Components of the integumental system:

A. Skin
B. Hair
C. Nail
D. Sweat gland
E. Sebaceous gland
F. Subcutaneous and deep fascia
G. Musculocutaenous junction around the body orifices
H. The breasts

General information:

A. The largest organ of the human body.

B. 15% of the total body weight.
C. A surface area of about 2 m2 .
D. Thickness of the skin ranges from 1.5 to 5.0 mm

*** It is continuous with the mucosae of the alimentary, respiratory and urogenital tracts, and fuses
with the conjunctiva at the margins of the eyelids, and with the lining of the lacrimal canaliculi at the
lacrimal puncta.

Functions:

A. A self-renewing interface between the body and its environment.

B. An effective barrier against microbial organisms.
C. Protects against mechanical, chemical, osmotic, thermal and ultraviolet radiation
damage.
D. An important site of immune surveillance against the entry of pathogens and the
initiation of primary immune responses.
E. Specific innate immune defences in the skin provide a resilient buffer against external
microorganisms.
F. Formation of vitamin D under the influence of ultraviolet B (UVB) radiation
G. Synthesis of cytokines and growth factors.
H. Skin is the target of a variety of hormones such as thyroxine, androgens and oestrogens.
I. Control of body temperature.
J. Involved in socio-sexual communication.
K. Signal emotional states by means of muscular and vascular responses.
L. A major sensory organ, richly supplied by nerve terminals and specialized receptors for
touch, temperature, pain and other stimuli,
M. Good frictional properties, assisting locomotion and manipulation by its texture.

Factors responsible for skin color:

 A. The amount of blood (and its degree of oxygenation) in the cutaneous circulation,
B. The thickness of the cornified layer,
C. The ratio of eumelanin (brown/black) and pheomelanin (red/yellow).

*** Melanin has a protective role against UV radiation and acts as a scavenger of harmful free radicals.

*** Racial variations in colour are mainly due to differences in the amount, type and distribution of
melanin and are genetically determined.

Clinical importance:

A. Racial variations in colour are mainly due to differences in the amount, type and distribution
of melanin and are genetically determined.
B. The earliest signs of many systemic disorders may be apparent in the skin.

Types of the skin:

A. The thick, hairless (glabrous) skin [forms the surfaces of the palms of the hands, soles of the
feet, and flexor surfaces of the digits].
B. The thinner, hairy type [covers large areas of the body].

Parts of the skin:

A. Epidermis
B. Dermis

The epidermis: a self-renewing stratified epithelial tissue.

Cells of the epidermis-

 A. Keratinocytes.
B. Melanocytes (pigment-forming cells from the embryonic neural crest),
C. Langerhans cells (immature antigen-presenting dendritic cells derived from bone
marrow),
D. Lymphocytes.
E. Merkel cells.

Cornification- Stem cells that reside in the basal layer of the epidermis transform from polygonal
living cells to non-viable flattened squames full of intermediate filament proteins (keratins) embedded in
a dense matrix of cytoplasmic proteins to form mature keratin. The process is known as cornification.

Layers of the epidermis:

A. The innermost layer is the basal layer (stratum basale).

B. The spinous or prickle cell layer (stratum spinosum).
C. Granular layer (stratum granulosum).
D. Clear layer (stratum lucidum).
E. Cornified layer (stratum corneum).
*** Turnover of keratinocytes is mediated by stem cells that reside in the basal layer of the epidermis.

*** The epidermal appendages (pilosebaceous units, sweat glands and nails) are formed
developmentally by the ingrowth of the epidermis.

Basal layer: the site of epidermal cellular proliferation.

Basal lamina: a thin layer of specialized extracellular matrix, not usually visible by light microscopy.

Layers-

A. A clear lamina lucida (adjacent to the basal cell plasma membrane).

B. A darker electron-dense lamina densa.

Components of Basement Membrane Zone (BMZ) at the dermoendodermal junction-

A. The basal plasma membrane of the basal keratinocytes.

B. The extracellular basal lamina (lamina lucida and lamina densa).
C. Anchoring fibrils composed of type VII collagen within the subjacent dermal matrix
(the lamina fibroreticularis).

Features of the basal keratinocytes:

A. Columnar to cuboidal in shape.

B. Large (relative to their cytoplasmic volume), mainly euchromatic nuclei and
prominent nucleoli.
C. The cytoplasm contains variable numbers of melanosomes and keratin filament
bundles corresponding to the keratin tonofilaments of classic electron microscopy.

*** Merkel cells are connected to keratinocytes by desmosomes.

*** Melanocytes and Langerhans cells lack these specialized contacts.

Structural beauty:
 A. Each group of basal cells consists of a central stem cell with an encircling ring of transit
amplifying proliferative cells and postmitotic maturing cells.
B. From the periphery of this unit, postmitotic cells transfer into the prickle cell layer.

*** The normal total epidermal turnover time is between 52 and 75 days.

Clinical importance: In some skin disorders, the turnover rates and transit times are significantly
shortened, e.g. in psoriasis, the total epidermal turnover time may be as little as 8 days.