The skin is the largest organ of the body, weighing 16% of total body weight. It has three structural layers - the epidermis, dermis, and subcutis. The epidermis forms the outer protective layer and is made up of keratinocytes that produce keratin and move upwards, shedding layers. Below this is the dermis, which provides structural support, and below that is the subcutis, which stores fat. The epidermis contains melanocytes that produce melanin pigment, protecting against UV radiation. Skin thickness and structure can vary between body sites and individuals.
The skin is the largest organ of the body, weighing 16% of total body weight. It has three structural layers - the epidermis, dermis, and subcutis. The epidermis forms the outer protective layer and is made up of keratinocytes that produce keratin and move upwards, shedding layers. Below this is the dermis, which provides structural support, and below that is the subcutis, which stores fat. The epidermis contains melanocytes that produce melanin pigment, protecting against UV radiation. Skin thickness and structure can vary between body sites and individuals.
The skin is the largest organ of the body, weighing 16% of total body weight. It has three structural layers - the epidermis, dermis, and subcutis. The epidermis forms the outer protective layer and is made up of keratinocytes that produce keratin and move upwards, shedding layers. Below this is the dermis, which provides structural support, and below that is the subcutis, which stores fat. The epidermis contains melanocytes that produce melanin pigment, protecting against UV radiation. Skin thickness and structure can vary between body sites and individuals.
The skin is the largest organ of the body, weighing 16% of total body weight. It has three structural layers - the epidermis, dermis, and subcutis. The epidermis forms the outer protective layer and is made up of keratinocytes that produce keratin and move upwards, shedding layers. Below this is the dermis, which provides structural support, and below that is the subcutis, which stores fat. The epidermis contains melanocytes that produce melanin pigment, protecting against UV radiation. Skin thickness and structure can vary between body sites and individuals.
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Skin structure and function
The integument or skin is the largest organ of the body, making up 16% of body weight, with a surface area of 1.8 m2 . It has several functions, the most important being to form a physical barrier to the environment, allowing and limiting the inward and outward passage of water, electrolytes and various substances while providing protection against micro-organisms, ultraviolet radiation, toxic agents and mechanical insults. There are three structural layers to the skin: the epidermis, the dermis and subcutis. Hair, nails, sebaceous, sweat and apocrine glands are regarded as derivatives of skin (see Figure 1.1).
Skin is a dynamic organ in a constant state of change, as cells of the outer
layers are continuously shed and replaced by inner cells moving up to the surface. Although structurally consistent throughout the body, skin varies in thickness according to anatomical site and age of the individual. Skin anatomy The epidermis is the outer layer, serving as the physical and chemical barrier between the interior body and exterior environment; the dermis is the deeper layer providing the structural support of the skin, below which is a loose connective tissue layer, the subcutis or hypodermis which is an important depot of fat (see Table 1.1).
Epidermis The epidermis is stratified squamous epithelium. The main cells of the epidermis are the keratinocytes, which synthesise the protein keratin. Protein bridges called desmosomes connect the keratinocytes, which are in a constant state of transition from the deeper layers to the superficial (see Figure 1.2)
In addition, the stratum lucidum is a thin layer of translucent cellsseen in
thick epidermis. It represents a transition from the stratum granulosum and stratum corneum and is not usually seen in thin epidermis. Together, the stratum spinosum and stratum granulosum are sometimes referred to as the Malphigian layer. Stratum basale Stratum basale The innermost layer of the epidermis which lies adjacent to the dermis comprises mainly dividing and non-dividing keratinocytes, which are attached to the basement membrane by hemidesmosomes. As keratinocytes divide and dierentiate, they move from this deeper layer to
the surface. Making up a small proportion of the basal cell population is the pigment (melanin) producing melanocytes. Melanin pigment provides protection against ultraviolet (UV) radiation; chronic exposure to light increases the ratio of melanocytes to keratinocytes, so more are found in facial skin compared to the lower back and a greater number on the outer arm compared to the inner arm. The number of melanocytes is the same in equivalent body sites in white and black skin but the distribution and rate of production of melanin is dierent. Merkel cells are also found in the basal layer with large numbers in touchsensitive sites such as the fingertips and lips. They are closely associated with cutaneous nerves and seem to be involved in light touch sensation.
Stratum spinosum As basal cells reproduce and mature, they move towards the outer layer of skin, initially forming the stratum spinosum. Intercellular bridges, the desmosomes, which appear as `prickles' at a microscopic level, connect the cells. Langerhans cells are dendritic, immunologically active cells derived from the bone marrow and are found on all epidermal surfaces but are mainly located in the middle of this layer. They play a signicant role in immune reactions of the skin, acting as antigen-presenting cells. Stratum granulosum Continuing their transition to the surface the cells continue to flatten, lose their nuclei and their cytoplasm appears granular at this level. Stratum corneum The final outcome of keratinocyte maturation is found in the stratum corneum, which is made up of layers of hexagonal-shaped, non-viable cornied cells known as corneocytes. In most areas of the skin, there are 1030 layers ofstacked corneocytes with the palms and soles having the most. Each corneocyte is surrounded by a protein envelope and is lled with water-retaining keratin proteins. The movement of epidermal cells to this layer usually takes about 28 days and is known as the epidermal transit time. Dermoepidermal junction/basement membrane This is a complex structure composed of two layers. Abnormalities here result in the expression of rare skin diseases such as bullous pemphigoid and epidermolysis bullosa. The structure is highly irregular, with dermal papillae from the papillary dermis projecting perpendicular to the skin surface. It is via diusion at this junction that the epidermis obtains nutrients and
disposes of waste. The dermoepidermal junction attens during ageing which
accounts in part for some of the visual signs of ageing.
