Difference Between Acanthosis and Acantholysis

The key difference between acanthosis and acantholysis is that acanthosis refers to the thickened epidermis while acantholysis is the loss of intercellular connections between keratinocytes.

Acanthosis and acantholysis are two skin conditions related to the epidermis. Acanthosis is the thickened epidermis. The increased thickness of the malpighian layer is the cause for acanthosis. Acantholysis is the loss of intercellular connections resulting in loss of cohesion between keratinocytes. It is seen in diseases such as pemphigus vulgaris.

CONTENTS

1. Overview and Key Difference
2. What is Acanthosis 
3. What is Acantholysis
4. Similarities Between Acanthosis and Acantholysis
5. Side by Side Comparison – Acanthosis vs Acantholysis in Tabular Form
6. Summary

What is Acanthosis?

Acanthosis is defined as the thickened epidermis. In fact, it is the increased thickness of the malpighian layer (stratum basale and stratum spinosum) of the epidermis. Acanthosis is also referred to as epidermal hyperplasia.  It can be regular with rete ridges of similar length or irregular with rete ridges with a marked difference in length and width. Acanthosis is associated with changes in the stratum corneum such as parakeratosis or orthokeratotic hyperkeratosis. Acanthosis (squamous cell hyperplasia) may be seen occasionally as a treatment effect. Moreover, it is seen with zinc deficiency. In malignant melanoma, prominent acanthosis with elongated epidermal rete is a common histopathologic feature. Furthermore, there is marked acanthosis, with some papillomatosis and hyperkeratosis.

Figure 01: Acanthosis

What is Acantholysis?

Keratinocytes are one of the four types of epidermal cells. They account for more than 95% of the cells in the epidermis. Keratinocytes release the protein called keratin. Keratin makes the skin impermeable to water. Acantholysis is the separation of keratinocytes within the epidermis. It happens due to the loss of intercellular connections between keratinocytes. As a result, keratinocytes loose cohesion between them. Adherence between keratinocytes is mediated by tight junctions, adherens junctions, gap junctions, and desmosomes. Acantholysis occurs due to the failure of the integrity of the intercellular and intraepidermal cell junctions.

Figure 02: Acantholysis

Acantholysis leads to the separation of the epithelial cells. It also causes a change in cell shape from polygonal to round. Acantholysis can be seen in diseases such as pemphigus vulgaris and related disorders.

What are the Similarities Between Acanthosis and Acantholysis?

  • Acanthosis and acantholysis are two processes related to the epidermis.
  • The abnormal epidermis is a result of both processes.

What is the Difference Between Acanthosis and Acantholysis?

Both acanthosis and acantholysis are two skin disease conditions. Acanthosis is the thickening of the epidermis. Meanwhile, acantholysis is the loss of intercellular connection between keratinocytes in the epidermis. So, this is the key difference between acanthosis and acantholysis. Acanthosis is prominent in diseases such as malignant melanoma, papillomatosis and hyperkeratosis while acantholysis is associated with pemphigus vulgaris and related disorders.

The following table summarizes the difference between acanthosis and acantholysis.

Summary – Acanthosis vs Acantholysis

The key difference between acanthosis and acantholysis is that the acanthosis is the epidermal thickening and elongation of rete ridges. But, acantholysis is the separation of keratinocytes within the epidermis. Acanthosis may be seen occasionally as a treatment effect. Acantholysis can be seen in diseases such as pemphigus vulgaris and related disorders. Thus, this summarizes the difference between acanthosis and acantholysis.