Acantholytic cells in pemphigus is –
**Core Concept**
Pemphigus is a group of autoimmune skin diseases characterized by the formation of intraepidermal blisters, resulting from the breakdown of intercellular connections between keratinocytes. Acantholytic cells are a hallmark of pemphigus, where the loss of cell-to-cell adhesion leads to the separation of keratinocytes.
**Why the Correct Answer is Right**
In pemphigus, autoantibodies are directed against desmoglein proteins, which are components of desmosomes – the intercellular junctions responsible for maintaining cell-to-cell adhesion in the epidermis. Desmoglein 1 and 3 are the primary targets in pemphigus vulgaris, leading to the separation of keratinocytes and the formation of acantholytic cells. These cells are characterized by their rounded, detached appearance and loss of intercellular connections.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as acantholytic cells are not characteristic of psoriasis, which is a different skin disorder characterized by hyperproliferation of keratinocytes.
**Option B:** This option is incorrect as acantholytic cells are not typically seen in lichen planus, which is an inflammatory skin condition characterized by a band-like lymphocytic infiltrate in the dermis.
**Option C:** This option is incorrect as acantholytic cells are not characteristic of staphylococcal scalded skin syndrome (SSSS), which is a bacterial infection caused by staphylococcal toxins that separate keratinocytes.
**Clinical Pearl / High-Yield Fact**
Acantholytic cells are a key diagnostic feature of pemphigus, and their presence can be confirmed by histopathological examination of a skin biopsy. The clinical presentation of pemphigus can vary widely, ranging from mild to severe forms of the disease.
**Correct Answer:** C. Acantholytic cells in pemphigus are seen in the epidermis, typically in the upper layers.