Lesions begin symmetrically on face and upper torso, and then extend rapidly. Maximal extension occurs in
2–3 days, but occasionally takes only a few hours. Individual macules are usually present around large
areas of confluence. Lesions may predominate in sunexposed areas, but may also affect the entire epidermis, including nail beds. The hairy scalp, however, usually remains intact. Palms and soles develop a painful edematous erythema. Flaccid blisters are typically present, together with full-thickness epidermal
necrosis. Nondenuded areas have a wrinkled paper appearance. A Nikolsky sign is easily demonstrated by
applying lateral pressure to the bullae. Full skin detachment usually occurs in areas subjected to
pressure, such as shoulders, sacrum, or buttocks. Areas of denuded epidermis are dark red with oozing
surfaces.
2–3 days, but occasionally takes only a few hours. Individual macules are usually present around large
areas of confluence. Lesions may predominate in sunexposed areas, but may also affect the entire epidermis, including nail beds. The hairy scalp, however, usually remains intact. Palms and soles develop a painful edematous erythema. Flaccid blisters are typically present, together with full-thickness epidermal
necrosis. Nondenuded areas have a wrinkled paper appearance. A Nikolsky sign is easily demonstrated by
applying lateral pressure to the bullae. Full skin detachment usually occurs in areas subjected to
pressure, such as shoulders, sacrum, or buttocks. Areas of denuded epidermis are dark red with oozing
surfaces.
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