In pemphigus, autoantibodies form against desmoglein. Desmoglein forms the "glue" that attaches adjacent epidermal cells via attachment points called desmosomes. When autoantibodies attack desmogleins, the cells become separated from each other and the epidermis becomes "unglued", a phenomenon called acantholysis. This causes blisters that slough off and turn into sores. In some cases, these bl...

Pemphigus vulgaris (PV) is one of the most common and studied autoimmune disorders of skin. The knock down of desmogleins in the skin by IgG antibodies will eventually leads to mucocutaneous problems in both genders. Targeting the cardinal molecules involved in the pathways of immune response is the main goal of given therapy. With regard to the side effects of long term use of immunosuppressiv...

Hailey-Hailey disease (HHD) is a chronic familial bullous disease characterized by recurrent blisters and erosions typically at friction-prone areas of the body accompanied by acantholysis upon histologic examination. There are a number of therapies used in the management of HHD. Its symptoms have been effectively treated with antimicrobial therapies, corticosteroids and other agents such as cy...

Warty dyskeratoma (WD), also known as isolated follicular dyskeratosis, is a relatively uncommon benign epidermal proliferation first reported by Szymanski in 1957 [1]. WD presents as a whitish or grayish solitary papule or as a small nodule with a keratotic plug, usually limited to the head and neck of middle-aged patients. Lesions are generally solitary, but grouped verrucous papules on the s...

Volume 89, Number 1 www.aafp.org/afp American Family Physician 7 A 62-year-old man with no significant medical history presented with multiple bullae on his trunk that had been present for one week. The rash was painful but not pruritic. He did not have a fever or sore throat, and had not used any new medications. Physical examination revealed multiple vesicles, flaccid bullae, and erosions wit...

Pemphigus vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes. The initial clinical manifestation is frequently the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin. The etiology of this disease still remains obscure although the presence of autoantibodies is consistent with an autoimmune ...

A variety of clinical and histological presentations can accompany the evolution of malignant melanoma. Unusual cytological variants of malignant melanoma include balloon cell, signet ring cell, myxoid and other metaplastic changes. With the exception of a case of pemphigus-like changes associated with malignant melanoma in paraneoplastic pemphigus, acantholysis is not a common histopathologica...

Pemphigus foliaceus is a rare, superficial form of pemphigus. Due to acantholysis localised in the stratum corneum or within the upper spinous layer of the epidermis, patients suffer mainly from extensive sores, while blisters are rarely found. The antigen in this form of pemphigus is desmoglein 1. The basic therapy consists of corticosteroids and immunosuppression, but in doses lower than in c...

Grover's disease is a benign condition of unknown origin characterized clinically by an erythematous papulovesicular eruption and histopathologically by intraepidermal clefting and four different patterns of acantholysis: Darier-like, pemphigus-like, spongiotic, and Hailey-Hailey-like. A case of a 54-year-old female affected by Grover's disease and showing a Darier-like histopathological patter...