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Ch. 5 The Integumentary System
Amerman - Human Anatomy & Physiology 2nd Edition
Amerman2nd EditionHuman Anatomy & PhysiologyISBN: 9780136873822Not the one you use?Change textbook
Chapter 5, Problem L3.A1

The disease pemphigus vulgaris involves a patient's own immune system attacking the desmosomes between the epithelial cells of the skin. What changes would you expect to see with this disease?

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1
Understand the role of desmosomes: Desmosomes are specialized structures that provide strong adhesion between epithelial cells, maintaining the integrity of the skin and preventing it from tearing under stress.
Recognize the impact of autoimmune attack: In pemphigus vulgaris, the immune system produces antibodies that target desmosomes, disrupting their function and weakening cell-to-cell adhesion.
Consider the physiological consequences: With desmosomes compromised, epithelial cells lose their ability to stay tightly connected, leading to separation of skin layers (acantholysis). This results in blister formation and skin fragility.
Identify symptoms: Patients with pemphigus vulgaris often experience painful blisters, erosions, and open sores on the skin and mucous membranes due to the loss of structural integrity.
Relate to clinical outcomes: The disease can lead to increased risk of infection, dehydration, and difficulty in healing, as the protective barrier of the skin is compromised.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Pemphigus Vulgaris

Pemphigus vulgaris is an autoimmune disorder characterized by the formation of blisters on the skin and mucous membranes. The immune system mistakenly targets desmosomes, which are structures that help cells adhere to one another, leading to the separation of skin layers and the development of painful lesions.

Desmosomes

Desmosomes are specialized cell structures that provide adhesion between epithelial cells, maintaining the integrity of tissues. They are crucial for skin stability, and their disruption in pemphigus vulgaris results in the loss of cell-to-cell adhesion, causing the skin to become fragile and blister easily.
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Autoimmune Response

An autoimmune response occurs when the body's immune system mistakenly attacks its own tissues. In pemphigus vulgaris, autoantibodies target proteins in desmosomes, leading to inflammation and damage to the skin, which manifests as blisters and erosions.
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Related Practice
Textbook Question

Explain what happens to dermal blood vessels when heat needs to be conserved (i.e., due to a cold environment).

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Textbook Question

Would a mild second-degree burn be likely to heal by regeneration or fibrosis? Would the same type of healing take place in a third-degree burn that involved muscle tissue? Why or why not?

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Textbook Question

Number the strata of thick skin epidermis from deepest (1) to most superficial (5). 

____Stratum spinosum     

____Stratum corneum     

____Stratum basale     

____Stratum lucidum     

____Stratum granulosum

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Textbook Question

Many antiaging skin creams contain collagen and hyaluronic acid. Manufacturers claim that the collagen and hyaluronic acid applied to the surface of the skin will be absorbed into the dermis, where they will be incorporated into dermal tissue.

Predict whether or not these substances are likely to be absorbed by the epidermis.

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Textbook Question

Many antiaging skin creams contain collagen and hyaluronic acid. Manufacturers claim that the collagen and hyaluronic acid applied to the surface of the skin will be absorbed into the dermis, where they will be incorporated into dermal tissue.

Predict the effectiveness of the creams.

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Textbook Question

Nguyen comes to your clinic with a mole that has recently changed in appearance. You examine the mole and note that its borders are irregular, it has a deep blue-black color, and the color is unevenly distributed throughout the mole.

Nguyen tells you that she has used a tanning booth once per week for the past several years and that the tanning salon advertises it as safe. What do you tell her about the tanning salon's claim? How does any UV exposure affect keratinocytes and melanocytes? Explain.

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