Light and electron microscopic aspects of pemphigus herpetiformis (eosinophilic spongiosis) in comparison with other acantholytic disorders.

Histopathological and electron microscopic analyses of pemphigus herpetiformis in a 64-year old woman with a previously operated atoxic goitre and suffering from a nephrotic syndrome and a chronic non-aggressive hepatitis revealed acantholysis preceded by eosinophilic spongiosis. Light microscopically the acantholysis is characterized by the occurrence of necrobiotic epidermal cells. No dyskeratotic cells are found. The mechanism of acantholysis depends on an exuberant elongation of desmosomes, leading to their disruption, spongiotic acantholysis. A conspicuous convolution of specific tight intercellular spaces is observed. Intracytoplasmatic occurrence of such tight intercellular spaces is seen in sections. Pseudomyeloid bodies of various types seem to be of significance. Particles closely similar to pox viruses are observed. The acantholytic process is compared with other acantholytic disorders in which the above-mentioned findings were not observed.