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Illustratively, the assessment included the morphologic features of mucosal injury (i.e., different grades of epithelial lifting, villi denudation, and necrosis), inflammation (i.e., focal to diffuse, according to lamina propria infiltration or subendothelial infiltration), and hyperemia/hemorrhage (i.e., focal to diffuse, according to lamina propria or subendothelial localization)

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Patients with Fitzpatrick IV-VI skin should be monitored for potential irritation during initial use, particularly in combination with other actives, and formulations should be pH-controlled (pH 3.5 or lower for efficacy without excessive irritation)