患者女,39岁,因头面部、双手皮肤黑色斑丘疹,全身皮肤进行性色素加深半年于2003年9月22日入院。患者半年前出现头顶、双颞部阵发性胀痛,1周后头顶皮肤出现散在绿豆至豌豆大小黑色斑、丘疹,皮疹渐散布全身,同时出现全身皮肤进行性色素加深。2个月后出现双手掌、指关节持续性酸痛 Female, 39, was admitted to hospital on September 22, 2003 for six months because of head and face, black rash on both hands, progressive darkening of whole body skin. Six months before the patient had paroxysmal head and neck, temporal and paroxysmal tenderness. After 1 week, the skin of the head appeared peeled mung bean-pea-sized black spots, and the pimples and rashes gradually scattered throughout the body. At the same time, systemic pigmentation progressed. Two months later, two palms appeared, which meant that the joint sustained soreness