Locations of acantholysis in 71 cases of pemphigus

Abstract

Objective To analyze locations of acantholysis in pemphigus vulgaris (PV) and pemphigus foliaceus (PF) , so as to explain why acantholysis in pemphigus occurs in different locations of the epidermis. Methods Clinical data, histopathological and immunopathological findings, and pemphigus antibody level values were collected from 43 patients with PV and 28 with PF, and retrospectively analyzed. Results Of the 43 patients with PV, 35 showed acantholysis in the upper basal layer, 8 in the middle-to-upper epidermis. Of the 28 patients with PF, 25 showed acantholysis in the granular layer and the upper prickle cell layer, 3 in the middle-to-lower epidermis. Patients with PF showed significantly higher levels of anti-Desmoglein 1 (Dsg1) antibody compared with patients with PV (P= 0.047) . However, there were no significant differences in the levels of anti-Dsg1 and anti-Dsg3 antibodies between PV patients who had acantholysis in the middle-to-upper epidermis and those in the upper basal layer. Conclusion Histopatho-logical examinations of PV and PF lesions show that acantholysis can occur in the middle-to-upper epidermis, as well as in the middle-to-lower epidermis, and locations of acantholysis may be associated with levels of anti-Dsg1 and anti-Dsg3 antibodies. Key words: Pemphigus; Acantholysis; Desmoglein 1; Desmoglein 3; Antibodies; Enzyme-linked immunosorbent assay