erythema multiforme

ERYTHEMA MULTIFORME

Apoptotic keratinocytes in the epidermis adjacent to a subepidermal vesicle that contains 'gossamer threads' is characteristic of some examples of erythema multiforme. Superficial and mid dermal perivascular lymphocytic infiltrates are common. The keratinocytes are larger than normal. Liquefaction change at the dermoepidermal junction is best seen in early cases. There are other variants of erythema multiforme that are not shown here.

Apoptosis above the basal layer and keratinocyte enlargement are also seen in viral dermatitis such as herpes. It is interesting that HSV DNA has been detected by polymerase chain reaction in biopsies of HSV related erythema multiforme.

The blister is subepidermal (SUV).

High power of area in rectangle. Note the high level apoptotic keratinocytes, keratinocyte enlargement, and liquefaction change at the dermoepidermal junction.

High power of a subepidermal vesicle that contains delicate fibrillar material (so-called gossamer threads). Note apoptotic keratinocytes to the right of the vesicle.

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	The blister is subepidermal (SUV).
	High power of area in rectangle. Note the high level apoptotic keratinocytes, keratinocyte enlargement, and liquefaction change at the dermoepidermal junction.
	High power of a subepidermal vesicle that contains delicate fibrillar material (so-called gossamer threads). Note apoptotic keratinocytes to the right of the vesicle.