Dome shaped papule with central ulcer and massive necrosis, prominent cytoplasmic ballooning degeneration of epithelial cells noted in peripheral edges of the papule.
The ballooning degeneration mainly occurred in the lower part of the epidermis, underlying dermis is necrotic with vascular occlusion and dense inflammation.
Epidermis is necrotizing with massive ballooning and karyorrhectic debris.
The margination of clumped nuclear chromatin in the necrotic keratinocytes with abundant of cytoplasm is noted, there’s also some molding of nuclei, the changes are similar with herpes but without multinucleation for this case.
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