Vesiculobullous and desquamating skin disorders Quiz: Ace Your Exams

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A 70-year-old man comes to the office because of severe generalized pruritus and blisters. The pruritus began a month ago, followed by multiple tense blisters over his body two weeks later. Some of the blisters ruptured, causing moist erosions. Past medical history is significant for Parkinson disease and hypertension. Current medications include levodopa/carbidopa and lisinopril. Vitals are within normal limits. Physical examination shows multiple 1 to 3 cm tense bullae as shown:

A close-up view of skin with multiple clear, fluid-filled blisters and red, inflamed areas, indicating a skin condition.

A close-up view of skin with multiple clear, fluid-filled blisters and red, inflamed areas, indicating a skin condition.

^{Reproduced from Flickr}Which of the following histological findings will be seen in this patient?

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A high-magnification histopathology slide shows numerous pink, concentric keratin pearls against a background of densely packed, dark pink tumor cells and inflammatory infiltrate. ^{Reproduced from ">Wikimedia Commons}

A microscopic image shows skin tissue with a clear epidermis and dermis. Within the dermis, there is an inflammatory infiltrate, appearing as a cluster of dark purple cells. ^{Reproduced from ">Wikimedia Commons}

A microscopy view shows pink-stained skin tissue. The epidermis is at the top with distinct layers. Below is the dermis with scattered cells and blood vessels. ^{Reproduced from} ^">Wikimedia ^Commons

A high magnification view of skin tissue shows an inflamed epidermis and dermis. Many small purple cells are visible in the top layers. ^{Reproduced from} ^{">Wikimedia Commons}

A high magnification microscopic image shows tissue with layered cells, irregular projections, and invaginations. Cells have large nuclei and varied shapes, with some areas densely packed. ^{Reproduced from:} ^{">Wikimedia Commons}