Introduction to skin
Dr. Somaya Taha Saleem
Objectives:
1- Describe the functions of the skin
2- Identify the major structures found in
the three layers of the skin.
3. Define some common
dermatopathological disorders.
Skin
Skin is an organ because it consists of
different tissues that are joined to perform a
specific function.
Largest organ of the body in surface area
and weight.
Dermatology is the medical specialty
concerning the diagnosing and treatment of
skin disorders.
Physiology (function)
1- Protection
- physical barrier - mechanical barrier is part of
non specific immunity
2- Regulation of body temperature
- 3-Sensation
4- Excretion
6- Synthesis of Vitamin D (cholecalciferol)
Anatomy (structure)
Epidermis (thinner outer layer of skin)
Dermis (thicker connective tissue layer)
Hypodermis (subcutaneous layer or Sub-Q)
Muscle and bone
• 1) Epidermis: keratinized stratified squamous
epithelium with four distinct cell types and five
distinct layers.
Cells in the epidermis:
- keratinocytes -produce keratin (fibrous protein)
- melanocytes - cells produce melanin
- Merkel cells
- Langerhans’ cells - epidermal dendritic cells
(macrophages)
5 layers of the epidermis:
1- Stratum corneum (horny layer)
- dead cells filled with keratin
- continuously shed and replaced (desquamation)
2- Stratum lucidum
3- Stratum granulosum
4- Stratum spinosum: “spiny layer”
5- Stratum basale: deepest epidermal layer
- attached to dermis - mostly columnar keratinocytes
with rapid mitotic division
- contain merkel cells and melanocytes
Stratum corneum
Stratum lucidum
Stratum
Stratum
granulosum
spinosum
Stratum
basale
2) Dermis:
- flexible and strong connective tissue
- elastic, reticular and collagen fibers
- cells: fibroblasts, macrophages (WBC),
mast cells (histamine).
- nerves, blood and lymphatic vessels
- sebaceous and sweat glands originate
- two layers: papillary and reticular
3) Hypodermis
- called subcutaneous, Sub-Q or superficial fascia
- contains adipose tissue and blood vessels
Dermatopathological terms –
MACROSCOPIC TERMS
• Macule – flat spot on skin with color <5 mm
(freckle)
• Patches are flat but larger than macules > 5
mm.
• Wheal – round and temp. elevation of skin
(hives)
• Papule - solid elevated area, epidermal and
papillary (insect bite) <5mm
• Plaques are raised lesions > 5 mm
• Nodule - large papules extending into
subcutaneous layer (cyst)
Dermatopathological terms
• Vesicle - papule with fluid core (varicella
zoster virus) <5 mm
• Bulla: Fluid-filled raised lesion >5 mm.
• Pustule - papule with pus core (acne)
• Xeroderma - "dry skin"
• Hemangiomas - benign tumor in the dermis
(capillary and cavernous)
Micro-scopic (histologic) TERMS
Hyperkeratosis: Thickening of the stratum corneum,
Parakeratosis: Modes of keratinization characterized by the
retention of the nuclei in the stratum corneum.
Hypergranulosis: Hyperplasia of the stratum granulosum,
often due to intense rubbing.
Acanthosis: Diffuse epidermal hyperplasia.
Papillomatosis: Surface elevation caused by hyperplasia
and enlargement of contiguous dermal papillae.
Dyskeratosis: Abnormal keratinization occurring
prematurely within individual cells or groups of cells below
the stratum granulosum. Generally the same as DYSPLASIA.
Acantholysis: Loss of intercellular connections resulting in
loss of cohesion between keratinocytes.
Micro-scopic (histologic) TERMS
Spongiosis: Intercellular edema of the epidermis.
Hydropic swelling (ballooning): Intracellular edema of
keratinocytes.
Exocytosis: Infiltration of the epidermis by inflammatory or
circulating blood cells.
Erosion: Discontinuity of the skin exhibiting incomplete loss
of the epidermis.
Ulceration: Discontinuity of the skin exhibiting complete loss
of the epidermis and often of portions of the dermis and even
subcutaneous fat.
Vacuolization: Formation of vacuoles within or adjacent to
cells; often refers to basal cell-basement membrane zone
area.
Lentiginous: Referring to a linear pattern of melanocyte
proliferation within the epidermal basal cell layer.
SKIN PATHOLOGY
•DEGENERATION
•INFLAMMATION, i.e., DERMATOSES
•NEOPLASMS: Epidermis, Dermis,
Benign, Malignant
•Thank you
