Liebman Tracey N, Tamez Rebecca, Daly Jeanine A
Ronald O. Perelman Department of Dermatology, NYU School of Medicine; New York, NY.
Department of Dermatology, Hofstra Northwell School of Medicine, Manhasset, NY.
Skinmed. 2020 Jan 1;18(1):46-49. eCollection 2020.
A 45-year-old woman with cirrhosis secondary to alcohol abuse was transferred from an outside hospital for management of a painful cutaneous eruption, progressively worsening over 2 weeks. On examination, the patient was a middle-aged white woman lying in bed in no acute distress, with jaundice and a protuberant abdomen consistent with ascites. The patient was afebrile (98.2°F), heart rate of 79 beats per minute, blood pressure of 105/61 mmHg, respiratory rate of 18 breaths per minute, and oxygen saturation of 93% on room air. She had multiple large stellate lesions of retiform purpura with central hemorrhagic necrosis on both thighs, with surrounding induration (Figures 1 and 2). These purpuric plaques and perilesional skin were exquisitely painful to palpation.
一名45岁因酒精滥用继发肝硬化的女性患者从外院转入，以处理一处疼痛性皮肤疹，该皮疹在2周内逐渐加重。体格检查时，患者为一名中年白人女性，躺在床上，无急性痛苦面容，有黄疸，腹部膨隆，符合腹水表现。患者体温正常（98.2°F），心率79次/分钟，血压105/61 mmHg，呼吸频率18次/分钟，室内空气中氧饱和度为93%。她双大腿有多处大的星状网状紫癜病变，中央有出血性坏死，周围有硬结（图1和图2）。这些紫癜斑块及病灶周围皮肤触诊时极为疼痛。
