NAILS

● development begins in utero between week 7 and 8 and is fully formed at birth
● earliest sign of nail development in the dorsum of the finger seen at age 10 weeks
● Keratigenous zone - area which the process of keratinization (nail plate formation)
occurs
● acts as a protective covering to the end of the digits
● assists in grasping small objects
● nail organ is made up of differently keratinizing cells
● fingernail grows faster than the toenail
● the average rate of growth of the thumbnail is 0.10-0.12mm/day
● an increase rate of growth during summer and it slows down in the cold climate

Beau’s lines - horizontal ridges or dents in one or more of your fingernails and toenails; sign that
an illness, injury or skin condition interrupted your nail growth

Nail Unit consists of:

1. Nail matrix
2. Nail bed epithelium
3. Hyponychium
4. Proximal nail fold
5. Cuticle
6. Lateral nail folds
7. Dermis of the nail matrix and bed

Nail matrix
● sole structure to produce nail plate
● nail plate formation - a process of flattening of basal cells of the matrix, fragmentation of
the nuclei and condensation of the cytoplasm to form horny flat cells adherent to each
other
● makes up one quarter to one third of the entire nail unit
● hidden under the proximal nail fold except its most distal portion normally seen as the
whitish lunula
● Lunula - the visible portion of the matrix; the distal lunula border is convex and runs
parallel to the most proximal (or apical) matrix
● Nail plate - major part is roughly rectangular, flat in shape; the pink color of the nail is
due to extensive vascular network underneath the plate
● Dorsal section - contributes to the most superficial layers of the nail plate
● Intermediate region - forms the deeper layers
● Ventral subdivision - is the most distal part of the nail matrix and it is contributed by the
nail bed

Nail bed
● area starting from the lunula to the hyponychium
● does not contribute to the nail plate formation nor aid in the distal movement of the plate
 ● Nail bed epithelium- responsible for the firm attachment to the dermis of the nail bed

Hyponychium
● the first area of the nail to keratinize in embryonic life
● extends from the nail bed to the distal grove, skin underlying the free edge of the plate
● marking distal end of the nail bed, sealing the subungual space
● the horny layer that is produced tends to accumulate under the free edge of the nail
plate
● common site for diseases

Proximal nail fold

● folds of the skin that envelope the proximal and lateral nail part respectively as it
emerges from the matrix
● undersurface of which is the eponychium firmly attached to the underlying nail plate and
forming cuticle as its free end
● Two layers: (1) the dorsal portion of the dorsum of the finger epidermis and (2) the
ventral portion overlying the newly formed nail plate

Lateral nail folds

● framing the nail plate and giving support

Cuticle
● the horny layer of the ventral portion becomes adherent to the surface of the nail plate
and moves distally for a short distance
● seals the nail pocket

Dermis of the nail matrix and bed

● lies directly on the periosteum of bone
● dermis is limited by the underlying phalanx
● in the nail bed, the capillaries run in parallel manner in conformity with the dermal ridges
● Glomus body - a specialized vascular tissue that is common in this area and also in the
tip of the volar skin
● Nail matrix dermis - contains thin papillary and thick reticular layer; contributes to nail
plate production through an epithelial-mesenchymal interaction
● Nail bed dermis - has one relatively uniform compartment of collagen bundles and elastic
fibers, rich in vascular network; glomus bodies are present

HAIR
● a sense organ
● serves as thermal regulator and a protection against the sun
● human hair growth rate on scalp is 0.37-0.44mm/day or approximately 1cm/month
● women scalp hair grows faster than in men, while body hair grows more slowly in women
than in men
● the rate of growth of body hair is increased by androgen hormones
 ● first hair follicle rudiments appear in human by the 9th week of fetal development
● follicle formation begins on the head, and then moves downward to the remainder of the
body in utero
● no follicular destruction occur during postnatal development, only decrease in actual
density as the body surface increases
● no new follicle develops in adult skin

Homeobox genes - patterning genes; responsible for nonrandom and symmetric distribution of
hair follicles over the body

Engrailed - type of homeobox gene responsible for dorsal-ventral patterning

Hair development:
● Each follicle is formed by an interaction between dermal and epidermal components.
● First sign or “pregerm” is the crowding of nuclei in the basal layer of the epidermis and
the underlying accumulation of mesodermal nuclei.
● The epidermal structure grows downward as a column passing through development of
the “germ”, the “peg” and the “bulbous peg” stages.

Lanugo hair
● is the first hair to be produced by the fetal follicle
● fine, soft, unmedullated, and unusually unpigmented
● shed between 32nd and 36th weeks
● one-third of the newborns retain lanugo hair up to several weeks after birth

Postnatal hair
A. Vellus hair - soft, unmedullated, usually unpigmented; seldom more than 2cm long
B. Terminal hair - longer, coarse, and often medullated and pigmented
● The type of hair produced by any particular follicle can change, like the replacement of
vellus hair by terminal hair at puberty.
● It starts on the pubic region for both sexes.
● Axillary hair usually appears about two years after the beginning of pubic hair growth.

Two Main Parts of Hair:

1. Root - implanted in the skin
2. Shaft - area projecting from the surface

Bulb
● proximal enlargement of the hair root
● moulded over the papilla
● composed of polyhedral cells

Hair follicle
● consists of hair surrounded by the epithelial sheath that continuous with the epidermis
 ● hair bulb that is set in an invagination of the epidermis and the upper portion of the
dermis
● When the hair grows long, the follicle extends downwards into the subcutaneous layer
● On the skin surface it starts as a funnel shape opening and goes downward in oblique
direction.
● One or more sebaceous gland duct opens into the follicle near the skin surface.

Microscopic Anatomy:
● Upper follicle - infundibulum, isthmus
● Lower follicle - suprabulbar, bulbar

● Nutrition of the hair comes from the capillaries in the vascularized papilla at the bottom.
● Pigment is transferred by the melanocytes into the newly formed cells which are situated
near the apex of the dermal papilla.
● Its innervation comes from the continuation of the nerve endings of the dermal layer of
the follicle.
● Myelinated sensory nerve fibers run parallel to hair follicles, surrounding them forming a
network.

Types of nerve endings:

1. Free nerve endings - pain
2. Lanceolate nerve endings - acceleration
3. Merkel cells - pressure
4. Pilo-Ruffini structures - tension

The hair has two coats:

1. The outer or dermis - fibrous, continuous with the dermis which is vascular
2. The inner of epidermis - adherent to the root

The two strata of hair:

1. Outer root sheath - corresponds to the stratum spinosum and at the bottom of the follicle
it becomes continuous with the root of the hair follicle
2. Inner root sheath consists of:
a. Cuticle - a layer of imbricated cells with atrophied nucleus
b. Huxley’s layer - horny flattened nucleated cells
c. Henle’s layer - layer of cuboidal cells with clear flat nucleus

Hair shaft
● starts from the surface to its external length
● Medulla - composed of polyhedral cells with airspaces between or within the cells
● Cortex - chief part of the shaft where the cells are elongated and united containing
pigment granules in dark hair and air in white hair
● Cuticle - a single layer of overlapping flat cells
Hair shaft
● Medulla
● Cortex
● Cuticle

Inner root sheath

● Cuticle
● Huxley’s layer
● Henley’s layer
● Companion layer

Outer root sheath

Connective tissue sheath

Arrector pili muscle

● minute bundles of involuntary muscular fibers
● connected with the hair follicles
● When the muscle contracts, the skin over their origin is depressed, while the skin
immediately around the hair is elevated, this results in the appearance of “goose skin”
seen on exposure to cold or in emotional reactions.

Sebaceous gland - situated in the angle which the arrector pili muscle forma with the superficial
portion of the hair follicle

3 Stages of Hair Follicle Cycle:

1. Anagen - growth
2. Catagen - involution
3. Telogen - rest

Anagen
● the active period
● hair is well pigmented, healthy, and may last three or more years
● the expanded base becomes keratinized to form a club which is retained for a time
● length of anagen determines the final length of hair and varies according to body site
● approximately 90-93% of scalp follicles are in anagen and the rest in telogen
● Scalp hair - 2 or more than 8 years
● Legs - 5 to 7 months
● Arms - 1.5 to 3 months
● Eyelash - 1 to 6 months
● Fingers - 1 to 3 months

Catagen
● the transition phase
 ● there is thickening and corrugation of the membrane, part of the connective tissue
sheath, and the release of dermal papilla
● the resulting epithelial column below lengthens as the club hair moves towards the skin
surface

Telogen
● the resting phase
● completed by shortening from below of the epithelial strand until it is reduced to a small
“secondary germ”

● In human scalp at any one time, less than 1% of the follicles are in catagen stage and on
the average, about 13% are in telogen stage.