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Dermatology?
Functions of the Skin
Sensation-
Immune function-
Thermoregulation-
Cutaneous absorption
Functions of the Skin
Excretion
Vitamin D synthesis-
UV light for 10-15 minutes.
Skin Anatomy
Layers
Epidermis- outermost, no blood vessels or blood
supply.
Stratum lucidum-
palms and soles of feet only.
Skin Anatomy
Epidermis-5 Layers
Stratum granulosum-
Most differentiated layer.
Skin Anatomy
Epidermis-5 Layers
Stratum spinosum-
Has desmosomes (spiny
projections and so spinosum).
Skin Anatomy
Epidermis-5 Layers
Stratum basale-
deepest layer of the epidermis.
Consists of a single layer of
keratinocytes.
Skin Anatomy
Epidermis-Cell Types
Melanocytes-
Produce melanin. Not many melanocytes in soles
or palms.
Albinos lack tyrosinase
Cancer of a melanocyte known as melanoma
Skin Anatomy
Epidermis-Cell Types
Keratinocytes
Produce keratin
Immunology role-
Merkel’s cells- Free nerve endings attached to
epidermal cells.
Skin Anatomy
Epidermis-Cell Types
Langerhans cells
Found in epidermal layers with keratinocytes
Involved in cell-mediated hypersensitivity, antigen
processing and recognition, stimulation of immune
competent cells and graft rejection.
Skin Anatomy
Epidermis-Cell Types
Parakeratosis-Retention
of nuclei in stratum
corneum.
Spongiosis-Intercellular
edema of the epidermis.
Skin Anatomy
Basement membrane(Basal
lamina)
Selectively filters molecules
moving between two layers.
Immunoglobulin and
complement deposition in
skin disease.
Skin Anatomy
Dermis
Thickest skin
layer/connective tissue layer.
Composed of collagen, blood
vessels, nerves, hair follicles,
and sweat glands
Skin Anatomy
Subcutaneous Tissue
Eccrine glands and
deep hair follicles
extend to this layer
Insulator/shock
absorber/stores energy
as calories
Skin Anatomy
Appendages-Hair
Hair follicle associated with
sebaceous gland to form
pilosebaceous unit.
Growth is cyclic
Anagen phase-
Catagen-
Telogen phase-
Skin Anatomy
Appendages-Nails
Hardened keratinized plates
Skin Anatomy
Appendages-Glands
Sebaceous- Entire
skin surface except
palms, soles, sides of
feet. Secrete sebum
Skin Anatomy
Appendages-Glands
Sweat glands-
Eccrine-Originate in
dermis and open on skin
surface.
Apocrine- Large, deep in
dermal layer. Open
through a hair follicle.
Mostly in axillae and
groin.
Common Skin Lesions
Equal to plane of the Skin
Common Skin Lesions
Equal to plane of the Skin
Telangiectasia-
Common Skin Lesions
Equal to plane of the Skin
Petechiae-
Common Skin Lesions
Equal to plane of the Skin
Purpura or ecchymosis:
Common Skin Lesions
Equal to plane of the Skin
Sclerosis:
Common Skin Lesions
Equal to plane of the Skin
Lichenification:
Common Skin Lesions
Equal to plane of the Skin
Acanthosis
Common Skin Lesions
Above the plane of the Skin
Callus Corn
Common Skin Lesions
Above the plane of the Skin
papule Nodule
Common Skin Lesions
Above the plane of the Skin
Wheal
Plaque
Common Skin Lesions
Above the plane of the Skin
Vesicle-
Blister-
Bulla-
Common Skin Lesions
Above the plane of the Skin
Pustule-
Cyst-
Common Skin Lesions
Above the plane of the Skin
Tumor:
Common Skin Lesions
Above the plane of the Skin
Verruca:
Common Skin Lesions
Above the plane of the Skin
Scale/crust
Desquamation
Common Skin Lesions
Above the plane of the Skin
Exudate
Common Skin Lesions
Above the plane of the Skin
Comedone
Common Skin Lesions
Below the plane of the Skin
Excoriation
Common Skin Lesions
Below the plane of the Skin
Ulcer
Common Skin Lesions
Below the plane of the Skin
Fissure
Common Skin Lesions
Below the plane of the Skin
Excoriation
Common Skin Lesions
Below the plane of the Skin
Eschar
Disorders of Pigmentation and
Melanocytes Blanched
Vitiligo
Disorders of Pigmentation and
Melanocytes
Albinism
Disorders of Pigmentation and
Melanocytes
Melasma
Disorders of Pigmentation and
Melanocytes
Lentigo-
Due to melanocyte proliferation.
Can be due to hypermelanosis,
Addison’s disease,
Hemochromatosis, Acanthosis
nigricans
Hydroquinone may temporarily
bleach the spots Inhibit synthesis
of pigment
Common Skin Lesions
Based on Color- Erythema
Erythema
Common Skin Lesions
Based on Color- Blue
Cyanosis
Common Skin Lesions
Based on Color- yellow
Jaundice
Approach to patient
Lesion-
Physical Exam
Shape of the Lesion
Round
Oval
Polygonal
Annular
Serpiginous
Umbilicated
Physical Exam
Arrangement of lesions
Grouped: herpetiform, arciform, annulra,
reticulated, linear,
Physical Exam
Arrangement of lesions
Disseminated-
Physical Exam
Arrangement of lesions
Demarcated
Discrete
Physical Exam
Arrangement of lesions
Diffuse-
Physical Exam
Distribution of lesions
Extent:
Pattern:
Any characteristic patterns such as seen in acne, chicken
pox.