Integumentary

Also cutaneous layer or skin

Epidermis

An epithelial layer of ectodermal

origin

Dermal papillae and Epidermal

ridges

Interdigitate at the irregular junction of

the dermis and epidermis to strengthen
adhesion of the two layers (2 words)

Functions of the Skin

Protective, sensory, thermoregulatory,

metabolic, sexual signaling

Keratinocytes

Stratified squamous keratinized

epithelium cells that comprise the
epidermis

Stratum basale

Basal layer of the epidermis; single layer of basophilic cuboidal or

columnar cells on the basement membrane at the dermalepidermal junction; characterized by intense mitotic activity and
contains progenitor cells for all epidermal layers; melanocytes and
Merkel cells present

Stratum spinosum

Stratum germinativum

Thickest layer of epidermis; polyhedral cells

actively synthesizing keratins that assemble
into tonofibrils; Langerhans cells present

The combined zone of basal and

spinous layer cells that are undergoing
mitosis

Stratum granulosum

Consists of three to five layers of flattened cells, now

undergoing the terminal differentiation process of
keratinization; cytoplasm is full of keratohyaline
granules; they also secrete lamellar granules

Keratohyaline granules

Dense, non-membrane bound masses of filaggrin

and other proteins associated with the keratins of
tonofibrils, linking them further into large
cytoplasmic structures

Lamellar granules

Stratum lucidum

Small ovoid structures containing various lipids;

keratinocytes secrete these via exocytosis, producing a
lipid-rich, impermeable layer around the cells; help make
the skin a barrier to water loss
Found only in thick skin, consists of a thin, translucent layer of
flattened eosinophilic keratinocytes held together by
desmosomes; nuclei and organelles have been lost and the
cytoplasm is almost exclusively packed keratin filaments

Stratum corneum

15 to 20 layers of squamous, keratinized cells filled

with birefringent filamentous keratins; anucleate
cells; protect against friction and water loss

Squames

Fully keratinized or cornified cells that are

continuously shed at the epidermal surface as the
desmosomes and lipid-rich cell envelopes break
down

Stratum compactum

Lower layer of stratum corneum; barrier layer

with dead, lipid-coated keratinocytes still held
together by desmosomes

Stratum disjunctum

Most superficial layer; outer layer of stratum

corneum; cornified cells (squames) are sloughed
off as desmosomes break down; desquamation

Basal cell carcinoma

Most common form of skin cancer; arises from basal stem cell; slow
growing; dome-shaped pink or skin-colored growth, shiny pink or red scaly
patch, waxy hard pale white to yellow or skin-colored scar-like growth, sore
that won't heal/bleeds easily/sunken center/visible blood vessels in or
around it

Squamous cell carcinoma

Second most common skin cancer; slow growing;

scaly red patches, open sores, elevated growths with
a central depression, warts, crusting/bleeding

Psoriasis

Condition where keratinocytes are produced and differentiate at an

accelerated rate, causing thickening of the epidermal layer and increased
keratinization and desquamation; autoimmune reaction in the skin caused
by genetic and environmental factors; red, scaly patches, papules, and
plaques; treat with steroids

Eumelanins

Brown or black pigments produced

by melanocytes

Pheomelanin

Red pigment produced by

melanocytes

Melanocytes

Neural crest derivatives that migrate into the embryonic epidermis' stratum
basale; 1:5-6 ratio with basal keratinocytes; pale-staining, rounded cell
bodies with long cytoplasmic extensions into the epidermis; anchored with
hemidesmosomes to basement membrane but lacking desmosomal
connections to keratinocytes

Tyrosinase

Catalyzes the first step in melanin synthesis; transmembrane

enzyme in Golgi-derived vesicles; converts tyrosine into 3,4dihydroxyphenylalanine (DOPA), which is then further
transformed and polymerized into different forms of melanin

Stage I of melanosome synthesis

Tyrosinase synthesized and packaged in

vesicles with a granular matrix of
structural proteins

Stage II of melanosome synthesis

Parallel filaments form from structural proteins

Tyrosinase converts tyrosine to DOPA, which is
transformed into dopaquinone, which then polymerizes
into melanin

Stage III of melanosome synthesis

Polymerized melanin accumulates

on parallel filaments

Stage IV of melanosome synthesis

Melanin granule is mature; no tyrosinase activity;

internal matrix is completely filled with melanin;
melanosome is now visible by light microscopy

Melanosome

Mature elliptical granule containing

melanin pigment linked to a matrix of
structural proteins

Transfer of the melanosome

Transport via kinesin to the tip of a cytoplasmic

extension; phagocytosis by a neighboring keratinocyte of
the tip of the dendrite; transport toward the nucleus via
dynein; accumulation into a supranuclear cap

Epidermal-melanin unit

One melanocyte plus the keratinocytes

into which it transfers melanosomes

Malignant melanoma

Most aggressive form of skin cancer;

ABCDE (asymmetry, border, color,
diameter, evolving)

Vitiligo

Skin depigmentation, often only in

affected patches, due to lost or
decreased activity of melanocytes

Langerhans cells

Antigen-presenting cells (APCs); 2-8% of epidermal cells; dendritic; develop In the

bone marrow and migrate to the epithelium; present in the spinous layer; their
cytoplasmic processes extend between keratinocytes of all layers; they bind, process,
and present antigens to T lymphocytes; upon antigen capture they leave and travel to
the lymph node; part of the skin's adaptive immunity; contain Birbeck granules

Merkel cells

Epithelial tactile cells; sensitive unencapsulated mechanoreceptors

essential for light touch sensation; originate from same stem cell as
keratinocyte but lack melanosomes; produce neurosecretory granules;
their basolateral surfaces contact unmyelinated sensory fibers penetrating
the basal lamina

Dermis

Layer of mesodermal connective tissue (stroma)

that supports the epidermis and binds it to the
subcutaneous tissue (hypodermis)

Papillary layer

More superficial layer of dermis; thin layer of loose areolar connective

tissue; includes the dermal papillae; contains subpapillary vascular plexus
as well as types 1 and 3 collagen, fibroblasts, mast cells, macrophages, and
other leukocytes; from this layer, anchoring fibrils of type 7 collagen insert
into the basal lamina, helping bind the epidermis to the dermis

Reticular layer

Deep layer of dermis; dense, irregular connective tissue (bundles of type 1 collagen)
surrounding hair follicles, sebaceous glands, sweat glands, nerves, and deep plexus
of blood vessels extending into subcutaneous layer; network of elastic fibers in this
layer provides skin with elasticity; between collagen and elastic fibers are abundant
proteoglycans rich in dermatan sulfate

Arteriovenous anastomoses

Shunts between the subpapillary plexus and the

deep plexus that regulate blood flow to the
former according to body temperature

Bullous pemphigoid

Blistering disorder where the epidermis lifts off from its

basement membrane; blisters are below the epidermis
and do not break easily; rare disorder; seen amongst the
elderly; autoimmune; treat with steroids

Pemphigus

Blistering disorder where the body attacks desmosomal

proteins (desmoglein); blisters within the epidermis that
break easily and leave a crater; occurs amongst Askenazi
Jews

Hypodermis

Subcutaneous layer; loose connective tissue that binds the skin

loosely to subjacent organs, making it possible for the skin to slide
over them; also called the superficial fascia; contains adipocytes
and extensive vascular supply that could be used for
subcutaneous drug delivery

Unencapsulated receptors

Merkel cells, free nerve endings,

root hair plexus

Encapsulated receptors

Meissner corpuscles, lamellated

(pacinian) corpuscles, Krause end bulbs,
Ruffini corpuscles

Meissner corpuscles

Elliptical structures consisting of sensory axons winding among flattened

Schwann cells arranged perpendicular to the epidermis in the dermal
papillae. They initiate impulses when light touch or low frequency stimuli
against skin temporarily deform their shape; numerous in fingertips, palms,
and soles

Lamellated (pacinian) corpuscles

Large oval structures found deep in the reticular dermis and

hypodermis with an outer capsule and thin, concentric flattened
Schwann cells and collagen surrounding a highly branched,
unmyelinated axon; specialized for sensing coarse touch,
pressure, and vibrations

Krause end bulbs

Simple, encapsulated, ovoid structures with extremely

thin collagenous capsules penetrated by a sensory fiber;
found in skin of penis and clitoris and sense lowfrequency vibrations

Ruffini corpuscles

Have collagenous fusiform capsules anchored firmly to

the surrounding connective tissue, with sensory axons
stimulated by stretch (tension) or twisting (torque) in the
skin

Parts of the hair root

Medulla, cortex, cuticle, internal root

sheath, external root sheath, glassy
membrane, connective tissue, sheath

Parts of the hair bulb

Dermis: Vascularized dermal papilla and connective tissue sheath

Basement membrane: Glassy membrane
Epidermis: External and internal root sheaths, cortex,
differentiating keratinocytes

Arrector pili muscle

Small bundle of smooth muscle that extends from the

midpoint of the fibrous sheath to the dermal papillary
layer; contraction pulls the hair shaft to a more erect
position

Three phases of hair growth

Anagen (long period of mitotic division)

Catagen (brief period of arrested growth, regression of hair bulb)
Telogen (final long period of inactivity during which hair may be
shed)

Sebaceous gland

Branched acinar gland with several acini converging

at a short duct that usually empties into the upper
portion of a hair follicle; holocrine secretion of
sebum

Sebocyte

Cell in a sebaceous gland that has undergone terminal

differentiation into a large, lipid-producing cell filled with small fat
droplets; this cell's nucleus and organelles will atrophy and the cell
will lyse to release its lipids as sebum

Sebum

A complex mixture of lipids, including wax, esters, squalene,

cholesterol, and triglycerides; covers hair shaft and epidermis;
helps maintain stratum corneum and hair shafts and exerts weak
antibacterial and antifungal properties

Eccrine sweat glands

Coiled glands with stratified cuboidal epithelium; widely

distributed in the skin; composed of three cell types:
clear cells, dark cells, and myoepithelial cells

Clear cells

Pale-staining cells of eccrine sweat glands that

produce sweat by transporting interstitial
fluid from the dermis into the gland's lumen

Dark cells

Cells in an eccrine sweat gland that are filled with

eosinophilic granules that undergo merocrine secretion
to release glycoproteins; line the gland's lumen and do
not touch the basal lamina

Myoepithelial cells

Cells in an eccrine sweat gland that contract to

move the watery secretion into the duct;
located on the basal lamina

Apocrine sweat glands

Secretory glands that are confined to the skin of the axillary and
perineal regions; develop during puberty; larger lumens with
simple cuboidal, eosinophilic cells that undergo merocrine
secretion; secretory product is more protein-rich; ducts open into
hair follicles

Fibroblasts

Cells that synthesize the extracellular

matrix, collagen, and stroma; plays a
major role in wound healing