199.The answer is b.(Kierszenbaum, pp 301, 303. Kasper, pp 303,
311–313. Kumar, pp 1260–1262.)The patient is suffering from bullous
pemphigoid in which BP antigens are produced to proteins specific to the
hemidesmosomes. The immunofluorescence image shows specific labeling
of the epidermal-dermal interface. Therefore, the entire epidermis sepa-
rates from the basal lamina in contrast to pemphigus in which the desmo-
somes disaggregate due to antibodies to the desmogleins causing a
disruption of the macula adherens [desmosomes (answer a)] in the stra-
tum spinosum. The gap junction (answer c)is a communicating junction;
the zonula occludens (answer d)prevents material from flowing between
cells; and the zonula adherens (answer e)is a belt-like component of the
junctional complex that links to the actin cytoskeleton. Below is a helpful
“memory grid” to remind you of the components of the junctional com-
plexes and their attachments to the cell. You can move down or across, but
not diagonally.
310 Anatomy, Histology, and Cell Biology
Cadherins IntegrinsActin Adhesion Focal No Plaque
Belts AdhesionsIntermediate Desmosomes Hemidesmo- Plaque
Filaments somesCell to Cell Cell to
MatrixMemory GridNo fair going diagonally!(Table courtesy of Dr. Ronal R. MacGregor.)