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患者,男,59岁。因进行性全身皮肤变黑7个月,咳嗽、胸闷5个月入院。患者7月前发现周身皮肤发黄、转黑、瘙痒,以头面、上肢、腋下、背部、会阴为著,2月后咳嗽、胸闷、活动后气促,无咯血,伴乏力、纳差、消瘦。体查:全身皮肤色素沉着,以头面、腋、背、乳头、乳晕、阴囊、肛周及会阴部为著,散在粟米至一分硬币大小灰黑色结节状或疣状突起,背部4cm×5cm大小褐色丘疹3块,呈轻度苔藓样变,双腋下、阴囊、会阴部皮损大片融合,呈炭黑色,皮纹变深变宽,表面粗糙,呈丝绒状增生,无分泌物(封3 附图)。浅表淋巴结不大。右下肺叩诊浊音,呼吸音低,余肺呼吸音正常。无杵
Patient, male, 59 years old. Due to progressive systemic darkening of the skin 7 months, cough, chest tightness 5 months admission. Patients found that the skin around the body before July yellow, turn black, itching to the head, upper limbs, armpits, back, perineum, coughing in February, chest tightness, shortness of breath after activities, without hemoptysis, with fatigue, anorexia, thin. Physical examination: whole body skin pigmentation, to the head side, axilla, back, nipple, areola, scrotum, perianal and perineum as the scattered corn size to a coin size gray-black nodular or verrucous processes, back 4cm × 5cm Size of brown papules 3, showed mild lichenification, double armpit, scrotum, perineal lesions of the large fusion, was carbon black, dark brown skin becomes wider, rough surface, showing velvet hyperplasia, no secretions 3 photo). Superficial lymph nodes are not. Lower right lung percussion dullness, low breath sounds, lungs, normal breathing sounds. No pestle