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1 病历摘要患者,女,20岁,已婚。因腹部、大腿内侧、肘窝、腕屈侧出现较密集的绿豆大小暗红色丘疹,微痒,诊为疥疮,给外用克罗米通软膏、疥灵霜及硫磺软膏治疗20余天无效,且皮损加重。查体;心肺脾肝(-),腹部、肘窝、腕屈侧、指间、腹股沟部均可见较密集的绿豆大小暗红色丘疹,皮损不融合,表面有少量鳞屑,部分皮损为脓疮疹,双手掌心见散在的黄豆大小紫红色丘疹,边缘可见鳞屑,全身未见隧道及抓痕。无疥疮接触史。丘疹刮片检查未发现疥螨和虫卵。PCR梅毒检测阳性。追问病史,其丈夫有嫖娼史。诊断:丘疹性梅毒疹。先后给予苄星青霉素、红霉素、四环素治疗,6周后皮损完全消失,PCR梅毒检查阴性。
1 medical record summary patient, female, 20 years old, married. Due to the abdomen, thighs, elbow fossa, wrist flexor side appear dark green mung bean size papules, micro itch, diagnosed as scabies, to topical crotamitonan ointment, cream and sulfur ointment cream treatment more than 20 days invalid, and skin Loss increased. Examination; heart lungs and spleen (-), abdomen, elbow fossa, wrist flexor side, interphalangeal, groin can be seen more dense mung bean size dark red papules, skin lesions do not fusion, the surface of a small amount of scales, some lesions pus Acne rash, palm see both scattered size of purple beans papules, the edge of visible scales, the body did not see the tunnel and scratches. No scabies exposure history. Papule scraper examination found no scabies mites and eggs. PCR syphilis test positive. Asked history, her husband has a history of prostitution. Diagnosis: papular syphilis. Has given benzathine penicillin, erythromycin, tetracycline treatment, 6 weeks after the skin lesions completely disappeared, PCR syphilis negative.