13.1.

1 Structure of the skin

Functions of the Skin
Physical protection
UV light protection
Bacterial defence
Prevent fluid loss
Regulate body temp
Sensation
Immunological surveillance

Epidermis

Composed of stratified squamous epithelium

Derived from ectoderm
Epidermal cells under go keratinization in which their cytoplasm is replaced
with keratin as the cell dies and becomes more superficial
Five layers:
1. Stratum germinativum (=basale) basal layer cytoplasmic projections
to link with basal lamina, only actively proliferating layer, contains
melanocytes BCC originates here
2. Stratum spinosum prickle cell layer large keratinocytes that produce
keratin, joined together with tonofibrils (prickles) SCC originates here
3. Stratum granulosum contains mature keratinocytes with cytoplasmic
granules of keratohyalin, gives a granular appearance. Site of protein
synthesis
4. Stratum lucidum clear layer of dead cells found in thick skin of palms
and feet only. Contains eleidin, which is clear and an intermediate form of
keratin
5. Stratum corneum non-viable keratinized cells, thick cells protect against
trauma, insulated against fluid loss, protects against invasion. Sebum
produced by the sebaceous glands of the stratum corneum is
bactericidal to both staphs and streps.

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Cellular composition of the Epidermis

Keratinocytes are the predominant cell type

Langerhans cells part of immune system antigen presenting cells
Merkel cells mechanoreceptors of neural crest origin
Melanocytes from neural crest, in stratum germinativum, produce melanin.

The Dermis

95% thickness of skin

Papillary is superficial more cells + finer collagen fibres
Reticular deep less cells + coarser collagen

Collagen Fibres
Fibres Produced by fibroblasts
Responsible for strength of dermis
Type 1 to Type 3 = 5:1(or 4:1 depending on who you speak to)
Elastin fibres
Secreted by fibroblasts
Responsible for elastic recoil
Ground Substance
Consists of glycosaminoglycans (GAGs),= hyaluronic acid, dermatan sulphate
and chondroitin sulphate.
GAGs are secreted by fibroblasts and become ground substance when
hydrated
Vascular Plexus
Separates the denser reticular dermis from the overlying papillary dermis
Skin Appendages

Hair follicles
o Each hair is composed of a medulla, cortex and outer cuticle
o The hair follicle consists of an inner root sheath derived from the
epidermis and an outer root sheath derived from the dermis.
o Several sebaceous glands drain into each follicle. Discharge is aided
by the contraction of the erector pili muscles.
o Vellus hairs are fine and downy, terminal hairs are coarse.
o Hairs are either in anagen (growth phase) 75% or telogen (resting)
25%.

Eccrine glands (Merocrine)

o Sweat glands odourless hypotonic fluid
o All over the body
o Esp. on eyelids, palms, feet and axillae
o Secrete opened vesicles by exocytosis

Apocrine glands
o Axilla and groins
o Thicker secretion body odour
o Hidradenitis suppurativa = infection of apocrine glands
o Secrete unbroken vesicles which later discharge.

Last printed 11/03/2012 00:51:00

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C:\Users\Zeeshan\Documents\My Dropbox\frcs(plast) notes and papers\Reinstalled frcsplast.com\1.
FRCS(Plast) Revision Notes\13. Micro & Flaps\13.1.1 Structure of the Skin.doc

Sebaceous glands
o Holocrine glands (whole cells later disintegrate) usually drain into
pilosebaceous units.
o They drain directly onto the skin in the labia, penis and tarsus
(meibomian glands)
o More frequently occur on forehead, nosed and cheek
o Not the sole cause of sebaceous cysts (these are epidermoid and
mostly contain keratin)

Histological Terms

Acanthosis hyperplasia of the epithelium

Papillomatosis depth of the corrugations at the junction between
epidermis and dermis
Hyperkeratosis thickness of the keratin layer
Parakeratosis nucleated cells at the skin surface.

Last printed 11/03/2012 00:51:00

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C:\Users\Zeeshan\Documents\My Dropbox\frcs(plast) notes and papers\Reinstalled frcsplast.com\1.
FRCS(Plast) Revision Notes\13. Micro & Flaps\13.1.1 Structure of the Skin.doc