Biochemical Acantholysis Provoked by Thiol Drugs-Reply

In Reply.—  It is remarkable that the results of studies performed independently by Ruocco et al¹ and ourselves are so similar. In our report on drug-induced pemphigus in vitro, our omission of a reference to the report by Ruocco and coworkers was not intended to downplay the numerous and significant contributions they have made in the study of drug-induced acantholysis, but simply reflected an imperfect literature search. What is important to note is that our data concurred in almost every detail, were derived independently, and were initially reported by each of our groups almost simultaneously in abstract form in 1987.^2,3The original hypothesis of Ruocco et al⁴ that drugs containing active thiol groups may interfere with pemphigus antigen-mediated adhesion through formation of mixed disulfides is highly likely to be accurate, especially in the light of detailed studies since published by Korman and coworkers.⁵ They showed that