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临床资料患者,女,52岁。主因四肢皮下结节反复发作4年余,于2010年4月就诊。患者4年前无明确诱因四肢出现大小不等的皮下结节,有轻微触痛,2~3个月后皮损可自行消退,不留痕迹,反复发作。否认有虫咬、外伤及异物接触史,家族中无类似疾病史。体格检查:一般情况好,全身浅表淋巴结未触及增大,各系统检查无异常。皮肤科检查:四肢散在蚕豆至鸡蛋大皮下结节,境界欠清,微隆起于皮面,表面皮肤呈正常肤色或淡紫红色(图1)、无破溃,皮温稍高,有轻度触痛。实验室及辅助检查:血、尿常规,肝、肾功能均正常,IgG 20.3 g/L(正常值6.9~16.2 g/L)。
Clinical data, female, 52 years old. Mainly due to repeated subcutaneous nodules limbs more than 4 years, in April 2010 treatment. Patient 4 years ago, there is no clear incentive to appear different sizes of subcutaneous nodules on the limbs, a slight tenderness, 2 to 3 months after the skin lesions can subside on their own, leaving no trace of recurrent. Denied the presence of insect bites, trauma and foreign body exposure history, family history of similar diseases. Physical examination: the general situation is good, systemic superficial lymph nodes did not touch increases, the system check no abnormalities. Dermatology examination: Extremities scattered in the broad bean nodules to the eggs, lack of realm, micro uplift in the skin, the skin was normal skin color or light purple (Figure 1), no ulceration, skin temperature slightly higher, mild tenderness. Laboratory and laboratory tests: blood, urine, liver, kidney function were normal, IgG 20.3 g / L (normal 6.9 ~ 16.2 g / L).