without any treatment self-healing. Palmoplantar erythema occurred after February, for RPR test positive. Diagnosis of secondary syphilis. Give benzathine penicillin 2.4 million units on both sides of the hip muscle injection, once a week, a total of 2 times. The spouse gives the same treatment. Follow-up 3 months, palmoplantar erythema disappeared.