| • An area of normal thin skin showing the epidermis towards the top of the image and the dermis occupying the rest of the picture.
• A single hair follicle is seen towards the center bottom of this picture showing the attached sebaceous glands slightly above the center bottom.
• Notice the multiple bundles of collagen cut in many different plains that comprise much of the dermis. |
| Normal |
| Etiology |
• Not applicable. |
| Pathogenesis |
• Not applicable. |
| Epidemiology |
• Not applicable. |
| Clinical |
• Not applicable. |
| General Gross Description |
•Grossly, the skin is a membranous structure that covers
the body and forms an interface between the external
environment and the internal structures.
•The level of pigmentation varies among ethnic groups.
•It varies in thickness from being extremely thick on
the palm and soles to being exceedingly thin, such as
over the upper and lower eye lids.
•The skin is covered with fine to coarse hairs over the entire body, except for a few areas, including the palms and soles, the skin covering the penis in males and clitoris in females, the inner margins of the labia and the lateral margin of the foot. |
| General Micro Description |
•Histologically, the skin is composed of two distinct
regions, the epidermis and the dermis or corium.
•The epidermis is a classical stratified squamous
epithelium.
•The precise structure of the stratified squamous
epithelium differs somewhat from region to region.
•In extremely thick skin, such as the sole of the foot
and the palm of the hand, there are five layers,
whereas in other parts of skin, there might only be
four.
•The constant feature of stratified squamous epithelium
is a basal layer or stratum germinativum.
•It is a single layer of cuboidal cells with relatively
large nuclei and a basophilic cytoplasm and is the
only layer where cell division normally occurs in
stratified squamous epithelium.
•Interspersed among these cells are other cells, such as
the neural crest derived melanocytes.
•As basal cells divide, they do so asymmetrically, with
one daughter cell remaining attached to the basement
membrane and the other proceeding up towards the
external surface.
•The layer immediately above the basement layer is the
stratum spinosum, so called because in routine
histological sections, the cells appear to be connected
to each other by spinous processes.
•These processes actually represent desmosomes between
adjacent cells.
•Shrinkage of cells during the fixation process results
in retraction of the cells from each other except at the
desmosomes, where because of the tight junctions, the
plasma membranes cannot separate.
•This gives rise to the appearance of a spinous
connection between the two adjacent cells; also termed "intercellular bridges". •The stratum spinosum is normally three to four cell
layers thick.
•Above the stratum spinosum is the granular cell layer
characterized by the accumulation of strongly
basophilic staining granules.
•In addition, the cytoplasm becomes significantly more
prominent and the nucleus-cytoplasm ratio decreases
significantly.
•The nucleus also is elongated and lies with
the long axis parallel to the basement membrane.
•The granular cell layer is three to four layers thick
in thick skin but may be significantly less in thin
skin.
•Above the granular cell layer, particularly in thick
skin, is a stratum lucidum with further accumulation of
cytoplasm and granules and markedly condensed nuclei
that lie with their long axes parallel to the basement
membrane.
•Lying above the stratum lucidum is a stratum corneum,
where the cells have essentially lost their nuclei.
•The layer is composed of dead, scaly cells,
significantly extended in the axis parallel to the
basement membrane.
•The cells desquamate into the external surface.
•The skin is also characterized by the presence of
adnexae, including hair follicles, sweat glands of two
types (eccrine and apocrine) and sebaceous glands.
•The dermis is composed of two areas, the reticular
dermis and the papillary dermis.
•The papillary dermis projects as round pegs into the
overlying epidermis.
•On either side of the papillary dermal peg is a
projection of epidermis called the rete peg.
•While cross-sections give this the appearance of this
being a projection into the dermis, it is the cut
columns that give rise to this appearance.
•The papillary dermis also contains numerous blood
vessels and muscles that are attached to the epidermis.
•It is composed of Type III collagen.
•The reticular dermis is composed
primarily of Type I collagen with numerous bundles that
lie essentially along the long axis of the basement
membrane, but may have other bundles running in other
directions.
•The reticular dermis also contains numerous sensory structures that can detect pain, pressure and temperature change. |
| Reference |
| Fawcett DW. Bloom and Fawcett a textbook of histology. 12th
ed. New York: Chapman & Hall, 1994, pp
Gray H. Gray^s Anatomy, 15th Edition. New York: Barnes & Noble,
Books, 1995, pp [65] et seq.
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