#no pruritis

++Reactivation of dormant varicella virus (located in DRG)

**Pain is the first symptom of any lesion

**Wherever the dermatome is "my seatbelt hurts"

**Pain for 2-3 days before lesions show up

**Lesions last for 3-5 days

*NOT ITCHY, but painful

**Less than 4% patients have recurrence

**intraepidermal vesicles, bulla

**Positive Nikolsky (skin will spread upon pressure)

**No itching

**become painful, extensive erosions (focal loss of epidermis with no scarring)

**Most common type of pemphigus (80%), autoimmune

**middle age, elderly

**usually begins in mouth

**Damaged intercellular attachments within epidermis and mucosal epithelium.

**Autoantibodies against desmosomes

**Superficial

**No itching, but is painful

**First lesion often in mouth

**Life-threatening if untreated

**Pathogenesis: desmosome autoantibody. release serine protease and plasminogen activator by epidermal cells.