was seen in 27 cases (87.1%) and this was comparable to the study done by Arya et al.5 Row of tombstone appearance was seen in 25 (80.6%) cases and this was higher to that seen in Arya et al.5 study.
The histologic hallmark of PV and PF is acantholysis
The importance of doing a simple bedside Tzanck smear in blistering disorders is very evident here, as the presence of both primary and secondary acantholysis
could be demonstrated in the same smear.
The acantholytic microscopic variant of squamous cell carcinoma is characterized by extensive acantholysis
resulting in pseudoglandular or pseudovascular spaces.
It can be considered as a chronic organ-specific disorder because the autoimmune injury which leads to the formation of intraepidermal blisters and acantholysis
is confined to the skin and mucosa.
Histopathology shows areas of intraepidermal acantholysis
causing the "dilapidated brick-wall" appearance.
This leads to an intraepithelial loss of adhesion called acantholysis
, and clinically it presents with vescicles and blisters .
The binding of autoantibodies results in acantholysis
and blistering, without a requirement for complement or inflammatory cells.
Histopathology shows suprabasal clefting, acantholysis
, and dyskeratosis with appearance of corps ronds and grains.
Ultimately, the mutation leads to impaired cell-to-cell adhesion with the common histological findings of suprabasal acantholysis
and dyskeratosis of cells in the epidermis.
Additionally, there is typically a vesicle (early) or ulceration (late) with surrounding pale and/or ballooning keratinocytes, acantholysis
, and necrosis (Figure 1, A).
Histopathological examination showed suprabasal partial acantholysis
. "Dilapidated brick wall" appearance was also seen.