DIFFERENT PATTERNS OF IN-VITRO ACANTHOLYSIS IN NORMAL HUMAN SKIN SAMPLES EXPLANTED FROM DIFFERENT SITES OF THE BODY

Background The factors that contribute to a preferential anatomic loca lization of pemphigus lesions are not well known. In particular, the q uestion arises as to whether certain skin areas may be more acantholys is-prone than others. Objective To verify whether, in pemphigus patien ts, a different susceptibility to acantholysis exists among different cutaneous regions, the technique of tissue cultures was used. Methods Normal human skin explants from two distinct anatomic regions (back an d buttocks) of two former pemphigus patients were cultured in vitro in the presence of enalapril (6 mM) or cystamine (10 mM), two substances with a proven biochemical acantholytic effect. After 4 days of cultur e, the tissues were processed for standard histology, Results Diffuse acantholysis, with large intraepidermal splits, was observed in the ex plants taken from the backs of both subjects and cultured with either enalapril or cystamine. Mild to moderate acantholytic changes were det ected in the explants taken from the buttocks of both subjects and cul tured with either enalapril or cystamine. No structural changes were s een in the control cultures. Conclusions Pemphigus patients present di fferent thresholds of acantholysis in different areas of their bodies. This might explain, at least in part, certain preferential anatomic l ocalizations of pemphigus lesions.