make their appearance in crops, and are more or
less persistent; fading sooner or later, however, and giving place to
new outbreaks. Vesicles are often intermingled, developing from
erythematous and erythemato-papular lesions or arising from apparently
normal skin.

It may continue in the same type, or change to the vesicular, bullous or
other variety.

#Describe the papular type of dermatitis herpetiformis.#

This is rarely seen as consisting purely of papular lesions, but is
commonly associated with the erythematous and vesicular varieties. In a
measure it resembles the papular manifestations of erythema multiforme,
with a distinct disposition toward group formation. The papules tend,
sooner or later, to develop into vesicles, new papular outbreaks
occurring from time to time; or the whole eruption changes to the
vesicular or other type of the disease. It is not a common type.

#Describe the vesicular type of dermatitis herpetiformis.#

This is the common clinical type of the disease, and is characterized by
pin-head to pea-sized, rounded or irregularly-shaped, distended or
flattened and stellate vesicles, occurring, for the most part, in
irregular and segmental groups of three or more lesions, seated either
upon apparently normal integument or upon hyperaemic or inflammatory
skin. They exhibit no tendency to spontaneous rupture, but after
remaining a shorter or longer time, are broken or disappear by
absorption. The lesions tend to appear in crops. It may, as it not
infrequently does, continue in the same type, or it may become more or
less erythematous or bullous in character. In not a few instances
pustules, few or in numbers, are at times intermingled.

#Describe the pustular type of dermatitis herpetiformis.#

This is rare. It is similar in its clinical characters to the vesicular
type, except that the lesions are pustular. It is met with, as a rule,
in association with the vesicular and bullous varieties of the disease.

#Describe the bullous type of dermatitis herpetiformis.#

The bullous expression of the disease is usually of a markedly
inflammatory nature, often innumerable blebs, small and large, appearing
almost continuously, and in some instances involving the greater part of
the surface. The lesions arise from erythematous skin, from preexisting
vesicles or vesicular groups, or from apparently normal integument.
There is a marked disposition to appear in clusters. A change of type to
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