Figure 2.

Images of skin lesions, healthy-looking spots, and epidermal histology. (A,B) The patients characteristic skin lesions, present since early childhood. (C) Intense erythema was present bilaterally on the thighs, and a few small spots of bleached skin within the erythema were observed at age of 20. (D,E) The non-inflamed areas of normal skin expanded and spread over time. (F) She also developed squamous cell carcinoma (SCC) at age of 30. (G) A skin biopsy of the edge between lesional and healthy-looking skin showed a relatively sharp shift (arrowhead) in epidermal histology from ortho-keratotic hyperkeratosis, hypergranulosis, and slight acanthosis (right) to almost healthy-looking skin (left). Image obtained using Masson’s staining: original magnification 100x.