1临床资料患者男,48岁。四肢皮肤红肿、破溃40d。3个月前患者自觉乏力、精神萎靡、食欲减退伴双侧足趾麻木,未予重视。40d前因收割小麦日晒后四肢暴露部位出现鲜红色水肿性红斑、水疱,伴刺痛、瘙痒,搔抓后出现溃破、渗液,当地医院应用抗生素等治疗未愈。皮损逐渐转变成棕褐色,表面粗糙、肥厚,覆以暗色的鳞屑和结痂。自发病以来患者无 1 clinical data patient male, 48 years old. Limb skin irritation, ulceration 40d. 3 months ago, patients with weakness, apathetic, loss of appetite with numbness of bilateral toes, no attention. 40d before harvesting wheat sun exposed limbs appear bright red edematous erythema, blisters, with stinging, itching, scratching after ulceration, exudate, the local hospital antibiotics and other treatment healed. Lesions gradually turn brown, rough surface, hypertrophy, covered with dark scales and scabs. No patient since onset