Which of the following is the histological feature of pemphigus: March 2010

Ans. C: Acantholysis Pemphigus: Epidemiology: Rare, equal in men and women, onset at 40 to 60 years of age, more common in Jewish Clinical features: Flaccid blisters or crushed erosions, located on head, upper trunk, interiginous areas, and mucosa; often begins on oral mucosa, may lead to hoarseness; skin is usually painful and Nikolsky's sign positive Diagnosis: - Light microscopy: suprabasilar blister with acantholysis - Direct Immunoflorescence (DIF): intercellular IgG and C3 - Biopsy of the margin of a bulla, when examined by light microscopy, will reveal a suprabasilar blister with acantholysis. The acantholysis is caused by a loss of cohesion between cells in the lower epidermis, resulting in the formation of a blister just above the basal cell layer Acanthosis is diffuse epidermal hyperplasia. It is not to be confused with acantholysis.