PHASE 1: WEEK 1 BASIC DERMATOLOGY

STRUCTURE OF THE SKIN EPIDERMIS HAS 5 LAYERS constituting a stratified squamous epithelium: 1. 2. 3. 4. 5. Stratum Basale (basal layer) Stratum Spinosum Stratum Granulosum Stratum Lucidum* Stratum Corneum

STRATUM BASALE (GERMINATIVUM) Deepest of 5 layers Continuous layer of epithelium only 2-3 cells thick (simple cuboidal / columnar) Made up of basal (germinative) cells (considered stem cells of epidermis) Divide to form keratinocytes of S. Spinosum Other cells include: Merkel (touch receptor) cells; Langerhans cells (immune cells); Melanocytes (pigment producing cells) K-5 and K-14 filaments bind cells of this layer to hemidesmosomes (basal lamina) and desmosomes (adjacent cells) Attached to basal lamina via HEMIDESMOSOMES Forms epidermal ridges which protrude into the dermis and interlock with dermal projections known as dermal papillae larger surface area = more strength of attachment

STRATUM SPINOSUM Numerous keratinocytes arranged in 8-10 layers Keratinocytes pushed superficially by continually dividing basal cells Adjacent cells bound via desmosomes Cells have spine-like projections only in histological preparations as cells shrink and pull apart leaving only points of attachment at desmosomes Keratinocytes produce coarser K-1 and K-10 intermediate filaments (tonofilaments) Langerhans cells and melanocyte projections from basal layer are present Some divisions occur in this layer as cells retain their ability to divide STRATUM GRANULOSUM 3-5 layers of keratinocytes undergoing apoptosis keratinocytes begin to synthesize large amounts of keratin and keratohyalin KERATOHYALIN forms dense cytoplasmic granules within the cell that promote cellular dehydration and aggregation and crosslinking of keratin intermediate filaments to form keratin Cells become thinner and flatter Cells stop dividing in this layer Organelles disintegrate and die as they move further from the dermal vessels and diffusion is no longer effective (Concomitantly) Keratinocytes secrete lamellar granules within the extracellular space between cells of the upper layers, promoting the formation of a hydrophobic lipid envelope; this acts as a water-repellant and sealant STRATUM LUCIDUM* *Only visible in palmoplantar / thick areas of skin (Lucida = clear) 4-6 layers of flattened, clear and dead keratinocytes containing large amounts of keratin thickened plasma membranes surrounded by exocytised oily substance consisting of proteins and lipids released by lamellar bodies STRATUM CORNEUM Outermost layer of epidermis Consists of up to 30 layers of flattened, dead keratinized keratinocytes No longer contain a nucleus or any organelles Cells in each layer of cells overlap Tightly interconnected by corneodesmosomes Cells are continually shed in the process of desquamation These cells are replaced by proliferating cells migrating from the basal layer renewal takes 15-30 days Cells form a protective barrier to underlying layers: - S. Cormeum is relatively dry and does not favour growth of microorganisms coted with water-repellant / sealant - Water-resistant but not waterproof as water escapes from interstitial fluids and penetrates surface (insensible perspiration); conversely, perspiration from sweat glands = sensible perspiration - (Burns victims are very vulnerable to excessive water losses in a condition known as xerosis in which exceedingly dry skin results by way of insensible perspiration becoming perilously high