AN ELECTRON MICROSCOPIC STUDY ON PEMPHIGUS VULGARIS OF MOUTH AND SKIN WITH SPECIAL REFERENCE TO INTERCELLULAR CEMENT

[摘要] Several specimens of both oral and cutaneous lesions of pemphigus vulgaris were studied by the electron microscope. Desmo-somes appeared to be normal in the vicinity of acantholytic areas, while the intercellular cementing substance was often dissolved. Desmosomes and attached bundles of tonofilaments were also preserved fairly well even in partially acantholized cells. Whenever the intercellular cement was preserved, the cells in the lesions were kept attached to each other no matter what had happened to the other cellular organelles. Thus cells were kept in firm contact if the cement was preserved, in spite of a complete absence of desmosome-tonofilament complex. In the oral lesions serum exudate often filled the intercellular spaces, but not the space between the basal cells and the basement membrane. The intercellular cementing substance is first involved in the process which leads to acantholysis. These observations also corroborate the findings of the immunofluorescence study in which the auto-antibodies present in pemphigus patients'' sera were shown to be bound only to intercellular substances.