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Acantholysis is the loss of intercellular connections, such as desmosomes, resulting in loss of cohesion between keratinocytes, [1] seen in diseases such as pemphigus vulgaris. [2] It is absent in bullous pemphigoid , making it useful for differential diagnosis .
Acantholytic cells with direct immunofluorescence positivity With the use of direct immunofluorescence examination, the specificity of cytology for diagnosing pemphigus can be increased from 43% to 100%. Erythema multiforme, Toxic epidermal necrolysis Apoptotic and necrotic cells, absence of acantholytic cells
Pemphigus vulgaris is a rare chronic blistering skin disease and the most common form of pemphigus.Pemphigus was derived from the Greek word pemphix, meaning blister. [1] It is classified as a type II hypersensitivity reaction in which antibodies are formed against desmosomes, components of the skin that function to keep certain layers of skin bound to each other.
Keratinocytes are the primary type of cell found in the epidermis, the outermost layer of the skin. In humans, they constitute 90% of epidermal skin cells. [ 1 ] Basal cells in the basal layer ( stratum basale ) of the skin are sometimes referred to as basal keratinocytes . [ 2 ]
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This layer is composed of polyhedral keratinocytes. [3] [4] These are joined with desmosomes. [3] Their spiny (Latin, spinosum) appearance is due to shrinking of the microfilaments between desmosomes that occurs when stained with H&E. Keratinization begins in the stratum spinosum, [5] although the actual keratinocytes begin in the stratum ...
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