Acantholysis is the loss of intercellular connections, such as desmosomes, resulting in loss of cohesion between

keratinocyte 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. Basal cells in the basal layer (''stratum basale'') of the skin are sometimes referre ...

s,Kumar, Vinay; Fausto, Nelso; Abbas, Abul (2004) ''Robbins & Cotran Pathologic Basis of Disease'' (7th ed.). Saunders. Page 1230. . seen in diseases such as

pemphigus vulgaris 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. It is classified as a type II hypersensitivity reaction in which antibody, ...

, Grover’s disease, and Hailey-Hailey Disease. It is absent in bullous pemphigoid, making it useful for

differential diagnosis In healthcare, a differential diagnosis (DDx) is a method of analysis that distinguishes a particular disease or condition from others that present with similar clinical features. Differential diagnostic procedures are used by clinicians to di ...

. This disruption between cells causes intra-epidermal clefts, vesicles and bullae due to cells becoming rounded and no longer attached to one another. Focusing on Pemphigus vulgaris, a blistering auto-immune disease, during acantholysis, circulating autoantibodies cause disruption of cell-cell and cell-matrix adhesion. The antibodies circulate against intercellular adhesion structures and demosomal protein desmoglein (DSG), which causes the disruption. Acantholytic cells also known as Tzanck cells are a distinguishing feature when diagnosing Pemphigus vulgaris. The Tzanck test can be used to diagnosis Pemphigus vulgaris for patients who are uncomfortable with a biopsy. he test can be used to identify acantholytic cells which are classified as large round

s characterized by an enlarged nucleus, indistinct or missing

nucleoli The nucleolus (; : nucleoli ) is the largest structure in the nucleus of eukaryotic cells. It is best known as the site of ribosome biogenesis. The nucleolus also participates in the formation of signal recognition particles and plays a ro ...

and plentiful basophilic cytoplasm. This

histological Histology, also known as microscopic anatomy or microanatomy, is the branch of biology that studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at large ...

feature is also seen in herpes simplex infections (HSV 1 and 2) and varicella zoster infections (chicken pox and shingles).

Epidemiology

The incidence of acantholysis varies according to the condition it is associated with. In Pemphigus vulgaris, the incidence ranges from 0.076 to 5 per 100,000 person-years. The occurrence of Pemphigus vulgaris is most common in adults between ages of 50 and 60 years old. Approximately 70% of cases of this condition come from

India India, officially the Republic of India, is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area; the List of countries by population (United Nations), most populous country since ...

China China, officially the People's Republic of China (PRC), is a country in East Asia. With population of China, a population exceeding 1.4 billion, it is the list of countries by population (United Nations), second-most populous country after ...

Malaysia Malaysia is a country in Southeast Asia. Featuring the Tanjung Piai, southernmost point of continental Eurasia, it is a federation, federal constitutional monarchy consisting of States and federal territories of Malaysia, 13 states and thre ...

and the

Middle East The Middle East (term originally coined in English language) is a geopolitical region encompassing the Arabian Peninsula, the Levant, Turkey, Egypt, Iran, and Iraq. The term came into widespread usage by the United Kingdom and western Eur ...

. While Pemphigus vulgaris affects all, the highest incidence occurs in

Ashkenazi Jews Ashkenazi Jews ( ; also known as Ashkenazic Jews or Ashkenazim) form a distinct subgroup of the Jewish diaspora, that emerged in the Holy Roman Empire around the end of the first millennium CE. They traditionally speak Yiddish, a language ...

. Some common factors that cause this condition are stress,

medication Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...

, surgical and dental procedures, physical trauma or other illnesses. Genetics is also a strong factor in inheriting Pemphigus vulgaris. This has been showed in Ashkenazi Jews with Pemphigus vulgaris. Grover’s disease, which is also caused by acantholysis, is most common in older adults with older adults likely to have more extensive and longer duration of the disease. The disease is around 1.6 to 2.1 times more common in males than females. Some factors that are associated with causing Grover’s disease are environmental factors like extensive sunlight exposure or heat and preexisting illnesses such as cancer and infections.

References

External links

Dermatologic terminology {{dermatology-stub

Epidemiology

See also

References

External links