What Type Of Tissue Makes Up The Epidermis Of The Skin

Introduction

Skin is the largest organ in the trunk and covers the body's unabridged external surface. It is fabricated up of three layers, the epidermis, dermis, and the hypodermis, all three of which vary significantly in their anatomy and function. The peel's structure is made up of an intricate network which serves as the trunk'southward initial bulwark against pathogens, UV light, and chemicals, and mechanical injury. It also regulates temperature and the amount of water released into the environment. This article discusses the relevant anatomical structures of the skin's epidermal layer, its structure, function, embryology, vascular supply, innervation, surgical considerations, and clinical relevance.

Peel Thickness

The thickness of each layer of the skin varies depending on trunk region and categorized based on the thickness of the epidermal and dermal layers. Hairless skin found in the palms of the hands and soles of the feet is thickest because the epidermis contains an extra layer, the stratum lucidum. The upper dorsum is considered thickest based on the thickness of the dermis, only it is considered "thin skin" histologically because the epidermal thickness lacks the stratum lucidum layer and is thinner than hairless skin.

Layers of Epidermis

The layers of the epidermis include the stratum basale (the deepest portion of the epidermis), stratum spinosum, stratum granulosum, stratum lucidum, and stratum corneum (the most superficial portion of the epidermis).

Stratum basale, besides known as stratum germinativum, is the deepest layer, separated from the dermis past the basement membrane (basal lamina) and attached to the basement membrane past hemidesmosomes. The cells found in this layer are cuboidal to columnar mitotically active stalk cells that are constantly producing keratinocytes. This layer also contains melanocytes.

Stratum spinosum, 8-x cell layers,besides known as the prickle cell layer contains irregular, polyhedral cells with cytoplasmic processes, sometimes called "spines", that extend outward and contact neighboring cells past desmosomes. Dendritic cells can exist institute in this layer.

Stratum granulosum, three-five cell layers, contains diamond shaped cells with keratohyalin granules and lamellar granules. Keratohyalin granules contain keratin precursors that somewhen amass, crosslink, and grade bundles. The lamellar granules contain the glycolipids that get secreted to the surface of the cells and function equally a gum, keeping the cells stuck together.

Stratum lucidum, 2-3 prison cell layers,present in thicker peel found in the palms and soles, is a thin clear layer consisting of eleidin which is a transformation product of keratohyalin.

Stratum corneum, 20-30 cell layers,is the uppermost layer, made up of keratin and horny scales made up of dead keratinocytes, known as anucleate squamous cells. This is the layer which varies most in thickness, especially in callused skin. Within this layer, the expressionless keratinocytes secrete defensins which are role of our first allowed defense force.

Cells of the Epidermis

• Keratinocytes

• Melanocytes

• Langerhans' cells

• Merkel'due south cell

Keratinocytes

Keratinocytes are the predominant cell type of epidermis and originate in the basal layer, produce keratin, and are responsible for the germination of the epidermal water barrier past making and secreting lipids. Keratinocytes also regulate calcium absorption by the activation of cholesterol precursors by UVB light to form vitamin D.

Melanocytes

Melanocytes are derived from neural crest cells and primarily produce melanin, which is responsible for the pigment of the skin. They are found between cells of stratum basale and produce melanin. UVB calorie-free stimulates melanin secretion which is protective against UV radiation, interim every bit a congenital-in sunscreen. Melanin is produced during the conversion of tyrosine to DOPA by the enzyme tyrosinase. Melanin and then travels from cell to cell by a process that relies on the long processes extending from the melanocytes to the neighboring epidermal cells. Melanin granules from melanocytes are transferred via the long processes to the cytoplasm of basal keratinocyte. Melanin transferred to neighboring keratinocytes past "paint donation"; involves phagocytosis of tips of melanocyte processes by keratinocytes.

Langerhans' Cells

Langerhans cells, dendritic cells, are the skins first line defenders and play a significant office in antigen presentation. These cells need special stains to visualize, primarily found in the stratum spinosum. These cells are the mesenchymal origin, derived from CD34 positive stem cells of bone marrow and are role of the mononuclear phagocytic system. They contain Birbeck granules, tennis racket shaped cytoplasmic organelles. These cells express both MHC I and MHC 2 molecules, uptake antigens in skin and transport to the lymph node.

Merkel Cells

Merkel cells are oval-shaped modified epidermal cells found in stratum basale, directly above the basement membrane. These cells serve a sensory role as mechanoreceptors for light touch, and are most populous in fingertips, though also found in the palms, soles, oral, and genital mucosa. They are leap to adjoining keratinocytes past desmosomes and contain intermediate keratin filaments and their membranes collaborate with costless nerve endings in the skin.

Dermis

The dermis is continued to the epidermis at the level of the basement membrane and consists of two layers, of connective tissue, the papillary and reticular layers which merge together without clear demarcation. The papillary layer is the upper layer, thinner, composed of loose connective tissue and contacts epidermis. The reticular layer is the deeper layer, thicker, less cellular, and consists of dense connective tissue/ bundles of collagen fibers. The dermis houses the sweat glands, hair, hair follicles, muscles, sensory neurons, and claret vessels.

Hypodermis

The hypodermis is deep to the dermis and is besides called subcutaneous fascia. It is the deepest layer of skin and contains adipose lobules forth with some skin appendages similar the hair follicles, sensory neurons, and blood vessels.

Structure and Function

The skin has many functions. It serves equally a barrier to water, invasion past microorganisms, mechanical and chemical trauma, and damage from UV low-cal. The epidermal water barrier established past the cell envelop, a layer of insoluble proteins on the inner surface of the plasma membrane. It is formed past cantankerous-linking of modest proline-rich proteins and larger proteins like cystatin, desmoplakin, filaggrin and contributes to strong mechanics of barrier. And the lipid envelope, a lipid/hydrophobic layer fastened to the outer surface of the plasma membrane. As keratinocytes in stratum spinosum produce keratohyalin granules, they also produce lamellar bodies (containing a mixture of glycosphingolipids, phospholipids, and ceramides) assembled inside Golgi.  Lamellar bodies' contents are then secreted by exocytosis into extracellular spaces between the stratum granulosum and corneum. Pare is the first site of immunologicaldefense by the action of the Langerhans cells in the epidermis which are dendritic epidermal T lymphocytes and part of the adaptive immune system. The skin preserves the bodies homeostasis by regulating temperature and water loss, while as well serving both endocrine and exocrine functions. The endocrine functions include the product of vitamin D in the keratinocytes which are responsible for converting 7-dehydrocholesterol in the epidermis to vitamin D, with the assistance of UV lite from the sun. The keratinocytes express the vitamin D receptor (VDR) and also contain the enzymes needed to catechumen vitamin D to its active form of 1, 25 dihydroxy vitamin D. The significance of the VDR is that stimulation of information technology plays a role in the proliferation of the stratum basale and differentiation of keratinocytes as they movement upwards in the epidermis. The exocrine functions of the skin are by way of the sweat and sebaceous glands. Another important role of the pare is asensation to bear on, heat, common cold, and pain by the actions of the nociceptors. The general advent, turgor, and other qualities also give insight into the full general health of the body. [7][8][9][10]

Embryology

The epidermis is derived from ectodermal tissue. The dermis and hypodermis are derived from mesodermal tissue from somites. The mesoderm is also responsible for the formation of Langerhans cells. Neural crest cells, responsible for specialized sensory nervus endings and melanocyte formation drift into the epidermis during epidermal development. [11][12]

Blood Supply and Lymphatics

Blood vessels and lymphatic vessels are establish in the dermal layer of the skin. Claret supply to the peel is an arrangement of ii plexuses, the get-go lies between the papillary and reticular layers of the dermis and the 2nd prevarication betwixt the dermis and subcutaneous tissues. Supply to the epidermis is by way of the superficial arteriovenous plexus (subepidermal/papillary plexus). These vessels are important for temperature regulation. The mechanism by which the body regulates temperature through the pare is very effective and works by increased claret menstruation to the skin, transferring heat from the body to the environment. The changes in claret menstruum are controlled by the autonomic nervous organization, sympathetic stimulation resulting in vasoconstriction (heat retention) and while vasodilation results in heat loss. Vasodilation of the claret vessels is the response to increased body temperature and is the consequence of inhibition of the sympathetic centers in the posterior hypothalamus whereas decreased body temperature will cause vasoconstriction of skin blood vessels. [13] [fourteen]

Nerves

Fretfulness of the skin include both somatic and autonomic fretfulness. The somatic sensory system is responsible for pain (nociceptors), temperature, light touch, discriminative impact, vibration, pressure level, and proprioception medicated primarily by specialized cutaneous receptors/end organs including Merkel disks, Pacinian corpuscles, Meissner'southward corpuscles, and Ruffini corpuscles. The autonomic innervation is responsible for the command of the tone of the vasculature, pilomotor stimulation at the hair root, and sweating. The complimentary nervus endings extend into the epidermis and sense pain, heat, and common cold. They are most numerous in the stratum granulosum layer and surround almost hair follicles. Merkel disks sense light bear upon and reach the stratum basale layer. The other nerve endings are found in the deeper portions of the skin and include the Pacinian corpuscle which senses deep pressure level, Meissner's corpuscle which senses low-frequency stimulation at the level of the dermal papillae, and Ruffini corpuscles which sense pressure. [15][16][17]

Muscles

The arrector pili muscles are bundles of smooth musculus fibers that attach to the connective tissue sheath of hair follicles. When the muscles contract, they pull the hair follicle outward resulting in the hair erecting up merely as well compresses the sebaceous glands, resulting in the secretion of their contents. Hair does non get out perpendicularly, just instead at an angle. This erection of hair besides produces goosebumps, the bumpy appearance of the pare. [eighteen]

Physiologic Variants

Skin is continuously shedding and desquamating and varies slightly depending on the body region. There are more layers of cells in thicker hairless peel with an boosted layer, known equally the stratum lucidum. Overall, the process of cell division, desquamation, and shedding become as follows:

1. Cell segmentation occurs in stratum basale/germinativum. One cell remains, another cell is pushed toward the surface. Basal cells begin synthesis of tonofilaments (equanimous of keratin) which are grouped into bundles (tonofibrils).

2. Cells are pushed into stratum spinosum. In the upper part of the spinous layer, cells begin to produce keratohyalin granules having intermediate-associated proteins, filaggrin, and trichohyalin; helps aggregate keratin filaments and conversion of granular cells to cornified cells, i.eastward. keratinization. Cells also produce lamellar bodies.

3. Cells are pushed into stratum granulosum and go flattened and diamond shaped. The cells accrue keratohyalin granules mixed between tonofibrils.

4. Cells go along to stratum corneum where they flatten and lose organelles and nuclei.  The keratohyalin granules turn tonofibrils into a homogenous keratin matrix.

5. Finally, cornified cells accomplish the surface and are desquamated via a break-down of desmosomes. Proteinase action of KLK (kallikrein-related serine peptidase) is triggered by lowered pH well-nigh the surface.[19][xx]

Surgical Considerations

Langer's Lines, also known equally cleavage lines, are topological lines used to ascertain the tension of the skin, corresponding to the alignment of collagen and elastic fibers in the reticular dermis. Surgical incisions fabricated forth these lines, less scarring volition occur. [21]

Clinical Significance

There are numerous clinically significant aspects of the pare, including the dermatomes of the skin, skin segments divided based on the afferent fretfulness they are supplied by which are numbered co-ordinate to the level of spinal vertebral from which they arise. In that location are 7 cervical, twelve thoracic, five lumbar, and five sacral. Certain diseases like shingles, caused by varicella-zoster infection, take pain sensation and eruptive rashes that involve a dermatomal distribution. Dermatomes are useful in the diagnosis of vertebral spinal injury levels. Aside from the dermatomes, the cells of the epidermis are susceptible to neoplastic changes resulting in various cancer types. Some autoimmune and immunological diseases target the desmosomes and hemidesmosomes founds in the epidermis. Sure infections can also disrupt the integrity of the epidermis forth with drug reactions that present variably as well.

Squamous cell carcinoma is cancer that arises from mutated keratinocytes, usually due to UV damage in individuals with Type I or Two pare types (lite skin, blue or light-green optics, blood-red or blonde pilus, burn and never tan) and often announced as scaly, flaky, thick red patches that may bleed or even appear wart-like. This type of pare cancer can metastasize. Squamous cell carcinoma may arise from actinic keratosis, which is also caused by sunday damage to the epidermal layer of skin and may have cutaneous horns. Basal cell carcinoma is a cancer of the basal layers of the epidermis and is much less likely to metastasize. This type of skin cancer is more common in sun-exposed areas and often announced are pearly papules on the confront, with telangiectasias and ulcerate easily. Melanomas are cancers of the melanocytes and have a high metastatic potential, significantly mediated past the depth of the lesion. Melanomas tin be found anywhere on the torso, are usually irregularly pigmented but tin be amelanotic. Langerhans Cell Histiocytosis is a type of cancer where Langerhans cells accumulate in the body and effect in the formation of granulomas, frequently in the bones, resulting in bone hurting. These granulomas can also appear in the skin like rashes, erythematous papules or blisters. An interesting clan with this condition is the outcome of the pituitary gland, which tin be affected and individuals may present with diabetes insipidus, infertility, or other endocrine diseases due to insufficient hormones. Other serious and deadly complications are due to pancytopenia (anemia, thrombocytopenia, leukocytopenia) every bit a straight response to overcrowding by the Langerhans cells. Merkel cell carcinoma is an uncommon cancer of the Merkel cells and is categorized every bit neuroendocrine small prison cell carcinoma

Pemphigus vulgaris is an autoimmune affliction that targets the intercellular proteins, desmosomes, that connect the keratinocytes to each other. Blisters grade within the epidermis and are easily ruptured, resulting in acantholysis histologically. This disease is associated with a positive nikolsky sign, peeling away from the epidermis with rubbing of that area. Bullous Pemphigoid is another blistering illness that results in tense subepidermal blisters in older populations, that are due to antibodies that target the hemidesmosomes that connect the epidermis at the level of the basement membrane to the extracellular matrix of the dermis. This condition is non acantholytic and is non associated with a positive nikolsky sign.

Infections that affect the integrity of the skin include scalded skin syndrome caused by the exfoliative toxin released past staphylococcal aureus bacteria infection. This infection results in peeling abroad of the skin, positive nikolsky, an advent of a astringent fire (very blood-red), and fever. Drug reactions like DRESS syndrome, erythema multiforme, Stevens-Johnsons syndrome, and Toxic Epidermal Necrolysis syndrome are oftentimes associated with sure medications that include sulfa-containing drugs, NSAIDs, and anti-seizure medications. [22][23][24][25][26][27][28][29]

Other Problems

The epidermal layer of pare contains much of our normal flora and the microbiome of the epidermis varies based on the body region. The microorganisms that inhabit our peel surface is nonpathogenic and can be commensal or mutualistic in nature. The bacteria that tend to predominate are staphylococci epidermidis, aureus, cutibacterium acnes, Corynebacterium, Streptococcus, candida and clostridium perfringens. When the protective pare barrier is altered, an infection can occur.  [thirty]

Review Questions

Figure

Histology, Trichodysplasia spinulosa, Trichodysplasia spinulosa polyomavirus, Healthy command on top, TS skin on the bottom, Skin over view, Epidermis, Hair follicle, Acanthosis, Eosinophilic poly peptide granules, trichohyalin, HE Stain. Contributed by Kazem (more...)

Figure

Cantankerous department of layers of the skin. Hair follicles, pilus roots and hair shafts, sweat glands, pores, epidermis, dermis, hypodermis. Papillary and reticular layer. Eccrine sweat gland. Arrector pili muscles, sebaceous oil glands. Contributed past Chelsea (more than...)

Figure

Analogy of cells of the epidermis. Stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale, dermis. Contributed past Chelsea Rowe

References

one.

Bonifant H, Holloway South. A review of the effects of ageing on skin integrity and wound healing. Br J Community Nurs. 2019 Mar 01;24(Sup3):S28-S33. [PubMed: 30817191]

2.

Herskovitz I, Macquhae F, Play a joke on JD, Kirsner RS. Skin motion, wound repair and development of engineered skin. Exp Dermatol. 2016 February;25(2):99-100. [PubMed: 26660718]

3.

Ravara B, Hofer C, Kern H, Guidolin D, Porzionato A, De Caro R, Albertin G. Dermal papillae flattening of thigh peel in Conus Cauda Syndrome. Eur J Transl Myol. 2018 Nov 02;28(4):7914. [PMC free commodity: PMC6317141] [PubMed: 30662702]

iv.

Rzepka Grand, Schaarschmidt Thousand, Nagler Thou, Wohlrab J. [Epidermal stem cells]. J Dtsch Dermatol Ges. 2005 Dec;3(12):962-73. [PubMed: 16405712]

five.

Karim N, Phinney BS, Salemi Thousand, Wu PW, Naeem M, Rice RH. Homo stratum corneum proteomics reveals cross-linking of a broad spectrum of proteins in cornified envelopes. Exp Dermatol. 2019 May;28(5):618-622. [PubMed: 30916809]

half-dozen.

Dark-brown TM, Krishnamurthy Thousand. StatPearls [Net]. StatPearls Publishing; Treasure Island (FL): May 10, 2021. Histology, Dermis. [PubMed: 30570967]

7.

O'Connell RL, Rusby JE. Anatomy relevant to conservative mastectomy. Gland Surg. 2015 December;4(6):476-83. [PMC free commodity: PMC4646999] [PubMed: 26645002]

8.

Andersson T, Ertürk Bergdahl Chiliad, Saleh M, Magnúsdóttir H, Stødkilde K, Andersen CBF, Lundqvist Grand, Jensen A, Brüggemann H, Lood R. Common peel bacteria protect their host from oxidative stress through secreted antioxidant RoxP. Sci Rep. 2019 Mar 05;9(1):3596. [PMC gratuitous article: PMC6401081] [PubMed: 30837648]

9.

Losquadro WD. Anatomy of the Pare and the Pathogenesis of Nonmelanoma Pare Cancer. Facial Plast Surg Clin North Am. 2017 Aug;25(iii):283-289. [PubMed: 28676156]

ten.

Slominski AT, Manna PR, Tuckey RC. On the role of pare in the regulation of local and systemic steroidogenic activities. Steroids. 2015 November;103:72-88. [PMC free article: PMC4631694] [PubMed: 25988614]

11.

Fenner J, Silverberg NB. Peel diseases associated with atopic dermatitis. Clin Dermatol. 2018 Sep - Oct;36(5):631-640. [PubMed: 30217275]

12.

Hall BK. Germ layers, the neural crest and emergent organization in development and evolution. Genesis. 2018 Jun;56(6-7):e23103. [PubMed: 29637683]

13.

Denkler KA, Denkler C. The Direction of Optimal Peel Incisions Derived from Striae Distensae. Plast Reconstr Surg. 2015 Jul;136(ane):120e-121e. [PubMed: 26111326]

14.

Schlader ZJ, Vargas NT. Regulation of Torso Temperature by Autonomic and Behavioral Thermoeffectors. Exerc Sport Sci Rev. 2019 Apr;47(two):116-126. [PubMed: 30632999]

fifteen.

Iizaka S. Skin hydration and lifestyle-related factors in customs-dwelling older people. Curvation Gerontol Geriatr. 2017 Sep;72:121-126. [PubMed: 28624752]

sixteen.

Stecco C, Pirri C, Fede C, Fan C, Giordani F, Stecco L, Foti C, De Caro R. Dermatome and fasciatome. Clin Anat. 2019 Oct;32(7):896-902. [PubMed: 31087420]

17.

Iheanacho F, Vellipuram AR. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Sep 12, 2021. Physiology, Mechanoreceptors. [PubMed: 31082112]

18.

Murphrey MB, Agarwal Due south, Zito PM. StatPearls [Cyberspace]. StatPearls Publishing; Treasure Island (FL): Aug eleven, 2021. Anatomy, Pilus. [PubMed: 30020684]

19.

Sanz-Gómez N, Freije A, Gandarillas A. Keratinocyte Differentiation past Flow Cytometry. Methods Mol Biol. 2020;2109:83-92. [PubMed: 31123997]

xx.

Wagner T, Beer L, Gschwandtner M, Eckhart L, Kalinina P, Laggner Grand, Ellinger A, Gruber R, Kuchler U, Golabi B, Tschachler E, Mildner Thousand. The Differentiation-Associated Keratinocyte Poly peptide Cornifelin Contributes to Cell-Cell Adhesion of Epidermal and Mucosal Keratinocytes. J Invest Dermatol. 2019 Nov;139(11):2292-2301.e9. [PubMed: 31129056]

21.

Lemperle One thousand, Knapp D, Tenenhaus M. Minimal Scar Germination After Orthopaedic Skin Incisions Forth Main Folding Lines. J Bone Joint Surg Am. 2019 Mar 06;101(v):392-399. [PubMed: 30845033]

22.

Tenea D, Dinkel J, Becker JC, van der Walt E. Merkel Jail cell Carcinoma of the Caput in a Immature African Albino Adult female with HIV/HTLV-1 Coinfection Associated with Multiple Squamous Cell Carcinomas. Case Rep Dermatol. 2019 Jan-Apr;11(one):113-122. [PMC free commodity: PMC6528093] [PubMed: 31143109]

23.

PDQ Adult Treatment Editorial Board. PDQ Cancer Information Summaries [Internet]. National Cancer Plant (US); Bethesda (Medico): Sep 3, 2021. Melanoma Treatment (PDQ®): Patient Version. [PubMed: 26389388]

24.

Cribier B. Ann Dermatol Venereol. 2019 May;146 Suppl ii:IIS10-IIS15. [PubMed: 31133224]

25.

PDQ Cancer Genetics Editorial Board. PDQ Cancer Data Summaries [Internet]. National Cancer Found (US); Bethesda (MD): Jul half dozen, 2021. Genetics of Skin Cancer (PDQ®): Health Professional Version. [PubMed: 26389333]

26.

Izumi Yard, Bieber Thousand, Ludwig RJ. Current Clinical Trials in Pemphigus and Pemphigoid. Front Immunol. 2019;10:978. [PMC free article: PMC6509547] [PubMed: 31130959]

27.

Jordan KS. Staphylococcal Scalded Peel Syndrome: A Pediatric Dermatological Emergency. Adv Emerg Nurs J. 2019 Apr/Jun;41(ii):129-134. [PubMed: 31033660]

28.

Vern-Gross TZ, Kowal-Vern A. Erythema multiforme, Stevens Johnson syndrome, and toxic epidermal necrolysis syndrome in patients undergoing radiations therapy: a literature review. Am J Clin Oncol. 2014 Oct;37(5):506-xiii. [PubMed: 22892429]

29.

PDQ Pediatric Handling Editorial Lath. PDQ Cancer Information Summaries [Internet]. National Cancer Institute (U.s.a.); Bethesda (Physician): Aug 27, 2021. Langerhans Prison cell Histiocytosis Treatment (PDQ®): Patient Version. [PubMed: 26389196]

30.

Sander MA, Sander MS, Isaac-Renton JL, Croxen MA. The Cutaneous Microbiome: Implications for Dermatology Practice. J Cutan Med Surg. 2019 Jul/Aug;23(four):436-441. [PubMed: 30938174]

Source: https://www.ncbi.nlm.nih.gov/books/NBK470464/

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