DMS

Skin Immunology
Ageng Brahmadhi

Integumentum layers

Functions

Protection against injury, bacterial invasion, and

desiccation

Regulation of body temperature

Reception of continual sensations from the

environment (e.g., touch, temperature, and pain

Excretion from sweat glands
Absorption of ultraviolet radiation from the sun for
the synthesis of vitamin D.

Epidermis

Mainly composed by Stratified squamous keratinized epithelium

another cells population:

Keratinocytes
Langerhans cells
Melanocytes
Merkel cells

Based on epidermis layer skin divided into 2 class:

Thick skin:

soles of feet, palms of hands

5 layer of epidermis

Thin skin

Most skin
4 layer of epidermis

Dermis (Corium)

The layer of skin immediately deep to the epidermis

Divided into two layers

papillary layer
reticular layer

Contains all the cells of connective tissue proper

Accessory organs :hair follicles and sweat glands,
Networks of blood vessels, lymph vessels, and nerve fibers

Hypodermis

Not a part of skin

Mostly adipose tissue (some

areolar)
Obesity due to accumulation
of subcutaneous fat
About 8% thicker in women
than men
Functions:
Binds skin to underlying tissue
Energy reservoir (fat)
Thermal insulation
Padding/cushioning

Skins Defense System

Inherent
Skin Immune System

Inherent (Non-immune) Skin Defenses

Physical

Resistance to mechanical trauma

Relatively water impermeable
Physical separation between self and nonself

Chemical

Free fatty acids

Free radical trapping
Antimicrobial peptides

Inherent Skin Defenses (contd)

Photoprotective

Melanin as a UV chromophore

Injury repair

Microbiological

Sebum production

Home for colonizing, nonpathogenic bacteria that:

Compete for nutrients

Compete for attachment
Produce antibacterial substances

Skin Immune System

Components
1. Cells: APCs, Phagocytes, lymphocytes, endothelial cells,
keratinocytes
2. Humoral components
3. Draining regional lymph vessels and nodes

Innate Immune Features of the Skin

No specialization for skin

Cellular component

Phagocytes: Macrophages, neutrophils, NK cells

Mast cells

Humoral:

Complement
Cytokines, histamine

Cells of the Cutaneous Adaptive Immune Response

Langerhans cell
Dermal dendrocytes
Keratinocytes
T-cells
Endothelial cells
B-cells
( T-cells)

Some cellular components of the skin

immune system
Keratinocytes

Prime role

make the protective horny layer

support to the outermost epithelium of the body
immunological functions
Produce large numbers of cytokines
Can be induced by -interferon to express HLA-DR

Produce -melanocyte-stimulating hormone immunosuppressive.

Upregulate ICAM-1

Expressed MHC II present antigen

Healing in epidermal injury

Cytokines produce by kertainocytes

Langerhans cells

Bone marrow-derived, Dendritic-shaped cell, Birbeck

granules
Migration and maturation
Bone marrow Blood (M) Epidermis (LC/ Langerhans cells)
Afferent lymph (VC/ veiled cells) Lymph node (FDC/
Follicular dendritic cells)

Functions

Antigen capture and processing

Presentation of antigen
Potent co-stimulator of nave T-cells
Produce activating cytokines

Langerhans cells

Dermal dendritic cells

poorly characterized cells

found around the tiny blood vessels of the papillary
dermis.
MHC Class II antigens
probably function as antigen presenting cells

Mast cells

present in most connective tissues, predominantly around

blood vessels
granules contain inflammatory mediators

Stimuli:
Immunologic : IgE binding antigen
Nonimmunologic: Physical, drugs, complement

Mast Cells

Endothelial Cells

Increase permeability

When activated, endothelial cells

cell surface expression of P and E-selectin enhanced

leukocyte margination

expression of VCAM-1 & ICAM-1 stop leukocytes and allow

diapedesis

Immune response amplified

 T-Cells

Intraepidermal lymphocytes
Resident in epithelia; do not recirculate
Restricted -TCR
Presence and function in human skin are still
controversial
May play a role in combating antigens that enter through
the skin

Another cells types:

T lymphocytes

T-helper (TH)/inducer cells

T-cytotoxic (TC) cells

L cells/null (non-T, non-B) cells

Natural killer cells

Molecular components of the skin immune system

Antigens and haptens

Superantigens
Antibodies (immunoglobulins)
Cytokines
Adhesion molecules

Cellular adhesion molecules (CAMs)

Histocompatibility antigens

Skin immunopathology
Mechanism

Disease

Viral infection

Varicella /herpes zoster

HSV1 & HSV2

Type IV
hypersensitivity

Tuberculin test
Contact dermatitis

Type I
Hypersensitivity
Bacterial infection

Urtikaria (wheal and flare) Mast cell, Th2, IgE

M. Leprae (intracellular)
Staphylococcal infection
(extracellular)

Immune
components
involved
Class I MHC
molecules
Cytotoxic T cell

Cell mediated
immunity

Th1 & Th2 response

Antibody, Th2,
complement

The keratinocyte and wound healing

T-lymphocyte activation

Type I: immediate hypersensitivity reactions

Urticaria: an immediate (type I) hypersensitivity reaction

Type II: humoral cytotoxic reactions

Bullous pemphigoid; a humoral cytotoxic (type II) reaction against a basement membrane zone antigen.

Type III: immune complex-mediated reactions

Immune complex-mediated vasculitis (type III reaction)

Type IV: cell-mediated immune reactions

Induction phase of allergic

Elicitation phase of allergic

contact dermatitis

contact dermatitis

Response to intracellular antigens

Intracellular fungi or viruses and tumour antigens

presented to cytotoxic T cells (CD8+) by the MHC Class I

molecule to destruction by cytotoxic T lymphocytes or K
cells.

Further readings

Skin Immune System; Cutaneous Immunology and Clinical

Immunodermatology Third Edition
Clinical Dermatology