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Dr . RANJAN DASH
 BASIS OF SKIN PIGMENTATION
 MELANOSOMES-types ,synthesis & maturation
 SYNTHESIS OF MELANIN
 TRANSPORT OF MELANIN
 DISORDERS OF HYPOMELANOSIS
 DISORDERS OF HYPERMELANOSIS
DIFFERENT COLOR OF SKIN IS
DUE TO :
1. Presence of CHROMATOPHORES
(pigment containing cells )
2. Presence & Distribution of
Pigments(coloured particles)
3. Hormonal and Neural control
REASON FOR VARIABLE SHADES OF
COLORATION
1. CAMOUFLAGE ( protective
resemblance),mimesis / crypsis
2. Aggressive Resemblance
Best example is CHAMELEON
Determined by : melanin
haemoglobin
carotenoids
At the level of Epidermis : Melanin , the major determinant and
carotenoids
At the level of Dermis - by oxygenated haemoglobin (red) in
capillaries - by reduced haemoglobin (blue) in venules
Constitutive skin colour : genetically predetermined
Facultative skin colour : induced by sun exposure(UV),
hormones & other regulatory factors
 derive from pluripotent neural crest cells
that differentiate into numerous cell
lineages including neurons, glia,smooth
muscle, craniofacial bone, cartilage, and
melanocytes.
 Progenitor melanoblasts migrate
dorsolaterally between the mesodermal
and ectodermal layers
 reach the hair follicles and the skin as
well as inner ear cochlea, choroid, ciliary
body, and iris.
 Melanoblast migration and
differentiation influenced by signaling
molecules Wnt, (ET)-3, bone
morphogenetic proteins (BMPs), steel
factor (SF) , and hepatocyte growth
factor .
 Melanoblasts migrate
dorsolaterally and then ventrally
around the trunk to the ventral
midline & differentiation into
melanocytes.
 During embryogenesis, melanin
producing melanocytes are found
diffusely throughout the dermis.
 By the end of gestation, active
dermal melanocytes disappear,
except in three anatomic locations
1. the head and neck,
2. the dorsal aspects of the
distal extremities
3. the presacral area
that coincide with the most common
sites for dermal melanocytosis and
dermal melanocytomas (blue nevi)
 Melanocytes in skin synthesize &
store melanin in cytosolic
organelles called melanosomes
 A constant need for synthesis &
transfer of melanosomes from
melanocytes to keratinocytes to
maintain cutaneous pigmentation.
 Melanocyte density/square mm
ranges from 550 to 1500, with the
highest concentration within face &
genitalia
 Association of a melanocyte with
approximately 30–40 surrounding
keratinocytes to which it transfers
melanosomes
 Follicular melanin unit undergoes cyclic
modifications along with the hair cycle
 located in the proximal hair bulb during anagen
 proliferate, migrate, and undergo maturation
during early to mid anagen.
 Melanogenesis and melanin transfer to
keratinocytes occurs throughout anagen.
 Melanocyteneventually apoptose during late
catagen
 in hair, melanocyte transfer melanin to
differentiated keratinocytes that ultimately form
the hair shaft.
 determine hair color by the amount of melanin
transferred, as well as by the ratio of eumelanin
(black–brown) to pheomelanin (red–yellow)
C . Ocular Melanocytes
- Unlike cutaneous melanocytes, ocular melanocytes are in contact
only with each other & don’t transfer melanosomes.
-Albinos may have visual abnormalities due to absence of melanin
D . Otic Melanocytes
- reside in cochlea & are important for hearing loss of otic melanocytes
may leads to deafness as in Waardenburg syndrome TYPE II
Depends upon :>
1) Melanogenic activity within the melanocyte
2) The proportion of mature melanosomes
3) Size of melanosomes
4) Type of melanin (eumelanin, or pheomelanin)
5) Melanosomes transfer & distribution within the
keratinocyte
 Definition: membrane-bound unique organelle
within the cytoplasm of melanocytes in which
in which melanin pigments are synthesized,
deposited and transported.
 And depending on the type of melanin
(eumelanin or pheomelanin) synthesized,
melanosomes can be divided into:
Eumelanosome and Pheomelanosome
1) Transcription of proteins required for melanin
synthesis
2) Melanosome biogenesis
3) Sorting of melanogenic proteins into
melanosomes to initiate melanin synthesis
within the melanosome
4) Transport of the mature melanosomes to the
tips of melanocyte dendrites migrates via
microtubules
5) Transfer of melanosomes to keratinocyte
1 .EXOCYTOSIS
- fusion of the melanosomal membrane with the melanocyte plasma membrane
- melanosome is released to the intercellular space
- phagocytosis by surrounding keratinocytes occur
2 .CYTOPHAGOCYTOSIS: projection of dendrites into keratinocyte cytoplasm
then keratinocytes cytophagocytose the tip of a melanocyte dendrite.
3. Fusion of melanocyte & keratinocyte plasma membrane create a space
through which melanosomes are transferred
4.Shedding of melanosome-filled vesicles followed by phagocytosis of the
vesicles by keratinocyte
A . Specific genes
B . Hormones: 1.MSH 2. ACTH 3. Estrogens
C . Biochemical factors: IL-1 2, IL-6 , TNF-alpha , basic
fibroblast growth factor (bFGF) 5- Endothelin-1, 3
D. External factors:
1- UV light (amount and wave-length)
2- melanocyte stimulating chemicals like
photosensitizers
 MITF, a basic-helix-loop-helix and leucine zipper transcription factor,
 the master gene for melanocyte survival
 A key factor regulating the transcription of the major melanogenic
proteins, tyrosinase, TRP-1, TRP-2 , PKC-β
 In melanocytes, it is the MITF-M isoform that stimulates transcription of
tyrosinase and PKC-b.
 MITF binds to conserved consensus elements in gene promoters, specifically
the M- (AGTCATGTGCT) and E- (CATGTG) boxes.
 MITF comprises a family of nine isoforms: (1) MITFM, (2) -A, (3) -B,
(4) –H , (5) -C, (6) -D, (7) -E, (8) -J, and (9) -Mc.
 MITF-M expression is highly specific for melanocytic cells.
 AMELANOSIS
 HYPOMELANOSIS
 HYPERMELENOSIS
 AD disorder of melanocyte development a/w Kit/SNCA gene
mutation
 Common characteristics include a congenital white forelock,
scattered normal pigmented and hypopigmented macules and a
triangular shaped depigmented patch on the forehead..
 In some cases, piebaldism occurs together with severe
developmental problems, as in Waardenburg
syndrome and Hirschsprung's disease.
 A kind of neurocristopathy, involving defects of various neural
crest cell lineages that include melanocytes, but also involving
many other tissues derived from the neural crest
 autosomal dominant
disorder
 White forelock
 Hypertelorism
 Congenital deafness
 Hypomelanotic
macules
 Heterochromic irides
 AD neurocutaneous syndrome
with skin lesions, mental
retardation and epilepsy
 Skin lesions are ash-leaf
macules, angiofibromas and
shagreen patches
 Ash-leaf macules - present at
birth in > 90% cases, so
important in early diagnosis
 Oval or ash-leaf shaped,
hypopigmented macules, look
prominent in Wood’s lamp Long
axis is axial on limbs and
transverse on trunk
HERMANSKYPUDLAK
SYNDROME
 autosomal recessive disorder
 Albinism and eye problems:
(photophobia), strabismus
(crossed eyes), and nystagmus
(involuntary eye movements)
 Bleeding disorders: due to
platelet dysfunction.
 Cellular storage disorders: The
syndrome causes a wax-like
substance (ceroid) to
accumulate in the body tissues
and cause damage, especially
in the lungs and kidneys
CHEDIAKHIGASHI
SYNDROME
A rare autosomal recessive disorder
that arises from a mutation of a
lysosomal trafficking regulator
protein,[ which leads to a decrease
in phagocytosis.
results in
recurrent pyogenic infection
s, albinism and
peripheral neuropathy
 May be epidermal or dermal
 Epidermal hyperpigmentation due to - Increased
melanin with normal number of melanocytes -
Increased number of melanocytes
 Dermal hyperpigmentation due to - Melanin from
epidermis transferred to dermis - Melanin formed
in dermal melanocytes - Melanin pigments
appears blue-gray due to Tyndall effect
A .EPIDERMAL
 Physiologic: Pigmentary demarcation lines, sun tanning
 Genetic and Developmental: Lentigines, Freckles, Peutz-Jeghers
syndrome, Melanocytic nevus, Café-au-lait spots, Xeroderma
pigmentosum, Becker’s nevus, Acanthosis nigrican
 Post-inflammatory: Eczema, Psoriasis, Lichen planus, Lupus
erythematosus, Scleroderma, Morphoea, Vagabond’s disease
 Nutritional: Kwashiorkor, Pellagra, Vit.B12, Vit.C, Folic acid
deficiency
 Physical: Trauma, Radiation dermatitis
 Endocrine: Melasma, Addison’s disease, Cushing’s syndrome,
Phaeochromocytoma, Acromegaly, Hyperthyroidism
 Neoplastic: Malignant melanoma, Seborrhoeic keratosis,
Pigmented basal cell carcinoma
 Genetic and Developmental: Mongolian spots,
Nevus of Ota/Ito, Incontinentia pigmenti
 Inflammatory: Stasis dermatitis, Post
inflammatory to eczema and fixed drug
eruption
 Chemicals and Drugs: Anti-malarials, OC Pills,
Minocycline, Clofazimine, Topical
hydroquinone, Tattoo
 Endocrine: Melasma
 Physical: Thermal burns, Post traumatic Infection:
Syphilis, Yaws, Pinta
 Neoplastic: Metastasis of melanoma
 Nutritional: Chronic nutritional deficiency Metabolic:
Hemochromatosis, Alkaptonuria, Macular / Lichen
amyloidosis
 Miscellaneous: Pigmented purpuric dermatosis,
Purpura
 Also known as Futcher’s or Voight’s
lines
 are borders of abrupt transition
between more deeply pigmented
skin and that of lighter pigmentation
 do not correspond to Blaschko’s lines
or dermatomal lines but to voigt’
lines
 Considered by some to be a variant
of normal pigmentation
Can be divided into five five categories:
 Group A - lines along the outer upper arms with variable extension
across the chest
 Group B - lines along the posteromedial aspect of the lower limb
 Group C - Paired median or paramedian lines on the chest, with
midline abdominal extension
 Group D - medial, over the spine
 Group E - bilaterally symmetrical, obliquely oriented, hypopigmented
macules on the chest
 Benign proliferations of cells at the dermo-epidermal
junction
 May be congenital or acquired
 Acquired nevi are more common
 Appear in infancy or childhood, slowly grow and mature
and then regress in older life
 Important for cosmetic reasons and as precursors for
melanoma (esp. in white)
 Round or oval, uniformly coloured and sharply bordered lesions
 Appear after birth
 Increase in frequency during childhood & adolescence and plateaus during middle age
 Most of them start as junctional nevi which are flat and histologically confined to
dermalepidermal junction
 Gradually mature to compound nevi which have nests and columns of nevus cells in
dermis along with the junctional component. These are raised, rounded, brown or black
 Intradermal nevi : Compound nevi mature to intradermal nevi with nevus cells only in
dermis having neuron like appearance. These are dome shaped, nonpigmented and may
have one or more coarse hair
 Acquired, pigmented, hairy
plaque common on trunk,
more common in males
 Appears in first or second
decade
 Common sites: shoulder,
chest, back
 May become verrucous with
hair growth and then remains
stable
 Circumscribed, brown
macules with irregular
margins, 2-5 cm in size
 Isolated CALM may occur
in 10-20% of normal
population
 No increase in the number
of melanocytes
 Five or more CALM of
size >0.5 cm in
prepubertal age group
and >1.5 cm in an adult
are strongly suggestive of
neurofibromatosis
 A common macular brown
coloured lesion seen on face in
males and females
 Common in pregnancy: Mask of
pregnancy (clears in few months)
 Forehead, nose, cheeks affected.
 The three clinical patterns are:
centrofacial, malar, mandibular
 Exacerbation on sun exposure
 Histologically may be epidermal,
dermal or mixed
Melanogenesis.doc 2
Melanogenesis.doc 2
Melanogenesis.doc 2

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Melanogenesis.doc 2

  • 1. Dr . RANJAN DASH
  • 2.  BASIS OF SKIN PIGMENTATION  MELANOSOMES-types ,synthesis & maturation  SYNTHESIS OF MELANIN  TRANSPORT OF MELANIN  DISORDERS OF HYPOMELANOSIS  DISORDERS OF HYPERMELANOSIS
  • 3. DIFFERENT COLOR OF SKIN IS DUE TO : 1. Presence of CHROMATOPHORES (pigment containing cells ) 2. Presence & Distribution of Pigments(coloured particles) 3. Hormonal and Neural control REASON FOR VARIABLE SHADES OF COLORATION 1. CAMOUFLAGE ( protective resemblance),mimesis / crypsis 2. Aggressive Resemblance Best example is CHAMELEON
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  • 7. Determined by : melanin haemoglobin carotenoids At the level of Epidermis : Melanin , the major determinant and carotenoids At the level of Dermis - by oxygenated haemoglobin (red) in capillaries - by reduced haemoglobin (blue) in venules Constitutive skin colour : genetically predetermined Facultative skin colour : induced by sun exposure(UV), hormones & other regulatory factors
  • 8.  derive from pluripotent neural crest cells that differentiate into numerous cell lineages including neurons, glia,smooth muscle, craniofacial bone, cartilage, and melanocytes.  Progenitor melanoblasts migrate dorsolaterally between the mesodermal and ectodermal layers  reach the hair follicles and the skin as well as inner ear cochlea, choroid, ciliary body, and iris.  Melanoblast migration and differentiation influenced by signaling molecules Wnt, (ET)-3, bone morphogenetic proteins (BMPs), steel factor (SF) , and hepatocyte growth factor .
  • 9.  Melanoblasts migrate dorsolaterally and then ventrally around the trunk to the ventral midline & differentiation into melanocytes.  During embryogenesis, melanin producing melanocytes are found diffusely throughout the dermis.  By the end of gestation, active dermal melanocytes disappear, except in three anatomic locations 1. the head and neck, 2. the dorsal aspects of the distal extremities 3. the presacral area that coincide with the most common sites for dermal melanocytosis and dermal melanocytomas (blue nevi)
  • 10.  Melanocytes in skin synthesize & store melanin in cytosolic organelles called melanosomes  A constant need for synthesis & transfer of melanosomes from melanocytes to keratinocytes to maintain cutaneous pigmentation.  Melanocyte density/square mm ranges from 550 to 1500, with the highest concentration within face & genitalia  Association of a melanocyte with approximately 30–40 surrounding keratinocytes to which it transfers melanosomes
  • 11.  Follicular melanin unit undergoes cyclic modifications along with the hair cycle  located in the proximal hair bulb during anagen  proliferate, migrate, and undergo maturation during early to mid anagen.  Melanogenesis and melanin transfer to keratinocytes occurs throughout anagen.  Melanocyteneventually apoptose during late catagen  in hair, melanocyte transfer melanin to differentiated keratinocytes that ultimately form the hair shaft.  determine hair color by the amount of melanin transferred, as well as by the ratio of eumelanin (black–brown) to pheomelanin (red–yellow)
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  • 13. C . Ocular Melanocytes - Unlike cutaneous melanocytes, ocular melanocytes are in contact only with each other & don’t transfer melanosomes. -Albinos may have visual abnormalities due to absence of melanin D . Otic Melanocytes - reside in cochlea & are important for hearing loss of otic melanocytes may leads to deafness as in Waardenburg syndrome TYPE II
  • 14. Depends upon :> 1) Melanogenic activity within the melanocyte 2) The proportion of mature melanosomes 3) Size of melanosomes 4) Type of melanin (eumelanin, or pheomelanin) 5) Melanosomes transfer & distribution within the keratinocyte
  • 15.
  • 16.  Definition: membrane-bound unique organelle within the cytoplasm of melanocytes in which in which melanin pigments are synthesized, deposited and transported.  And depending on the type of melanin (eumelanin or pheomelanin) synthesized, melanosomes can be divided into: Eumelanosome and Pheomelanosome
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  • 24. 1) Transcription of proteins required for melanin synthesis 2) Melanosome biogenesis 3) Sorting of melanogenic proteins into melanosomes to initiate melanin synthesis within the melanosome 4) Transport of the mature melanosomes to the tips of melanocyte dendrites migrates via microtubules 5) Transfer of melanosomes to keratinocyte
  • 25.
  • 26. 1 .EXOCYTOSIS - fusion of the melanosomal membrane with the melanocyte plasma membrane - melanosome is released to the intercellular space - phagocytosis by surrounding keratinocytes occur 2 .CYTOPHAGOCYTOSIS: projection of dendrites into keratinocyte cytoplasm then keratinocytes cytophagocytose the tip of a melanocyte dendrite. 3. Fusion of melanocyte & keratinocyte plasma membrane create a space through which melanosomes are transferred 4.Shedding of melanosome-filled vesicles followed by phagocytosis of the vesicles by keratinocyte
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  • 29. A . Specific genes B . Hormones: 1.MSH 2. ACTH 3. Estrogens C . Biochemical factors: IL-1 2, IL-6 , TNF-alpha , basic fibroblast growth factor (bFGF) 5- Endothelin-1, 3 D. External factors: 1- UV light (amount and wave-length) 2- melanocyte stimulating chemicals like photosensitizers
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  • 35.  MITF, a basic-helix-loop-helix and leucine zipper transcription factor,  the master gene for melanocyte survival  A key factor regulating the transcription of the major melanogenic proteins, tyrosinase, TRP-1, TRP-2 , PKC-β  In melanocytes, it is the MITF-M isoform that stimulates transcription of tyrosinase and PKC-b.  MITF binds to conserved consensus elements in gene promoters, specifically the M- (AGTCATGTGCT) and E- (CATGTG) boxes.  MITF comprises a family of nine isoforms: (1) MITFM, (2) -A, (3) -B, (4) –H , (5) -C, (6) -D, (7) -E, (8) -J, and (9) -Mc.  MITF-M expression is highly specific for melanocytic cells.
  • 37.  AD disorder of melanocyte development a/w Kit/SNCA gene mutation  Common characteristics include a congenital white forelock, scattered normal pigmented and hypopigmented macules and a triangular shaped depigmented patch on the forehead..  In some cases, piebaldism occurs together with severe developmental problems, as in Waardenburg syndrome and Hirschsprung's disease.  A kind of neurocristopathy, involving defects of various neural crest cell lineages that include melanocytes, but also involving many other tissues derived from the neural crest
  • 38.  autosomal dominant disorder  White forelock  Hypertelorism  Congenital deafness  Hypomelanotic macules  Heterochromic irides
  • 39.  AD neurocutaneous syndrome with skin lesions, mental retardation and epilepsy  Skin lesions are ash-leaf macules, angiofibromas and shagreen patches  Ash-leaf macules - present at birth in > 90% cases, so important in early diagnosis  Oval or ash-leaf shaped, hypopigmented macules, look prominent in Wood’s lamp Long axis is axial on limbs and transverse on trunk
  • 40. HERMANSKYPUDLAK SYNDROME  autosomal recessive disorder  Albinism and eye problems: (photophobia), strabismus (crossed eyes), and nystagmus (involuntary eye movements)  Bleeding disorders: due to platelet dysfunction.  Cellular storage disorders: The syndrome causes a wax-like substance (ceroid) to accumulate in the body tissues and cause damage, especially in the lungs and kidneys CHEDIAKHIGASHI SYNDROME A rare autosomal recessive disorder that arises from a mutation of a lysosomal trafficking regulator protein,[ which leads to a decrease in phagocytosis. results in recurrent pyogenic infection s, albinism and peripheral neuropathy
  • 41.
  • 42.  May be epidermal or dermal  Epidermal hyperpigmentation due to - Increased melanin with normal number of melanocytes - Increased number of melanocytes  Dermal hyperpigmentation due to - Melanin from epidermis transferred to dermis - Melanin formed in dermal melanocytes - Melanin pigments appears blue-gray due to Tyndall effect
  • 43. A .EPIDERMAL  Physiologic: Pigmentary demarcation lines, sun tanning  Genetic and Developmental: Lentigines, Freckles, Peutz-Jeghers syndrome, Melanocytic nevus, Café-au-lait spots, Xeroderma pigmentosum, Becker’s nevus, Acanthosis nigrican  Post-inflammatory: Eczema, Psoriasis, Lichen planus, Lupus erythematosus, Scleroderma, Morphoea, Vagabond’s disease  Nutritional: Kwashiorkor, Pellagra, Vit.B12, Vit.C, Folic acid deficiency  Physical: Trauma, Radiation dermatitis  Endocrine: Melasma, Addison’s disease, Cushing’s syndrome, Phaeochromocytoma, Acromegaly, Hyperthyroidism  Neoplastic: Malignant melanoma, Seborrhoeic keratosis, Pigmented basal cell carcinoma
  • 44.  Genetic and Developmental: Mongolian spots, Nevus of Ota/Ito, Incontinentia pigmenti  Inflammatory: Stasis dermatitis, Post inflammatory to eczema and fixed drug eruption  Chemicals and Drugs: Anti-malarials, OC Pills, Minocycline, Clofazimine, Topical hydroquinone, Tattoo
  • 45.  Endocrine: Melasma  Physical: Thermal burns, Post traumatic Infection: Syphilis, Yaws, Pinta  Neoplastic: Metastasis of melanoma  Nutritional: Chronic nutritional deficiency Metabolic: Hemochromatosis, Alkaptonuria, Macular / Lichen amyloidosis  Miscellaneous: Pigmented purpuric dermatosis, Purpura
  • 46.  Also known as Futcher’s or Voight’s lines  are borders of abrupt transition between more deeply pigmented skin and that of lighter pigmentation  do not correspond to Blaschko’s lines or dermatomal lines but to voigt’ lines  Considered by some to be a variant of normal pigmentation
  • 47. Can be divided into five five categories:  Group A - lines along the outer upper arms with variable extension across the chest  Group B - lines along the posteromedial aspect of the lower limb  Group C - Paired median or paramedian lines on the chest, with midline abdominal extension  Group D - medial, over the spine  Group E - bilaterally symmetrical, obliquely oriented, hypopigmented macules on the chest
  • 48.  Benign proliferations of cells at the dermo-epidermal junction  May be congenital or acquired  Acquired nevi are more common  Appear in infancy or childhood, slowly grow and mature and then regress in older life  Important for cosmetic reasons and as precursors for melanoma (esp. in white)
  • 49.  Round or oval, uniformly coloured and sharply bordered lesions  Appear after birth  Increase in frequency during childhood & adolescence and plateaus during middle age  Most of them start as junctional nevi which are flat and histologically confined to dermalepidermal junction  Gradually mature to compound nevi which have nests and columns of nevus cells in dermis along with the junctional component. These are raised, rounded, brown or black  Intradermal nevi : Compound nevi mature to intradermal nevi with nevus cells only in dermis having neuron like appearance. These are dome shaped, nonpigmented and may have one or more coarse hair
  • 50.
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  • 52.  Acquired, pigmented, hairy plaque common on trunk, more common in males  Appears in first or second decade  Common sites: shoulder, chest, back  May become verrucous with hair growth and then remains stable
  • 53.  Circumscribed, brown macules with irregular margins, 2-5 cm in size  Isolated CALM may occur in 10-20% of normal population  No increase in the number of melanocytes  Five or more CALM of size >0.5 cm in prepubertal age group and >1.5 cm in an adult are strongly suggestive of neurofibromatosis
  • 54.  A common macular brown coloured lesion seen on face in males and females  Common in pregnancy: Mask of pregnancy (clears in few months)  Forehead, nose, cheeks affected.  The three clinical patterns are: centrofacial, malar, mandibular  Exacerbation on sun exposure  Histologically may be epidermal, dermal or mixed