Acantholysis, a term derived from the Ancient Greek words "akantha" meaning "thorn" and "lysis" meaning "loosening or breaking apart," refers to a pathological condition characterized by the disruption or dissolution of the connections between cells in the epidermis or epithelium.
In dermatology and pathology, acantholysis specifically describes the loss of adhesion between individual cells of the epidermis, resulting in the separation of these cells from each other. This often leads to the formation of intraepidermal clefts or separation of the affected tissue layers, which are visualized microscopically.
Acantholysis frequently occurs as a consequence of several diseases, most notably including pemphigus vulgaris, a potentially life-threatening autoimmune disorder. In pemphigus vulgaris, antibodies are mistakenly produced against proteins responsible for cell adhesion in the skin and mucous membranes, leading to the detachment of epithelial cells and the formation of blisters.
In addition to pemphigus vulgaris, acantholysis may also be observed in other dermatological conditions, such as pemphigus foliaceus, pemphigus erythematosus, Hailey-Hailey disease, Darier's disease, and some forms of toxic epidermal necrolysis.
Histologically, acantholysis is characterized by the presence of rounded individual cells or clusters of cells called "acantholytic cells" within intercellular spaces. These cells lack normal intercellular adhesions and can be observed floating freely or connected to a small remnant of desmosomes.
Diagnosis of acantholysis is primarily based on clinical symptoms, supported by histopathological examination of affected tissues, including
