Dr UJJWALA VERMA 1st yr Junior Resident Dept. of Skin and V.D.

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€ Sweating

is perhaps one the most visible physiological events we experience in our daily lives.

€ It

is only humans & apes who sweat.

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€

Three structurally & functionally distinguishable types of sweat glands exist in human skin: the eccrine , apocrine , & apoeccrine glands.

Eccrine glands are merocrine ,in that no breakdown of cellular materials occurs during secretion &the secretion is discharged by the fusion of the membranous walls of the secretory vesicles with the plasma membrane so that only the contents of the vesicles are released.
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€ In

apocrine glands, during secretion a small amount of cytoplasm is ´pinched offµ along with the secretory vesicles. € Eccrine glands are called atrichial since they develop from the superficial epidermis & remain independent of the hair follicle. € Apoccrine gland are called epitrichial ,because they develop from the external root sheath of the hair follicle & usually remain attached to it. € Eccrine gland produce eccrine sweat which are primarily involved in thermoregulation.
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5 .€ Apoeccrine gland or mixed glands have some of the morphological & functional features of both eccrine and apocrine glands and are found in adult human axilla &contribute to overall axillary sweating in the adult.

€ Density & distribution: ~Present almost everywhere on the human skin including glans penis & the foreskin. ear canal -clitoris.and -labia minora. ~ Absent on the ²vermillion border of the lips -nail bed . ~ 6 .ext.

0 mcgm ~aggregate wt in human skin = 00 gm ~Sweat gland density also varies with body size . males perspire more profusely than females & prepubertal children. density varies from glands/cm on the back 08 /cm ----forearm 8 /cm ----forehead 00-700/cm ----palms and soles ~ There are estimated .~their avg.million sweat gland on the body surface. ~each sweat gland weigh about 0. . 7 .& in general.

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Development: ~Embryologically . ~no new sweat glands are formed after birth. 9 . ~ by about eighth fetal month they resemble adult sweat glands.and a little later over the other parts of body. ~but are not functional until yr of age. eccrine sweat glands develop as specialised downgrowths of the epidermis at about the th month of intrauterine life of the volar surfaces of the hands & feet & in the th gestational month in axillae.

~Eccrine sweat glands possess. .situated in the lower third of the dermis or at dermo hypodermal interface. A spiral intraepidermal duct (acrosyringium) that opens directly on to the surface.€ Structure: ~simple tubular epithelial structures. ¡  . A straight intradermal ductal portion . Basal coiled portion called fundus or acinus. The whole length of secretory gland is surrounded by a thin fibrous sheath and an investing basal lamina.

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Secretory coils:.. -single layered str . made up of three distinct cell types :large clear cells (secretory) : small dark cell (mucoid) :myoepithelial cells 1 ¢ .mm in length .0-80micro m in diameter .

K-ATPase activity & the basolateral membrane is believed to be the sodium pump site & the site for active transport of ions during sweat secretion.  Instead they face one or more small intercellular canaliculi that are confluent with the lumen. € 13 .Clear cells are the cells pricipally responsible for sweat secretion.  The basal infoldings of the clear cells show marked Na.  Pyramidal shape  Bases resting partly on the basal lamina or on the myoepithelial cells  The cells infrequently reaches the lumen .  The cytoplasm are also rich in glycogen granules & mitochondria.

are probably secreted by the dark cells. 14 .the constituents of the human sweat . € PAS positive glycoprotiens .€ Dark cells occur either as cuboidal cells that rest on the clear cells or as inverted pyramidal cells with their wedge shaped cytoplasmic process extending towards the BM between clear cells € Dark cells occupy almost all the luminal surface of the secretory tubules .

 Not only provide mechanical support to the secretory coil wall against an Increase in in luminal hydrostatic pressure during sweat secretion .cells are discontinuous row of spindle shaped cells.  These cells are filled with masses of myofilaments  Arranged more or less parallel to the course of the secretory tubules . € Myoepithelial 15 .  Also help propel the sweat towards the surface.  Myoepithelial cells respond to cholinergic but not to adrenergic stimuli.

 Peripheral to myoepithelial cells lies a hyaline basement membrane zone containing collagen fibres that separate the glandular epithelium from the richly vascular connective tissue of the periadenexal dermis. 16 .

1 £ .cuboidal . The proximal (coiled) intradermal duct appears to be functionally more active than the distal (straight)portion. A dense layer of the tonofilament near the luminal membrane (pseudocuticle) gives a certain rigidity to the periluminal region & assures patency. The basal ductal cells are rich in mitochondria & the entire circumference of the cell membrane shows a strong Na-K-Atpase activity suggesting that the cells play a critical role in ductal sodium reabsorption. and -an outer ring of basal cells. and are deeply basophilic. The cells are small.an inner ring of luminal cells .Intradermal sweat duct:      The dermal ductal portion of the eccrine sweat gland is composed of two layer of cell : .

 Acrosyringeal cells contain desmosomes and occasionally melanocytes & cornify independently of the epidermis. It has enzyme systems.Acrosyringium: the intaepidermal sweat duct runs spirally from the base of the rete ridge to the surface.  Prior to keratinisation .and plays a critical role in the formation of final sweat 18 . acrosyrigeal lumen is lined by an eosinophilic cuticle.  Sweat duct is not an inert conducting channel. a liberal blood supply .  Consist of the single layer of inner or luminal cells & two or three rows of outer or basal cells.

principal function of eccrine glands is to produce sweat during periods of heat stress.  During heat stress. € The other major function is to moisten the skin of the palms & soles during periods of activity. of evaporated sweat removes 8 kilocalories of heat from the body.  One lit. L/hr can be maintained.  Each sweat gland during peak secretory activity may produce as much as 0nL per min.and a rate of . sweat rate of l/hr can attached .. € The 19 . thus improving their grip. a max.

€ Lactate in sweat may regulate desquamation of stratum corneum. 2 ¤ .€ Eccrine glands are also lesser organs of excretion and several substances are excreted in sweat € The presence of interleukins & proteolytics enzymes raises the possibilities that eccrine sweat can be potentially pro-inflammatory & is capable of modifying various dermatoses. € Eccrine sweat may also have mitogenic effects on ds such as psoriasis.

€ Thermoregulatory sweating ²believed to be controlled by thermo-sensitive neurons in the hypothalamus.Types of sweating sweat gland activity is controlled by three principle physiological stimuli: >thermal >emotional >gustatory. 21 . It mostly affects the upper trunk & face but may also involve the whole body.

Emotional stimuli-produces sweating on palms & soles. -axon & spinal reflexes. sensory stimuli arising from frontal or premotor areas (Brodman area )are involved. controlled by medullary nuclei. € Other factors:that may modify the quality &quantity of sweat in presence of an intact nerve nerve supply include-local temperature changes -periglandular vascular activity. -plasma electrolyte concentration -harmones (Androgens) € 22 . € Gustatory stimuli-induces sweating on the lips forehead & nose.

the most imp component of this network is the nucleus tractus solitarius located in the dorsomedial region of medulla oblongata.and -glandular receptors.  23 .The Sympathetic Sudomotor Pathway. -preganlionic effector pathways.  The overall chain of sympathetic command involves -central autonomic network . Eccrine sweating is the result of sympathetic activity . -post ganglionic sympathetic fibres. -periglandular neurotransmitters.

. triggering a sequence of event leading to sweat secretion. Elaboration of nearly isotonic .chiefly acetylcholine (Ach). Modification of the primary sweat through partial reabsorption of NaCl by the sweat duct to produce the ultimate secretory product .Mechanism of sweat secretion Stimulation of sympathetic neuronal outflow result in release of periglandular neurutransmitters . primary or precursor sweat from the interstitial fluid by the secretory coil through active transportation of electrolytes.the hypotonic eccrine sweat. ¥ 4 .Ach interacts with a special receptor in the secretory cell membrane . The formation of sweat within the eccrine sweat gland is a two step process and consist of .

€ Effect of aging on eccrine sweat glandular structure & function There is either a reduction in absolute number of eccrine sweat glands or in their functional capacity or both Microscopically. there is disarray &shrinkage of secretory cells & the lumen Lipofuscin granules within the secretory cells increases both in no.making them prone to heat stress. & size with the age The sweating response to dry heat is decrease in elderly individuals . 25 ‡ ‡ ‡ ‡ .

€ Similar in composition to plasma containing the same electrolytes. hypotonic solution with sp. € The sweat rate also influences the composition of the final secretory product because ductal modification of primary sweat is often a function of the flow rate. although in more dilute conc. € Eccrine sweat is an odorless. gr. Of . colorless.00 26 .

€ Constituents:- Na K Cl urea lactate glucose ammonia amino acid protiens(glycoprotiens& mucopolysaccharides) ¦ 2 .

Proteolytic enzymes.cysteine protienase -& their endogenous inhibitors Epidermal growth factor 28 . -Glandular kallikrein -Kininase -C1 esterase -urokinase .

test sympathetic axonal integrity  local pharmacological sweat test . or .intradermal inj.01% pilocarpine or methacholine  QSART(quantitative Sudomotor Axon Reflux Testing)  Galvanic skin resistance test € Visualization of individual sweat droplet -Iodine starch method € To 29 .iontophoretic application of 0.

scleroderma) € Determination 3 § . € Skin biopsy for absence or atrophy of sweat gland (in ds. -collection of sweat droplet under mineral oil -anaerobic bag method.of maximal sweat rate: -water vapour analyzer -the filter paper method. As anhidrotic ectodermal dysplasia.

develop from the primary epithelial germs or hair germs during the th to th month of intrauterine life.Development Apocrine glands together with hair and sebaceous glands . € Apocrine gland development is dependent on sex hormones and not their functional activity. € 31 .

-perineal -cicumoral areas -prepuce.Distribution: -axillae -areolae (montgomery·s tubercles) -periumbilical. -mons pubis -labia minora Modified apocrine glands -ceruminous glands in ext ear canal -the ciliary or Moll·s glands on the eyelids -mammary glands 32 .

Occasionally .can be found on the -face scalp abdomen(heterotopic) 33 .

€ The coiled secretory portion is situated in the lower dermis or in subcutaneous fat. Apocrine ducts ocassionally opens directly on the surface independently of the hair follicles. 34 . € Contains .& a straight excretory duct empties into the infundibulum of the hair follicle slightly above the entrance of the sebaceous duct.Structure: Larger than eccrine glands.secretory .ductal portion.

except in the apical portion .Secretory coil:      Simple convulated tubular str. Surrounding the secretory cell is a layer of contractile myoepithelial cells. 35 . Secretory cells possess an eosinophilic cytoplasm&. contains large PAS +ve & Diastase-resistance granules distributed around the nucleus. As wide as mm Lumen is lined by single layer of secretory cells which are either cuboidal or columnar depending upon stage of secretion.

or viscid . Distally. 36 .the epithelial of apocrine duct merge into the epithelium of the infundibular portion of the hair follicle.Ductal portion: ‡ ‡ ‡ Apocrine sweat duct is made up of a double layer of basophilic cuboidal cells & an inner myoepithelial cells.milky. The apocrine duct is straight & not spiral. Apocrine secretion:  Human apocrine sweat is a protien rich .  Bacterial decomposition responsible for the characteristic mephitic odor.colourless secretion when it is first formed.

the secretion is discharged on to the surface only intermitentaly.Mechanism of apocrine sweat secretion     Secretion is of apocrine type Merocrine & holocrine type secretion also occur In classical apocrine type of secretion an apical cap & a dividing membrane are formed initially. the apical cap is then detached & discharged into the lumen of the gland by a process called ´apocapationµ. Although . ¨ 3 .apocrine sweat formation is a continuous process .

Control of apocrine glandular activity Apocrine gland respond to emotional stimuli that promote sympathetic discharge. 38 . Denervation or atropine do not abolish apocrine glandular response to emotional stimuli .suggesting that apocrine glandsare stimulated humorally by circulating catecholamines.

With aging . 39 Effects of aging: o o . Apocrine gland possess a marked ²alpha reductase activity. That is why there is often a reduced body odor in the aged.apocrine glands tends to accumulate lipofuscin &undergo attenuation . There is shrinkage of apocrine glands after menopause.Humoral influences and apocrine glandular activity ‡ ‡ ‡ Gonadectomy of mature individual does not affect apocrine glandular function.

4 © . especially the glands in the axillae.are highly specialised functional units and are concerned with human behavioural & sexual interaction.Function of apocrine glands: Human apocrine glands .

Larger than eccrine glands and smaller than apoccrine glands. The apocrine glands has a long duct that opens directly on to the skin surface. 41 . Represent <10% of all glands in human axilla. Axillary skin of black contains more glands. Found in adult human axillae.        Also called mixed gland. Found in all level of the dermis and their size may be quite variable . The apocrine secretory portion is often irregularly dilated.

 42 .  They develop during puberty from the eccrine glands or eccrine like precursor glands.  Yeilds copious sweat in response to both methacholine(cholinergic) and epinephrine(adrenergic).Apocrine glands are not present at birth.  Apoeccrine glands basically eccrine glands that underwent ´apoeccrinization·due to local factors.

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