女,25岁。入院前3周手足发麻,继而不规则发热,四肢及躯干逐渐出现细小红色皮疹,咽痛,全身关节痛,活动障碍。手硬性水肿,不能屈指和握物。心悸、乏力。抗感染治疗无效。体查:体温39℃,脉搏120次,四肢及躯干皮肤有分布不均之细小红色斑疹,双手轻度非凹隐性水肿,手掌、指皮肤粗糙变硬。唇干燥潮红,杨梅舌。右颌下扪及一个 Female, 25 years old. 3 weeks before admission, numbness of hands and feet, followed by irregular fever, limbs and torso gradually appear small red rash, sore throat, joint pain, mobility disorders. Hand hard edema, can not flexor and hold things. Heart palpitations, fatigue. Anti-infective therapy is invalid. Physical examination: body temperature 39 ℃, pulse 120 times, limbs and trunk skin uneven distribution of small red rash, mild non-concave hands and hands edema, palm, refers to the skin rough and hardened. Dry lips flush, bayberry tongue. Palpable under the right one