In order to maintain epidermal structural homeostasis, keratinocytes need to modulate their proliferation, differentiation, and cell death. Although terminal differentiation of keratinocytes is characterized by cornified cell envelope (CE) formation and one major mechanism of cell death is apoptosis, the precise relationship between these processes remains obscure. Using normal human cultured keratinocytes (NHK), we compared A23187-induced CE formation and ultraviolet B irradiation (UVB)-induced apoptosis. A23187 stimulated CE formation in 1 mM Ca 2+-pretreated NHK cells. CE formation was detected by 1 h and the maximal induction was observed at 6 h. Morphological analysis using acridine orange staining revealed that UVB-irradiated NHK cells show distinctive round, homogeneous fragmented nuclear beads, a characteristic feature of apoptotic cells, while A23187-treated cells showed enlarged nuclei with weak chromatin staining, which is not typical of apoptosis. The UVB-irradiated NHK cells did not show CE formation. Caspase activation is a characteristic event during apoptosis. Although UVB irradiation increased caspase 3 activity, no increase in caspase 3 activity was detected during A23187-induced CE formation. Multiple nucleosome-sized fragments of DNA were observed in UVB-treated NHK cells, but not in A23187-treated NHK cells. FACS analyses using anti-annexin V antibody and propidium iodide (PI) showed that UVB irradiation induced both annexin V-positive and PI-negative early apoptotic cells and annexin V-positive and PI-positive late apoptotic cells. On the other hand, A23187-treated NHK cells showed only annexin V-negative and PI-positive non-apoptotic dying cells. Cell death assay revealed a significantly increased apoptotic cells in UVB-irradiated NHK cells, but not in A23187-treated NHK cells. UVB irradiated NHK cells showed increased cytosolic transglutaminase activity, while A23187-treated NHK cells showed increased membrane-associated transglutaminase activity. These results indicate that CE formation is distinct from apoptosis in epidermal keratinocytes.