18. Erythema multiforme (dermal and epidermal types)

 
Quotation from the 9th edition of Lever's:
 
"The predominance of epidermal and dermal changes [in erythema multiforme] reflects the site of biopsy within an individual lesion and when, in the temporal evolution of the disease, the biopsy is taken. In addition, many cases of primarily "dermal erythema multiforme" may represent hypersensitivity reactions in which interface dermatitis is not the characteristic reaction pattern."
 
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA):
 
Ackerman AB, Ragaz A. Erythema multiforme. Am J Dermatopathol. 1985 Apr;7(2):133-139.
 
No reference to ideas of ABA published since 1985.
 
Statements contrary by ABA:
 
"There is neither a wholly epidermal nor an entirely dermal expression of erythema multiforme; erythema multiforme is an inflammatory process that involves the dermis (the upper part of it especially), the dermo-epidermal junction, and the epidermis in characteristic, repeatable fashion."
 
Ackerman AB, Böer A, Bennin B, Gottlieb GJ. Histologic Diagnosis of Inflammatory Skin Diseases, 3rd Edition. New York: Ardor Scribendi, 2005. (www.derm101.com)
 
Other works of ABA in which the ideas contrary are expressed:
 
1. Ackerman AB. Chongchitnant N, Sanchez J, Guo Y. Histologic Diagnosis of Inflammatory Skin Diseases. 2nd edition. Baltimore: Lippincott Williams & Wilkins, 1997.
 
2. Ackerman AB, Ragaz A. The Lives of Lesions: Chronology in Dermatopathology. pp 57. Masson Publishing USA, Inc., 1984. (Now on list of Lea & Febiger, Philadelphia.)
 
3. Ackerman AB, Niven J, Grant-Kels J. Differential Diagnosis in Dermatopathology. Philadelphia: Lea & Febiger, 1982.
 
4. Ackerman AB. Histologic Diagnosis of Inflammatory Skin Diseases: A Method by Pattern Analysis. Philadelphia: Lea and Febiger, 1978.
 
5. Ackerman AB, Penneys NS, Clark WH Jr. Erythema multiforme exudativum: distinctive pathologic process. Br J Dermatol 84:554-566, 1971.