acantholysis - Health Topics
Suprabasal acantholysis with vesicle formation is the principal microscopic finding Elongation of rete ridges with focal acantholysis and eosinophils may be the only early changes in Grover disease Main 4 histopathological patterns are: Pemphigus vulgaris / foliaceous-like: predominantly limited to suprabasal acantholysis, with basal keratinocytes attached to basement membrane forming a ... Large intraepidermal bullae without acantholysis may represent healed subepidermal bullae (re-epitheliazation phenomemon) Blisters can be a result of spongiotic or lichenoid inflammatory reaction patterns, infection, autoimmune mediated processes, inherited / genetic mutations, paraneoplastic, drug and physical injury / external alterations Skin, punch biopsy: Intraepidermal acantholysis, suggestive of (or consistent with) pemphigus vulagaris (see comment) Comment: Examination of the specimen shows intraepidermal acanthosis in the lower portions of the epidermis and spongiosis with eosinophil and neutrophil exocytosis. There is a perivascular infiltrate with eosinophils in the dermis.
Understanding the Context
Sample pathology report Skin, punch biopsy, chest: Intraepidermal acantholysis, consistent with pemphigus vulgaris (see comment) Comment: Examination of the specimen shows intraepidermal acanthosis with eosinophil and neutrophil exocytosis. There is a perivascular infiltrate with eosinophils in the dermis. Acantholysis is rather a rounding of keratinocytes with detached intercellular attachments (desmosomes). Dyskeratotic acantholysis shows acantholysis in addition to dense eosinophilia of keratinocytes but no reticular degeneration of finely speckled keratohyalin granules.
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Key Insights
Comment Here Reference: Epidermolytic acanthoma The photomicrograph shows acantholysis with dyskeratosis (corp ronds and grains) as well as the formation of villi classically seen in Darier disease. While Hailey-Hailey disease may have acantholysis with dyskeratosis, prominent corp ronds and grains are lacking.