Acantholysis

Not to be confused with Acanthosis.
Acantholysis
Foot-and-mouth disease - acantholysis in a sample of a skin vesicle: Necrosis of the stratum spinosum can be observed, and keratinocytes floating in the vesicular fluid (spongiosa).
SpecialtyDermatology

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, Grover’s disease, and Hailey-Hailey Disease.[2][3] It is absent in bullous pemphigoid, making it useful for differential diagnosis. This disruption between cells causes intra-epidermal clefts, vesicles and bullae due to cells becoming rounded and no longer attached to one another.[4]

Focusing on Pemphigus vulgaris, a blistering auto-immune disease, during acantholysis, circulating autoantibodies cause disruption of cell-cell and cell-matrix adhesion.[5] The antibodies circulate against intercellular adhesion structures and demosomal protein desmoglein (DSG), which causes the disruption.[6] Acantholytic cells also known as Tzanck cells are a distinguishing feature when diagnosing Pemphigus vulgaris.[7] The Tzanck test can be used to diagnosis Pemphigus vulgaris for patients who are uncomfortable with a biopsy.[8] he test can be used to identify acantholytic cells which are classified as large round keratinocytes characterized by an enlarged nucleus, indistinct or missing nucleoli and plentiful basophilic cytoplasm.[9] This histological feature is also seen in herpes simplex infections (HSV 1 and 2) and varicella zoster infections (chicken pox and shingles).

  1. ^ Kumar, Vinay; Fausto, Nelso; Abbas, Abul (2004) Robbins & Cotran Pathologic Basis of Disease (7th ed.). Saunders. Page 1230. ISBN 0-7216-0187-1.
  2. ^ Kumaran, MSendhil; Kanwar, AmrinderJ; Seshadri, Divya (2013). "Acantholysis revisited: Back to basics". Indian Journal of Dermatology, Venereology and Leprology. 79 (1): 120–126. doi:10.4103/0378-6323.104688. PMID 23254748.
  3. ^ "Acantholysis - Medical Definition from MediLexicon". medilexicon.com. Archived from the original on 2016-07-31. Retrieved 2017-04-22.
  4. ^ Kumaran, MSendhil; Kanwar, AmrinderJ; Seshadri, Divya (2013). "Acantholysis revisited: Back to basics". Indian Journal of Dermatology, Venereology and Leprology. 79 (1): 120–126. doi:10.4103/0378-6323.104688. PMID 23254748.
  5. ^ Mohammad Beigi, Pooya Khan (2018). "Overview of Pemphigus Vulgaris". A Clinician's Guide to Pemphigus Vulgaris. pp. 11–12. doi:10.1007/978-3-319-67759-0_2. ISBN 978-3-319-67758-3.
  6. ^ Mohammad Beigi, Pooya Khan (2018). "Overview of Pemphigus Vulgaris". A Clinician's Guide to Pemphigus Vulgaris. p. 11. doi:10.1007/978-3-319-67759-0_2. ISBN 978-3-319-67758-3.
  7. ^ Singhi, Mk; Gupta, LalitKumar (2005). "Tzanck smear: A useful diagnostic tool". Indian Journal of Dermatology, Venereology and Leprology. 71 (4): 295–299. doi:10.4103/0378-6323.16632. PMID 16394449.
  8. ^ Singhi, Mk; Gupta, LalitKumar (2005). "Tzanck smear: A useful diagnostic tool". Indian Journal of Dermatology, Venereology and Leprology. 71 (4): 295–299. doi:10.4103/0378-6323.16632. PMID 16394449.
  9. ^ Singhi, Mk; Gupta, LalitKumar (2005). "Tzanck smear: A useful diagnostic tool". Indian Journal of Dermatology, Venereology and Leprology. 71 (4): 295–299. doi:10.4103/0378-6323.16632. PMID 16394449.
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