Which condition is characterized by subepithelial destruction without acantholysis?

The condition characterized by subepithelial destruction without acantholysis is mucous membrane pemphigoid. This autoimmune blistering disorder primarily affects mucosal surfaces, especially the oral cavity. The hallmark of mucous membrane pemphigoid is the presence of the separation of the epithelium from the underlying connective tissue (subepithelial blisters), where there is destruction of the basement membrane zone.

In mucous membrane pemphigoid, the immune system mistakenly targets components of the basement membrane, leading to the formation of vesicles or bullae. Unlike pemphigus vulgaris, which involves acantholysis (the degeneration of connections between epithelial cells), mucous membrane pemphigoid occurs without this process. Therefore, the presence of subepithelial blisters in conjunction with the absence of acantholysis distinctly identifies mucous membrane pemphigoid among the conditions listed.