CANTHARIDIN-INDUCED ACANTHOLYSIS IN DARIERS-DISEASE - DOES ACANTHOLYSIS INITIATE DYSKERATOSIS

We have examined the action of cantharidin on the skin of patients wit h Darier's disease, and used immunohistological techniques to determin e the distribution of desmosomal components, keratin intermediate fila ments, and proteases in cantharidin-induced blisters. Cantharidin indu ced acantholysis, but the presence of acantholysis did not trigger the development of the characteristic warty, dyskeratotic papules in pati ents with Darier's disease. The distribution of desmosomal components, keratins and proteases within the acantholytic keratinocytes in the c antharidin-induced blisters was similar to that previously found in ac antholytic cells within lesions of Darier's disease: peripheral staini ng for extracellular desmosomal components was reduced; some desmosoma l components were detected diffusely in the acantholytic cells; basal cell keratin markers were expressed by some suprabasal acantholytic ce lls, and plasminogen was detected in association with acantholytic cel ls. Cleavage of desmosomes did not reveal the underlying abnormality i n Darier's disease.