This report gives an account of seven patients with pemphigus in whom the early biopsies showed spongiosis and diffuse epidermal infiltration with eosinophils. This histopathology which we refer to as eosinophilic spongiosis occurred independently of obvious acantholysis, but transitions between it and the usual histological findings in pemphigus were also observed. Eosinophilic spongiosis occurred both in pemphigus vulgaris and pemphigus foliaceus. Three of the patients who were eventually found to have superficial pemphigus had had an atypical initial presentation resembling dermatitis herpetiformis clinically. The histological differentiation of eosinophilic spongiosis from eczema, dermatitis herpetiformis, and, possibly, the vesicular stage of incontinentia pigmenti is discussed.
Emmerson RW, Wilson-Jones E. Eosinophilic Spongiosis in PemphigusA Report of an Unusual Histological Change in Pemphigus. Arch Dermatol. 1968;97(3):252-257. doi:10.1001/archderm.1968.01610090024004