Acantholytic cells in pemphigus. A scanning and transmission electron microscopic study

Area of Science:

• Oral pathology
• Dermatology
• Cell biology

Background:

• Pemphigus vulgaris is an autoimmune blistering disease.
• Acantholytic cells are characteristic of pemphigus.
• Understanding acantholytic cell morphology is crucial for diagnosis.

Purpose of the Study:

• To characterize acantholytic cells using scanning electron microscopy (SEM) and transmission electron microscopy (TEM).
• To investigate the interaction between acantholytic cells and neutrophils.

Main Methods:

• SEM and TEM were performed on oral scrapings and skin samples from patients with pemphigus vulgaris and pemphigus vegetans.
• Cells were identified and their surface morphology analyzed.
• Neutrophil-acantholytic cell interactions were examined.

Main Results:

• Three types of acantholytic cells were identified by SEM: smooth-surfaced, wrinkled, and microvillous.
• Acantholytic cells exhibited rounded to ovoid shapes with surface indentations.
• TEM suggested acantholytic cells are dead or dying, with potential microvilli loss over time.
• No gap was observed between acantholytic cells and surrounding neutrophils, suggesting a direct interaction.

Conclusions:

• SEM and TEM provide valuable insights into acantholytic cell morphology in pemphigus.
• Neutrophils may play a role in the cytolysis of antibody-coated acantholytic cells.
• Acantholytic cell surface features, including microvilli, change as cells age.