surface may be involved, including the eyes, lips ( Fig 68.11 ), tongue, buccal mucosa, nose, and genitalia In severe cases, pulmonary and renal involvement has also been reported Ocular manifestations include conjunctivitis with photophobia, keratitis, uveitis, or corneal ulcerations Close ophthalmologic care is essential to prevent long-term complications, such as corneal neovascularization, symblepharon, and blindness Bullae may not be obvious on mucous membranes, and often appear as a gray–white film that leaves erosions, ulcerations, and hemorrhagic crust Mucosal involvement may lead to difficulty eating, drinking, dysuria, and pain with defecation Ultimately, if scarring occurs, it can result in functional impairment from esophageal stenosis, urethral stenosis, vaginal stenosis, and anal strictures FIGURE 68.10 Confluent epidermal necrosis on the face results in diffuse desquamation and erosions Note the involvement of the lips with hemorrhagic crust and erosions (Reprinted with permission from Garg SJ Color Atlas and Synopsis of Clinical Ophthalmology—Wills Eye Institute—Uveitis Philadelphia, PA: Lippincott Williams & Wilkins; 2011.)