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男,51岁。因腹胀一月,指趾端掌跖角化增殖一年入院,开始时双侧手指肿胀、紫红色,继而指关节处皮肤局限突起成小结节变硬,双手掌、足底皮肤广泛变硬,有少量鳞屑围着,剥脱后渗血,受压、行走时疼痛。腹胀一月并日趋加重,全身乏力、消瘦。查:恶病质,皮肤、巩膜无黄染,浅表淋巴结不肿大,心肺正常,肝在右锁骨中线肋下3cm,剑下5cm,质硬,边钝,结节感,压痛。
Male, 51 years old. Due to abdominal distension in January, toe palmoplantar hyperkeratosis proliferation year hospital admission, the beginning of both fingers swollen, purple, and then refers to the junction of the skin at the junction of the prominence into a small nodules hardened, palms, plantar skin extensively hardened , A small amount of scales around, after exfoliation oozing, pressure, pain when walking. Bloating in January and increasingly heavier, malaise, weight loss. Check: cachexia, skin, sclera no yellow dye, superficial lymph nodes are not enlarged, normal heart and lung, liver in the right subclavian midline rib 3cm, sword 5cm, hard, blunt, nodular, tenderness.