PMC3339763_01
Ulceronecrotic lesions with hemorrhagic crusts varying from 5 to 20 mm in diameter.
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F1
Physical skin examination revealed confluent erythematous and/or purpuric macules, papules, plaques with peripheral scaling, vesicopustules, and ulceronecrotic lesions with hemorrhagic crusts (fig. 1).
Polymorphous clinical appearance of early lesions.
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F2
Lesions in different evolutionary stages varying in size from 5 to 20 mm were observed on the trunk and extremities, including palms and soles, and were particularly exuberant in the flexural, neck, and genital area (fig. 2).
Histopathology showing mild acanthosis, vacuolization of the basal layer with necrotic keratinocytes and exocytosis of red blood cells and lymphocytes. In the dermis, a lymphocytic perivascular and periadnexal inflammatory infiltrate can be observed. The infiltrating cells showed no atypia. HE, x100.
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F3
Histopathology showed mild acanthosis, vacuolization of the basal layer with necrotic keratinocytes and exocytosis of red blood cells and lymphocytes, and a dermal perivascular and periadnexal lymphocytic infiltrate with no atypia (fig. 3).