Polycythemia Vera with Painful Erythema on the Palm as the First Symptom:A Case Report
A 66-year-old male presented with painful erythematous edema in the right palm for 1 month.Dermatological manifestation:diffuse flushing in the right palm,dark purplish-red edematous plaques were seen in the large and small fissures,skin temperature was slightly high,and tenderness was obvious.Histopathology of the lesions showed hyperkeratosis,epidermal hyperplasia,capillary hyperplasia and dilatation in the superficial dermis,and a small number of lymphocytes and scattered neutrophil infiltration around the blood vessels.Laboratory tests:white blood cell count 19.82 x 109/L,hemoglobin 196 g/L,platelet count 494 × 109/L;Bone marrow biopsy considered myeloprolitera-tive neoplasms(MPN),high possibility of polycythemia vera(PV);Genetic testing suggested that missense mutations were detected in the JAK2 gene.Diagnosis:polycythemia vera.The patient was given traditional Chinese medicine orally 2 times/d,and topical 0.05％Halometasone cream 1g,1 time/d.The lesions gradually subsided after 3 weeks.
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