Loss of attachment between epithelial cell that results in separation of those cells from one another and ,as a consequence, their assumption of round shapes. Cell in the spinous, granular and cornified layers of the epidermis and epithelial structures of adnexa are the ones that usually undergo acantholysis, but basal cells may separate from their neighbors in the manner of acantholysis when neutrophils accumulate in dermal papillae and subepidermal spaces. Acantholytic cells appear in inflammatory conditions such as pemphigus vulgaris, in neoplasms such as squamous cell carcinoma, and in cystic lesions scuh as warty dyskeratoma.

A cantholysis may be induced by the effects of (1) immunoglobulins alone or with immunoglobulins in concert with complement on epidermal and adnexal keratinocytes in pemphigus foliaceus and in pemphigus vulgaris; (2) neutrophils on keratinocytes in the lower part of the epidermis of subepidermal vesicular dermatitides such as dermatitis herpetiformis, keratinocytes in the spinous zone of intraepidermal pustular dermatitides such as impetigo, and infundibular keratinocytes of suppurative folliculitides such as Majocchi's granuloma; and (3) vesicants such as the oil, cantharidin, on epidermal keratinocytes.