Sean Klepper M.D.
Stephen Lyle, M.D., ...
- Generalized eruption of lesions of varying ages which progress as follows: papule, central vesiculation, pustulation, erotion with ulceration, crusting and eventual healing with scar formation
- Predilection for flexural surfaces
- Systemic symptoms may occur.
- More common in children and young adults
- Parakeratotic scale, often containing neutrophils
- Interface change with necrosis of basal keratinocytes
- Marked upper and deep dermal perivascular lyphocytic inflammation (predominantly CD4+ T-cells)
- Frequently marked exocytosis of lymphocytes into the epidermis
- Fully developed lesions may show dermal and epidermal hemorrhage along with endothelial cell swelling and rarely vasculitis.
- Older lesions show confuent necrosis of keratinocytes and eventual vesicle formation, ulceration and granulation tissue, terminating with dermal scar formation.