Study of skin

2. The structure of the skin:The skin consists of three layers. The
superficial layer, the epidermis, is the thinnest, but the most
complex in structure. Under it is the dermis - cutis propria -
comprising two layers: papillary and reticulate. Under the dermis is
hypodermis (subcutaneous fatty tissue,no-on eyelids).
.

3.  Consists of 1 row a series of
prismatic cells disjoined with
intracellular canaliculi
 Keratinocytes- synthesis of keratin
 Melanocytes- pigmentation
 Merkel cells- tactile sensation
 Reproduction of epidermal cells

4.  3-8 rows of keratinocytes- irregular
polygonal shape- Langerhans cells
 Special tonofibrils presence in
cytoplasm, not moving from cell to
cell and ending in cytoplasmatic
structures. In the upper layer
become flar and migtare into the
next layer

5.  Consist of 1-2 cell row
 Thin of cells, which are
elongated, located paralell
layer to skin surface
 Contain keratohyalin grains-
lamellar granules (similar to
DNA)

6.  Flattened, poorly contoured,
non- nuclear homogeneous
keratinocytes- on palms and
soles
 Contains glycogen, fatty
substances and eleidin

7.  10-20 rows of flattened cells with no
nuclei and cell organelles
 In the outermost layer the
corneocytes, as they gradually
detach, cause permanent
physiological exfoliation of epitelial
cells
 Vit A involves in formation

8. Consisting of loose connective
tissue containing capillaries,
elastic fibers, bundles of
collagen, reticular and
argyrophil fibers, fibroblasts,
histiocytes, melanophages,
blood vesells, nerve endings

9.  Collagen and elastin fibers
 The strength of the skin depends on this layer
Hypodermis
Subcutaneous fat- coarse- meshed network of
collagen fibers with fat slices
Absent on eyelids

10. Skin attachments
1.Sebaceous glands
The glands are located in
the dermis, are
(non)connected with the
hair follicle. One hair
follicle has 1 or 2 sebaceous
glands
Sebaceous glands function
by holocrine type, i.e. when
the secretion of the cells of
the gland gradually
accumulates lipid droplets,
degenerates and then
completely destroyed, and
their remains are part of the
secret.
Regulates the secretion of
sebaceous glands by sexual
hormones

11.  No- on palms and soles
 On the border of the lips, the glans
penis, the inner layer of the
prepuce, on the labia minora,
nipple, areola of the breast, eyelids-
open directly into the surface of the
skin
 Large gland- on face (T-zone),
chest, on the back
 The secret- sebum

12. 2.Sweat glands
By the type of secretion the sweat
glands are divided into eccrine and
apocrine.
Eccrine glands- the secretion are
excreted via exocytosis and no part
of the glands is lost or damaged,
located throughout the skin.
Apocrine glands- secretion occurs
by destroying the apical part of the
gland,secretory cell located deep in
the dermis.
The apocrine glands are located in
the armpits, in the pubic region,
inguinal folds, genital organs, the
anus circumference and the nipple
of the mammary glands
No- glans penis, the inner layer of
the prepuce and the outer surface of
the labia minora.

13. 3. Hair
Types: 1.Vellus-
skin hair
2. Bristly-
eyebrows,
eyelashes, beard,
mustache, in the
genital area
3. Long- on the
scalp

15. nerve-receptor skin
• Tactile sensation- Meissner's bodies are
located inside the papillae of the dermis,
there are many of them in the skin of the
palmar-lateral surfaces of the fingers,
lips, and genitals;
•Thermal sensation- End-bulbs of
Krause are localized in the dermis,
especially a lot of them in places where
the skin passes into the mucous
membranes in the region of the lips,
eyelids, and external genitalia- cold
The lower body of the dermis and the
upper part of the hypoderm are localized
to the body of Ruffini-heat.
• in the deep layers of the dermis and
hypodermis, mainly in the area of the
palms, soles, nipples of the mammary
glands, genitals-Fatera-Pacini bodies-
body position and the pressure
• Dogel's genital bodies are found in the
skin of the genital organs, providing
increased sensitivity of these zones.
Pain, itching, burning- free nerve
endings in epidermis

16. 1. As immune organs- contribute to the
maturation of T-lymphocytes
2. Protection- mechanical, from microbes, from
sun rays
3. Secretory
4. Sensory
5. Respiratory, resorption
6. Thermoregulatory(constriction or dilating of
blood vessels)
7. Metabolic

17. Pathogystological changes.
1)Parakeratosis - the presence of cells in the stratum corneum of the
epidermis with rod-shaped colored nuclei (granular and eleidin layers
are absent).
2) Hyperkeratosis (hyperkeratosis) – thickening of the stratum corneum
without structural changes in cells,
3)Acanthosis- increased multiplication of the cells of the stratum
spinosum (up to 20-30 layers) with elongation of the intrapapillary
outgrowths of the epidermis.
4)Acantholysis- melting of intercellular epithelial bridges, disruption of
a strong bond between epithelial cells, as a result of which cells easily
separate from each other and form bullas in stratum spinosum
5)Granulosis (granulosis)-Increasing the number of the granular layer.
Can form epidermal papules (warts), epidermal-dermal papules (lichen
planus)
6) Papillomatosis- proliferation of the cellular elements of the dermal
papilla.
Acanthosis/papillomatosis form papules (psoriasis, atopic dermatites)

18. 1. Spongiosis- formation of bubbles in the stratum
spinosum due to the accumulation of intermittent
edema fluid
2. Vacuolar degeneration- fluid accumulation in the
basal and spinosum layers due to degenerative
processes in the nucleus,cytoplasm of these cells.
D: dyshidrotic eczema, epidermophytosis of the
feet
3. Ballooning degeneration- cells of stratum
spinosum increase in size due to accumulation of
fluid, become spherical, then cells are separated,
resulting in the formation of cavities filled with
exudate. D: herpes simplex and zoster

20. 1) Macula(spot,stains)- is a limited change in skin
color without disturbing its relief and consistency.
The spots on the skin are called "exanthema", on the
mucous membrane - "enanthema".

21. 1. inflammatory-as the result of the expansion of
surface blood vessels in the skin- roseola(d up
to 25mm), Erythema(d than 25mm)
2. Non-inflammatory- due to improper
development of blood vessels-hemangiomas;
due to hemorrhage- purpura
3. Hyperpigmented- nevus
4. Depigmented- vitiligo

22. 2)NODULE (NODUS,KNOT) - A
LARGE INFILTRATIVE DENSE
ELEMENT OF GLOBULAR OR OVOID
FORM, LOCATED IN THE DEEP
LAYERS OF THE DERMIS AND
SUBCUTANEOUS FATTY TISSUE. THE
KNOT HAS DIMENSIONS FROM A PEA
TO A WALNUT AND MORE .. THE
KNOTS CAN BE MOBILE OR WELDED
TO THE SKIN. THE OUTCOME OF THE
NODES IS DETERMINED BY THE
NATURE OF THE DISEASE AND CAN
BE TRACELESS, WITH SCARRING,
WITH CICATRICIAL ATROPHY.
3)BLISTER (URTICA) - AN
INFLAMMATORY, BESIEGED ELEMENT
THAT RISES ABOVE THE SURFACE OF
THE SKIN, IN THE BASIS OF WHICH
LIES THE EDEMA OF THE UPPER
LAYERS OF THE DERMIS. IT DIFFERS
IN DENSITY, PINK-RED, AND
SOMETIMES PEARLY-WHITE COLOR
AND INTENSE ITCHING. THE
DIMENSIONS OF THE BLISTER VARY
WIDELY - FROM THE SIZE OF POPPY
SEEDS TO THE PALM OF YOUR HAND
AND MORE.

23. 4)PAPULA- INFILTRATIVE, ELEVATIONS OF THE
SKIN; ARISE FROM THE EPIDERMIS AND UPPER
DERMIS
-EPIDERMAL, DERMAL AND EPIDERMAL-DERMAL
-MILIARY (1-2MM)
-LENTICULAR (1CM)
-NUMMULAR (2-2,5CM)
-PLAQUES (>2,5CM)
-BY SHAPE: CONICAL, POLYGONAL, FLAT, OVAL
-PINK, RED, PURPLE
-SURFACE: SMOOTH, COVERED WITH SCALES
5)TUBERCULUM- INFILTRATIVE
ELEMENT THAT RISES ABOVE THE
SURFACE OF THE SKIN, IS RESOLVED
BY SCAR OR SCARRING ATROPHY.
OCCURS AS A RESULT OF LIMITED
FOCI OF PRODUCTIVE
INFLAMMATION OF THE TYPE OF
INFECTIOUS GRANULOMA WITH THE
PHENOMENA OF NECROSIS,
ULCERATION AND SCARRING. THE
TUBERCLES HAVE A DIFFERENT SIZE -
FROM THE MILLET GRAINS (DIAMETER
1 MM) TO THE HAZELNUT.

24. 6)VESICULA (VESICLE)-
INTRAEPIDERMAL CAVITY
SURFACE ELEMENT FILLED WITH
SEROUS TRANSPARENT
CONTENTS. RESOLUTION-
EROSION, CRUST
D- UP TO 5 MM
7)BUBBLE (BULLA) - A LARGE
CAVITY ELEMENT OF ROUND OR
OVAL SHAPE WITH A CLEAR,
CLOUDY OR HEMORRHAGIC
CONTENT. THE SIZE MORE THAN
5 MM. THE BLADDER COVER IS
TENSE OR FLABBY, EASILY
OPENING AND FORMING EROSIVE
WETTING SURFACES

25. 8)Pustula - a cavity element, filled with pus, surrounded by a
halo of inflammation. The pustular cavity is formed in the
epidermis as a result of necrosis of epithelial cells under the
influence of various pyogenic microorganisms
-big form-abscess -associated with hair follicle-furuncle
-with apocrine sweat
glands- hydradenitis

26. 1)Scales (squamae) - loosened, detached horny
plates that have lost contact with the
underlying cells.

27. CRUSTA (CRUSTA) - IS A DRIED OUT
EXUDATE OF THE CONTENTS OF
VESICLES, BLISTERS, DECAY OF
SKIN TISSUES, SEPARATED
EROSIONS AND ULCERS. THE
COLOR OF THE CRUSTS DEPENDS
ON THE TYPE OF EXUDATE TO BE
SEPARATED
ABRASION (EXCORIATIO) (FIG. A), OR
EXCORIATION, IS A SKIN DEFECT
CAUSED BY MECHANICAL DAMAGE
TO THE SKIN (BRUISES, SCRATCHES,
SCRATCHES). DEPENDING ON THE
DEPTH OF THE ABRASION, THERE ARE
SURFACE (WITHIN THE EPIDERMIS) OR
DEEP (IN THE THICKNESS OF THE
DERMIS).
THE CRACK (RHAGAS, FISSURA) (FIG.
B) IS A SKIN DEFECT THAT RESULTS
FROM ITS LINEAR RUPTURE WITH
PROLONGED INFLAMMATORY
INFILTRATION, DRYNESS AND LOSS
OF SKIN ELASTICITY. MORE OFTEN,
CRACKS OCCUR IN PLACES OF
NATURAL FOLDS

28.  Appear after the primary lesions
(nodules, vesicles, pustules) as
hypopigmented,de- or hyper- spots

29. 3)EROSION- IS A SUPERFICIAL
DEFECT OF THE EPIDERMIS,
WHICH IS FORMED AFTER THE
OPENING OF EXUDATIVE
PRIMARY ELEMENTS (VESICLE,
BLADDER, ABSCESS).
DIMENSIONS AND OUTLINES OF
EROSION CORRESPOND TO
PREVIOUS PRIMARY ELEMENTS.
4)ULCER (ULCUS)- IS A DEEP
DEFECT IN THE SKIN WITHIN THE
DERMIS AND HYPODERMIS. UNLIKE
WOUNDS, ULCERS ARE THE RESULT
OF PATHOLOGICAL CHANGES THAT
HAVE CAUSED NECROSIS OF THE
DEEP LAYERS OF THE DERMIS. THE
ULCER ALWAYS HEALS BY A SCAR,
BY THE NATURE OF WHICH IT IS
SOMETIMES POSSIBLE TO JUDGE A
PREVIOUSLY TRANSFERRED
PATHOLOGICAL PROCESS.

30. 5)Cicatrix (Scar)- s a newly formed skin tissue that arises in the places
of its deep injuries when this defect is replaced with a coarse fibrous
connective tissue. The scar contains no hair, sebaceous, sweat glands,
vessels and elastic fibers. Clinically distinguish:-flat scars located on
one level with the skin
-hypertrophic scars that rise above the surface of the skin
-atrophic scars with a thinned surface, located below the level of the
surface of normal skin.

31. 6)LICHENIFICATION- IS A
THICKENING OF THE SKIN DUE
TO VARIOUS INFLAMMATORY
INFILTRATES. CLINICALLY, THE
CENTER OF LICHENIFICATION
HAS THE FORM OF COMPACTED
SKIN WITH AN UNDERLINED
DIAMOND PATTERN, ROUGH,
DRY AND HYPERPIGMENTED
(SHAGREEN SKIN)
7)VEGETATION-
PROLIFERATION OF PAPILLARY
LAYER AND THICKENED
EPIDERMAL HORNY CELL
LAYERS.
EXP: GENITAL WARTS

34. - Is solified keratin and exudate that forms on an
erosion or on ulcerous skin. The color demends
on the nature of the exudate.