Acantholysis involves:
Ans: A (Epidermis) Acantholysis (Robins 6th/1260-61)The common denominator, histologically in all forms of pemphigus is acantholysisThis term implies dissolution or lysis of the intercellular adhesion sites within a squamous epithelial surface.Acanthoiytic cells that are no longer attached to other epithelial cells lose their polyhedral shape & characteristically become rounded.Acantholysis is separation of epidermal cells from each other- Neena Khanna 1st/55In pemphigus vulgaris & pemphigus vegetans, acantholysis selectively involves the layer of cells immediately above the basal cell layer (the vegetans variant has considerable overlying epidermal hyperplasia). The suprabasal acanthalytic bister that forms is characteristic of pemphigus vulgaris. In pemphigus foliaceus, blister form by similar mechanisms but, unlike at the level of the stratum granulosum.Patient with pemphigus vulgaris have IgG antoantibodies directed against desmogleins (H17th/ 337)The antibodies are deposited in the intercellular area & induce the keratinocyte to release serine proteases which are enzyme which dissolve the intercellular substance (Neena Khanna 1st/55)Epidermis layers (from outside to inside) Stratum Corneum (Homy cell layer) St. Lucidum St Granulosam (Granular layer) St. Malpighi4 (Prickle ceil layer) St. Germinativum (Basal layer)
Epidermis
Dermis
Epidermis-Dermis junction
Subcutaneous tissue
Anatomy of Skin