S7C14P11-1: This rather remarkable example of “staphylococcal scalded skin syndrome” shows hyperplasia of the basal unit in psoriasiform patterns. A cleft has formed between the granular layer and the keratin layer. The superficial unit of the epidermis consists mostly of a granular layer (hypergranulosis). Granular cells along the floor of the defect show acantholysis in patterns reminiscent of those seen in lesions of pemphigus foliaceus . The dermis is relatively free of inflammation. The acantholytic process involves the epithelium of the follicular infundibulum. To the right, necrotic, acantholytic cells are free in the defect.

S7C14P11-3: The acantholysis affects an acrosyringium. Acantholytic granular cells merge with collections of necrotic keratinocytes. Spaces among the dying granular cells are irregular. The pattern in this area has a reticulated quality (thin strands of necrotic epithelium outline the spaces).

S7C14P11-4: The zone of keratinization is abnormal. Some of the dead cells in the abnormal zone have pyknotic nuclei; the nucleated, dying cells are “parakeratotic.”