History: 2209tm 37 years old female who developed an acute blistering eruption overnight after working 36 hrs before in the garden. Rash also on right inner thigh. Clinically acute plant contact dermatitis but exclude an immune blistering disease. ( Biopsy req by refering Physicians!)

Description: Prominent dermal eosinophils

Comments: The biopsy shows basketweave orthokeratosis underlying which there is spongiosis with prominent spongiotic vesiculation. There is a superficial and deep dermal perivascular and interstitial infiltrate that includes numerous eosinophils and is associated focally with flame figure formation. The features appear consistent with a severe acute photosensitive contact dermatitis. Immunofluorescence studies are negative