1临床资料患者女,56岁。右上肢及背部皮肤出现丘疹和结节20年。20年前,患者无明显诱因右上肢出现米粒大结节,无明显自觉症状,遇冷后有轻微疼痛,曾手术切除背部一较大皮损,当时未送病理检查。近年来,皮损逐渐增多,渐累及背部,近日来皮损发展较快。患高血压和糖尿病十年,无午后低热等,否认外伤、手术及药物过敏史,无结核病史及接触史,家族中无类似疾 1 Clinical data Female patient, 56 years old. Right upper extremity and back skin pimples and nodules appear 20 years. Twenty years ago, there was no apparent inducement in patients with large nodules of the right upper limb. There was no obvious symptoms. After the cold, there was a slight pain. A large skin lesion had been surgically removed and no pathological examination was performed at that time. In recent years, skin lesions gradually increased, gradually and the back, the rapid development of skin lesions in recent days. Suffering from hypertension and diabetes ten years, no afternoon fever, etc., denied trauma, history of surgery and drug allergy, no history of tuberculosis and exposure history, no similar family disease