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An erythem-atous maculopapular rash progresses to clusters of clearvesicles on an inflamed base; such skin lesions may vari-ably affect the tympanic membrane, the external auditorycanal, the auditory meatus, and, less commonly, the exter-nal ear, adjacent skin of the mastoid process, the mucousmembranes of the soft palate (presumably via the greatersuperficial petrosal nerve), and the anterior two-thirds ofthe tongue (presumably via the chorda tympani nerve)(Shapiro et al., 1994).

In chronic PSJI withlow-virulent bacteria, macroscopic findings can be unspecific or even almost unremark-able. Therefore,the myelin between two sequential nodes of Ranvier is calledan internodal segment (Plate 28, page 396).

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