CBIHS - Pharmacy

Human Anatomy and Physiology

with Pathophysiology

SKIN AND BODY MEMBRANES

BODY MEMBRANES  This membrane type lines all body

 Body membranes cover surfaces, line body cavities that open to the exterior, such as
cavities, and form protective (and often those of the hollow organs of the
lubricating) sheets around organs. respiratory, digestive, urinary, and
 They fall into two major groups: reproductive tracts.
 Epithelial Membranes: include the  Notice that the term mucosa refers only
cutaneous, mucous, and serous to the location of the epithelial
membranes membranes, not their cellular makeup,
 Connective Tissue Membranes: include which varies. However, most mucosae
synovial membranes. contain either stratified squamous
epithelium (as in the mouth and
esophagus) or simple columnar
Classification of Body Membranes epithelium (as in the rest of the digestive
tract).
1. EPITHELIAL MEMBRANES  In all cases, they are "wet," or moist
 The epithelial membranes, also called membranes that are almost continuously
covering and lining membranes, include bathed in secretions or, in the case of the
the cutaneous membrane (skin), the urinary mucosae, urine.
mucous membranes, and the serous  The epithelium of mucosae is often
membranes. adapted for absorption or secretion.
 However, calling these membranes Although many mucosae secrete mucus,
"epithelial" is not only misleading but also not all do. The mucosae of the respiratory
inaccurate. Although they all do contain and digestive tracts secrete large
an epithelial sheet, it is always combined amounts of protective, lubricating mucus;
with an underlying layer of connective that of the urinary tract does not.
tissue.
 Hence these membranes are actually
simple organs.

A. Cutaneous Membrane
 The cutaneous membrane is your skin
 Its superficial epidermis is composed of a
keratinizing stratified squamous
epithelium.
 The underlying dermis is mostly dense
(fibrous) connective tissue.
 Unlike the other epithelial membranes,
the cutaneous membrane is exposed to
air and is a dry membrane.
C. Serous Membranes
 A serous membrane (serosa) is
composed of a layer of simple squamous
B. Mucous Membranes epithelium resting on a thin layer of
 A mucous membrane (mucosa) is areolar connective tissue.
composed of epithelium (the type varies  In contrast to mucous membranes, which
with the site) resting on a loose line open body cavities, serous
connective tissue membrane called a membranes line body cavities that are
lamina propria. closed to the exterior (except for the
dorsal body cavity and joint cavities).
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 Serous membranes occur in pairs. 2. CONNECTIVE TISSUE MEMBRANE

 The parietal (parie = wall) layer lines
a specific portion of the wall of the A. Synovial Membrane
ventral body cavity.  Synovial membranes are composed of
 It folds in on itself to form the soft areolar connective tissue and contain
visceral layer, which covers the no epithelial cells at all.
outside of the organs in that cavity. 
 You can visualize the relationship  These membranes line the fibrous
between the serosal layers by pushing capsules surrounding joints where they
your fist into a limp balloon only partially provide a smooth surface and secrete a
filled with air or water. The part of the lubricating fluid. They also line small sacs
balloon that clings to your fist can be of connective tissue called bursae and
compared to the visceral serosa clinging the tube-like tendon sheaths. Both of
to the organ's external surface. The outer these structures cushion organs moving
wall of the balloon represents the parietal against each other during muscle activity
serosa that lines the walls of the cavity. - such as the movement of a tendon
across a bone’s surface.

 In the body, the serous layers are

separated not by air but by a scanty
amount of thin, clear fluid, called serous
fluid, which is secreted by both
membranes. Although there is a potential
space between the two membranes, they
tend to lie very close to each other.
 The serous fluid allows the organs to
slide easily across the cavity walls and
one another without friction as they carry
out their routine functions. This is
THE INTEGUMENTRAY SYSTEM (SKIN)
extremely important when mobile organs
 The skin and its derivatives (sweat and oil
such as the pumping heart and a
glands, hair, and nails) serve a number of
churning stomach are involved.
functions, mostly protective. Together,
 The specific names of the serous
these organs are called the
membranes depend on their locations.
integumentary system.
The serosa lining the abdominal cavity
and covering its organs is the
peritoneum. In the thorax, serous
Functions of the Integumentary System
membranes isolate the lungs and heart
 Also called the integument, which simply
from one another. The membrane
means "covering," the skin multitasks. Its
surrounding the lungs is the pleura; that
functions go well beyond serving as a large
around the heart is the pericardium.
opaque bag for body contents. It is absolutely
essential because it keeps water and other
precious molecules in the body. It also keeps
water (and other things) out. (This is why you
can swim for hours without becoming
waterlogged.)
 Structurally, the skin is a marvel. It is pliable
yet tough, which allows it to take constant
punishment from external agents. Without our
skin, we would quickly fall prey to bacteria
and perish from water and heat loss.
 The integumentary system performs a variety
of functions; most, but not all, protective .
 It insulates and cushions the deeper body
organs
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 It protects the entire body from

mechanical damage (bumps and cuts),
chemical damage (such as from acids
and bases), thermal damage (heat and
cold), ultraviolet radiation (in sunlight),
and bacteria.
 The uppermost layer of the skin is full of
keratin and is cornified, or hardened, to
help prevent water loss from the body
surface.
 The skin's rich capillary network and
sweat glands (both controlled by the
nervous system) play an important role in
regulating heat loss from the body
surface. The skin acts as a mini-excretory 1. EPIDERMIS
system; urea, salts, and water are lost  The epidermis is composed of up to five
when we sweat. layers or strata ("bed sheets"). From the
 The skin is also a chemical plant; it inside out these are the (1) stratum
manufactures several proteins important basale, (2) stratum spinosum, (3)
to immunity and synthesizes vitamin D. stratum granulosum, (4) stratum
(Modified cholesterol molecules located lucidum, and (5) stratum corneum.
in the skin are converted to vitamin D by Stratum lucidum is found only in thick
sunlight.) skin.
 Finally, the cutaneous sensory receptors,  Like all other epithelial tissues, the
which are actually part of the nervous epidermis is avascular; that is, it has no
system, are located in the skin. These blood supply of its own. This explains
tiny sensors, which include touch, why a man can shave daily and not bleed
pressure, temperature, and pain even though he cuts off many cell layers
receptors, provide us with a great deal of each time he shaves.
information about our external  Most cells of the epidermis are
environment. They alert us to bumps and keratinocytes (keratin cells), which
the presence of tissue-damaging factors produce keratin, the fibrous protein that
as well as to the feel of wind in our hair makes the epidermis a tough protective
and a caress. layer.
 The deepest cell layer of the epidermis,
the stratum basale, lies closest to the
Structure of the Skin dermis and is connected to it along a
 The skin is composed of two kinds of tissue. wavy borderline that resembles
The outer epidermis is made up of stratified corrugated cardboard. This basal layer
squamous epithelium that is capable of contains the most adequately nourished
keratinizing, or becoming hard and tough. The of the epidermal cells because nutrients
underlying dermis is made up mostly of diffusing from the dermis reach them first.
dense connective tissue. These cells are constantly dividing, and
 The epidermis and dermis are firmly millions of new cells are produced daily;
connected and the dermis is fairly tear hence its alternate name, stratum
resistant. However, a burn or friction (such as germinativum ("germinating layer").
the rubbing of a poorly fitting shoe) may  The daughter cells are pushed upward,
cause them to separate, allowing interstitial away from the source of nutrition, to
fluid to accumulate in the cavity between the become part of the epidermal layers
layers, which results in a blister. closer to the skin surface. As they move
 Deep to the dermis is the subcutaneous away from the dermis and become part of
tissue, or hypodermis, which essentially is the more superficial layers, the stratum
adipose tissue. It is not considered part of the spinosum and then the stratum
skin, but it does anchor the skin to underlying granulosum, they become flatter and
organs and provides a site for nutrient (fat) increasingly full of keratin (keratinized).
storage. As they leave the stratum granulosum,
 Subcutaneous tissue serves as a shock they die, forming the clear stratum
absorber and insulates the deeper tissues lucidum. This latter epidermal layer is
from extreme temperature changes occurring not present in all skin regions. It occurs
outside the body. It is also responsible for the only where the skin is hairless and extra
curves that are more a part of a woman's thick, that is, on the palms of the hands
anatomy than a man's. and soles of the feet.
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 The outermost layer, the stratum  Inside the keratinocytes, the melanin forms a
corneum, is 20 to 30 cell layers thick but pigment umbrella over the superficial, or
it accounts for about three-quarters of the "sunny," side of their nuclei and shields their
epidermal thickness. The shingle-like
dead cell remnants, completely filled with genetic material (DNA) from the damaging
keratin, are referred to as cornified or effects of ultraviolet radiation in sunlight.
horny cells (cornu = horn). Freckles and moles are seen where melanin
 The stratum corneum rubs and flakes off is concentrated in one spot.
slowly and steadily as the dandruff
familiar to everyone. The average person
sheds about 18 kg (40 lb) of these flakes Epidermal Dendritic Cells
in a lifetime, providing a food source for
the dust mites that inhabit our homes and  Scattered in the epidermis are epidermal
bed linens. This layer is replaced by cells dendritic cells, which are important in alerting
produced by the division of the deeper and activating immune system cells to a
stratum basale cells. Indeed, we have a threat such as bacterial or viral invasion.
totally "new" epidermis every 25 to 45 Seen here and there at the epidermal-dermal
days. junction are Merkel cells, which are
associated with sensory nerve endings and
serve as touch receptors called Merkel discs.

2. DERMIS
 It is a strong, stretchy envelope that helps
to bind the body together.
 The dense (fibrous) connective tissue
making up the dermis consists of two
major regions - the papillary and the
reticular areas.
 Like the epidermis, the dermis varies in
thickness. For example, it is particularly
thick on the palms of the hands and soles
of the feet but is quite thin on the eyelids.
 The papillary layer is the upper dermal
region. It is uneven and has peg-like
projections from its superior surface,
called dermal papillae (papill = nipple),
which indent the epidermis above.
 Many of the dermal papillae contain
Melanin capillary loops, which furnish nutrients to
 Melanin, a pigment that ranges in color from the epidermis. Others house pain
yellow to brown to black, is produced by receptors (free nerve endings) and touch
special spider-shaped cells called receptors. On the palms of the hands and
melanocytes, found chiefly in the stratum soles of the feet, the papillae are
basale. When the skin is exposed to sunlight, arranged in definite patterns that form
which stimulates the melanocytes to produce looped and whorled ridges on the
more of the melanin pigment, tanning occurs. epidermal surface that increase friction
 As the melanocytes produce melanin, it and enhance the gripping ability of the
accumulates within them in membrane-bound fingers and feet. Papillary patterns are
granules called melanosomes. These genetically determined. The ridges of the
granules then move to the ends of the fingertips are well provided with sweat
melanocytes' spidery arms, where they are pores and leave unique, identifying films
taken up by nearby keratinocytes. of sweat called fingerprints on almost
anything they touch.
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 The reticular layer is the deepest skin Skin Color

layer. It contains irregularly arranged
connective tissue fibers, as well as blood Three pigments contribute to skin color:
vessels, sweat and oil glands, and deep 1. The amount and kind (yellow, reddish brown,
pressure receptors called lamellar or black) of melanin in the epidermis.
corpuscles. Phagocytes found here (and, 2. The amount of carotene deposited in the
in fact, throughout the dermis) act to stratum corneum and subcutaneous tissue.
prevent bacteria that have managed to (Carotene is an orange-yellow pigment
get through the epidermis from plentiful in carrots and other orange, deep
penetrating any deeper into the body. yellow, or leafy green vegetables.) The skin
 Both collagen and elastic fibers are found tends to take on a yellow-orange cast when
throughout the dermis. the person eats large amounts of carotene-
 Collagen fibers are responsible for rich foods.
the toughness of the dermis; they 3. The amount of oxygen-rich hemoglobin
also attract and bind water and thus (pigment in red blood cells) in the dermal
help to keep the skin hydrated. blood vessels.
 Elastic fibers give the skin its
elasticity when we are young. People who produce a lot of melanin have brown-
 As we age, the number of collagen toned skin. In light-skinned (Caucasian) people,
and elastic fibers decreases, and the who have less melanin, the crimson color of
subcutaneous tissue loses fat. As a oxygen-rich hemoglobin in the dermal blood
result, the skin loses its elasticity and supply flushes through the transparent cell layers
begins to sag and wrinkle. above and gives the skin a rosy glow.
 The dermis is abundantly supplied with
blood vessels that play a role in
maintaining body temperature
homeostasis. Appendages of the Skin
 When body temperature is high, the  The skin appendages include cutaneous
capillaries of the dermis become glands, hair and hair follicles, and nails. Each
engorged, or swollen, with heated of these appendages arises from the
blood, and the skin becomes epidermis and plays a unique role in
reddened and warm. This allows maintaining body homeostasis.
body heat to radiate from the skin
surface.
 If the environment is cool and body 1. CUTANEOUS GLANDS
heat must be conserved, blood  The cutaneous glands are all exocrine
bypasses the dermis capillaries glands that release their secretions to the
temporarily, allowing internal body skin surface via ducts. They fall into two
temperature to stay high. groups: sebaceous glands and sweat
glands. As these glands are formed by
the cells of the stratum basale, they push
into the deeper skin regions and
ultimately reside almost entirely in the
dermis.

A. Sebaceous (Oil) Glands

 The sebaceous glands, or oil glands, are
found all over the skin, except on the
palms of the hands and the soles of the
feet. Their ducts usually empty into a hair
follicle, but some open directly onto the
skin surface.
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 The product of the sebaceous glands,  Sweat is acidic (pH from 4 to 6), a
sebum (seb = grease), is a mixture of characteristic that inhibits the growth of
oily substances and fragmented cells. certain bacteria, which are always
 Sebum is a lubricant that keeps the skin present on the skin surface.
soft and moist and prevents the hair from  Typically, sweat reaches the skin surface
becoming brittle. Sebum also contains via a duct that opens externally as a
chemicals that kill bacteria, so it is funnel-shaped pore.
important in preventing the bacteria  The eccrine sweat glands are an
present on the skin surface from invading important and highly efficient part of the
the deeper skin regions. The sebaceous body's heat-regulating equipment. They
glands become very active when male are supplied with nerve endings that
sex hormones are produced in increased cause them to secrete sweat when the
amounts (in both sexes) during external temperature or body temperature
adolescence. Thus, the skin tends to is high.
become oilier during this period of life.  When sweat evaporates off the skin
surface, it carries large amounts of body
heat with it. On a hot day, it is possible to
lose up to 7 liters of body water in this
way. The heat-regulating functions of the
body are important - if internal
temperature changes more than a few
degrees from the normal 37°C (98.2°F),
life-threatening changes occur in the
body.

ii. Apocrine Sweat Glands

 Apocrine glands are largely confined to
the axillary (armpit) and genital areas of
the body. They are usually larger than
eccrine glands, and their ducts empty into
hair follicles.
 Their secretion contains fatty acids and
proteins, as well as all the substances
B. Sweat Glands present in eccrine secretion;
 Sweat glands, also called sudoriferous consequently, it may have a milky or
(sudor = sweat) glands, are widely yellowish color. The secretion is odorless,
distributed in the skin. Their number is but when bacteria that live on the skin
staggering more than 2.5 million per use its proteins and fats as a source of
person. nutrients for their growth, it takes on a
 There are two types of sweat glands, musky, unpleasant odor.
eccrine and apocrine.  Apocrine glands begin to function during
puberty under the influence of androgens
(male sex hormones). Although their
i. Eccrine Sweat Glands secretion is produced almost
 The eccrine glands are far more continuously, apocrine glands play a
numerous and are found all over the body. minimal role in thermoregulation. Their
They produce sweat, a clear secretion precise function is not yet known, but
that is primarily water plus some salts they are activated by nerve fibers during
(sodium chloride), vitamin C, traces of pain and stress and during sexual
metabolic wastes (ammonia, urea, uric foreplay.
acid, and lactic acid (a chemical that
accumulates during vigorous muscle
activity).
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 Each hair consists of a central core called

the medulla surrounded by a bulky
cortex layer. The cortex is, in turn,
enclosed by an outermost cuticle formed
by a single layer of cells that overlap one
another like shingles on a roof. This
arrangement of the cuticle cells helps to
keep the hairs apart and keeps them from
matting. The cuticle is the most heavily
keratinized region; it provides strength
and helps keep the inner hair layers
tightly compacted.
 Because it is most subject to abrasion,
the cuticle tends to wear away at the tip
of the shaft, allowing the keratin fibrils in
the inner hair regions to frizz out, a
phenomenon called "split ends." Hair
pigment is made by melanocytes in the
hair bulb, and varying amounts of
different types of melanin (yellow, rust,
brown, and black) combine to produce all
varieties of hair color from pale blond to
2. HAIR AND HAIR FOLLICLES pitch black.
 There are millions of hairs scattered all  Hairs come in a variety of sizes and
over the body. But, other than serving a shapes. They are short and stiff in the
few minor protective functions - such as eyebrows, long and flexible on the head,
guarding the head against bumps, and usually nearly invisible almost
shielding the eyes (via eyelashes), and everywhere else. When the hair shaft is
helping to keep foreign particles out of oval, hair is smooth and silky and the
the respiratory tract (via nose hairs) - our person has wavy hair. When the shaft is
body hair has lost much of its usefulness. flat and ribbon-like, the hair is curly or
Hair served early humans (and still kinky. If it is perfectly round, the hair is
serves hairy animals) by providing straight and tends to be coarse. Hairs are
insulation in cold weather, but now we found all over the body surface except
have other means of keeping warm. the palms of the hands, soles of the feet,
nipples, and lips.
 Humans are born with as many hair
A. Hair follicles as they will ever have, and hairs
 A hair, produced by a hair follicle, is a are among the fastest growing tissues in
flexible epithelial structure. That part of the body. Hormones account for the
the hair enclosed in the follicle is called development of hairy regions the scalp
the root. The part projecting from the and, in the adult, the pubic and axillary
surface of the scalp or skin is called the areas.
shaft.
 A hair forms by division of the well-
nourished stratum basale epithelial cells
in the matrix (growth zone) of the hair
bulb at the inferior end of the follicle. As
the daughter cells are pushed farther
away from the growing region, they
become keratinized and die. Thus the
bulk of the hair shaft, like the bulk of the
epidermis, is dead material and almost
entirely protein.
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

B. Hair Follicles  The stratum basale of the epidermis

 Hair follicles are actually compound extends beneath the nail as the nail bed.
structures. The inner epidermal sheath Its thickened proximal area, called the
is composed of epithelial tissue and nail matrix, is responsible for nail growth.
forms the hair. The outer dermal sheath As the nail cells are produced by the
is actually dermal connective tissue. This matrix, they become heavily keratinized
dermal region supplies blood vessels to and die. Thus, nails, like hairs, are mostly
the epidermal portion and reinforces it. nonliving material.
Its nipple-like papilla provides the blood  Nails are transparent and nearly colorless,
supply to the matrix in the hair bulb. but they look pink because of the rich
 Small bands of smooth muscle cells - blood supply in the underlying dermis.
arrector pili ("raiser of hair") - connect The exception to this is the region over
each side of the hair follicle to the dermal the thickened nail matrix that appears as
tissue. When these muscles contract (as a white crescent and is called the lunule
when we are cold or frightened), the hair  (lunul = crescent).
is pulled upright, dimpling the skin  When the supply of oxygen in the blood is
surface with "goose bumps." This action low, the nail beds take on a cyanotic
helps keep animals warm in winter by (blue) cast.
adding a layer of insulating air to the fur.
It is especially dramatic in a scared cat,
whose fur actually stands on end to make
it look larger to scare off its enemy.
However, this hair-raising phenomenon is
not very useful to human beings.

Homeostatic Imbalances of the Skin

 Loss of homeostasis in body cells and
organs reveals itself on the skin, sometimes
in startling ways. The skin can develop more
than 1,000 different ailments. The most
common skin disorders are bacterial, viral, or
fungal infections. Less common, but far more
damaging to body well-being, are burns and
3. NAILS skin cancers.
 A nail is a scale-like modification of the
epidermis that corresponds to the hoof or 1. DECUBITUS ULCER
claw of other animals.  Any restriction of the normal blood supply
 Each nail has a free edge, a body (visible to the skin results in cell death and, if
attached portion), and a root (embedded severe or prolonged enough, skin ulcers.
in the Skin). The borders of the nail are  Decubitus ulcers (bedsores) occur in
overlapped by skin folds, called nail folds. bedridden patients who are not turned
The edge of the thick proximal nail fold is regularly or who are dragged or pulled
commonly called the cuticle. across the bed repeatedly.
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 The weight of the body puts pressure on  First, the body loses its precious supply
the skin, especially over bony projections. of fluids containing proteins and
Because this pressure restricts the blood electrolytes as these seep from the
supply, the skin becomes pale or burned surfaces. Dehydration and
blanched at pressure points. At first, the electrolyte imbalance follow and can lead
skin reddens when pressure is released, to a shutdown of the kidneys and
but if the situation is not corrected, the circulatory shock (inadequate circulation
cells begin to die, and small cracks or of blood caused by low blood volume). To
breaks in the skin appear at compressed save the patient, lost fluids must be
sites. replaced immediately.
 Permanent damage to the superficial  Later, infection becomes the most
blood vessels and tissue eventually important threat and is the leading cause
results in degeneration and ulceration of of death in burn victims. Burned skin is
the skin. sterile for about 24 hours.
 The dermis also has a rich nerve supply.  But after that, pathogens such as bacteria
As mentioned earlier, many of the nerve and fungi easily invade areas where the
endings have specialized receptor end- skin has been destroyed and multiply
organs that send messages to the central rapidly in the nutrient-rich environment of
nervous system for interpretation when dead tissues. To make matters worse,
they are stimulated by environmental the patient's immune system becomes
factors (pressure, temperature, and the depressed within one to two days after
like). severe burn injury.
 Burns are classified according to their
severity (depth) as first-, second-, or
third-degree burns:
 In first-degree burns, only the
epidermis is damaged. The area
becomes red and swollen. Except for
temporary discomfort, first-degree
burns are not usually serious and
generally heal in two to three days
without any special attention.
Sunburn is usually a first-degree
burn.
 Second-degree burns involve injury
to the epidermis and the upper
region of the dermis. The skin is red
and painful, and blisters appear.
Because sufficient numbers of
epithelial cells are still present, re-
growth (regeneration) of the
epithelium can occur. Ordinarily, no
permanent scars result if care is
2. BURNS taken to prevent infection. First- and
 A burn is tissue damage and cell death second-degree burns are referred to
caused by intense heat, electricity, as partial thickness burns.
ultraviolet radiation (sunburn), or certain
chemicals (such as acids), which
denature proteins and cause cell death in
the affected areas.
 When the skin is burned and its cells are
destroyed, two life-threatening problems
result.
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Human Anatomy and Physiology
with Pathophysiology

 Third-degree burns destroy the  Cold sores usually occur around the lips
entire thickness of the skin, so these and in the oral mucosa of the mouth.
burns are also called full-thickness
burns. The burned area appears
blanched (gray-white) or blackened,
and because the nerve endings in
the area are destroyed, the burned
area is not painful. In third-degree
burns, regeneration is not possible,
and skin grafting must be done to
cover the underlying exposed tissues.
6. CONTACT DERMATITIS
 Itching, redness, and swelling of the skin,
3. ATHLETE'S FOOT progressing to blistering. It is caused by
 An itchy, red, peeling condition of the skin exposure of the skin to chemicals (such
between the toes, resulting from fungus as those in poison ivy) that provoke
infection. Also called tinea pedis. allergic responses in sensitive individuals.

4. BOILS AND CARBUNCLES

 Inflammation of hair follicles and 7. IMPETIGO (impet = an attack).
sebaceous glands, common on the dorsal  Pink, water-filled, raised lesions
neck. Carbuncles are composite boils (commonly around the mouth and nose)
typically caused by bacterial infection that develop a yellow crust and eventually
(often Staphylococcus aureus). rupture. Caused by a highly contagious
Staphylococcus infection, impetigo is
common in elementary school-aged
children.

5. COLD SORES (FEVER BLISTERS)

 Small fluid-filled blisters that itch and
sting, caused by a herpes simplex 8. PSORIASIS
infection. The virus localizes in a  A chronic condition, characterized by
cutaneous nerve, where it remains overproduction of skin cells that results in
dormant until activated by emotional reddened epidermal lesions covered with
upset, fever, or UV radiation. dry, silvery scales that itch, burn, crack,
and sometimes bleed. When severe,
psoriasis may be disfiguring.
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Human Anatomy and Physiology
with Pathophysiology

 It is believed to be an autoimmune  Basal cell carcinoma is relatively slow-

disorder in which the immune system growing, and metastasis seldom occurs
attacks a person's own tissues. Attacks before it is noticed. Full cure is the rule in
are often triggered by trauma, infection, 99 percent of cases in which the lesion is
hormonal changes, or stress. removed surgically.

B. Squamous Cell Carcinoma

 Squamous cell carcinoma arises from the
cells of the stratum spinosum. The lesion
appears as a scaly, reddened papule
(small, rounded elevation) that gradually
forms a shallow ulcer with a firm, raised
border.
 This variety of skin cancer appears most
often on the scalp, ears, dorsum of the
hands, and lower lip. It grows rapidly and
metastasizes to adjacent lymph nodes if
not removed.
 This epidermal cancer is also believed to
9. SKIN CANCER
be sun-induced. If it is caught early and
 Numerous types of neoplasms (tumors)
removed surgically or by radiation
arise in the skin. Most skin neoplasms
therapy, the chance of complete cure is
are benign and do not spread
good.
(metastasize) to other body areas. (A
wart caused by a virus is one such
example.)
 However, some skin neoplasms are
malignant, or cancerous, and they tend to
invade other body. areas. Indeed, skin
cancer is the single most common type of
cancer in humans. The most important
risk factor is overexposure to ultraviolet
radiation in sunlight. Frequent irritation of
the skin by infections, chemicals, or
physical trauma also seems to be a
predisposing factor.

C. Malignant Melanoma
A. Basal Cell Carcinoma
 Malignant melanoma is a cancer of
 Basal cell carcinoma is the least
melanocytes. It accounts for only about 5
malignant and most common skin cancer.
percent of skin cancers, but its incidence
Cells of the stratum basale, altered so
is increasing rapidly and it is often deadly.
that they cannot form keratin, no longer
 Melanoma can begin wherever there is
honor the boundary between epidermis
pigment; most such cancers appear
and dermis. They proliferate, invading the
spontaneously, but some develop from
dermis and subcutaneous tissue. The
pigmented moles. It arises from
cancer lesions occur most often on sun-
accumulated DNA damage in a skin cell
exposed areas of the face and appear as
and usually appears as a spreading
shiny, dome-shaped nodules that later
brown to black patch that metastasizes
develop a central ulcer with a "pearly"
rapidly to surrounding lymph and blood
beaded edge.
vessels.
 CBIHS - Pharmacy
Human Anatomy and Physiology
with Pathophysiology

 The chance for survival is about 50

percent, and early detection helps. The
American Cancer Society suggests that
people who sunbathe frequently or attend
tanning parlors examine their skin
periodically for new moles or pigmented
spots and apply the ABCD rule for
recognizing melanoma:
 (A) Asymmetry. The two sides of the
pigmented spot or mole do not match.
 (B) Border irregularity. The borders
of the-lesion are not smooth but
exhibit indentations.
 (C) Color. The pigmented spot
contains areas of different colors
(blacks, browns, tans, and
sometimes blues and reds).
 (D) Diameter. The spot is larger than
6 millimeters (mm) in diameter (the
size of a pencil eraser).