Mechanism of xerosis

Invasion of Mycobacterium leprae bacteria in skin area, nerves, airway, sweat glands & hair
follicles. Mycobacterium leprae will migrate along the exoplasm. Phagocytes by perineum cells.
Crossing endoneurium & Schwan cells. Mycobacterium leprae will be destructing Schwan cells on
nerves. It will disturb the autonomic nerves system. Physical disability and deformity in leprosy occurs
due to nerve damage (resultant sensory, autonomic and motor impairment). Impulse from brain travels
to sweat glands stimulating glands to function. Trophic changes in the form of loss of sweating, absence
of hair and dry shiny skin are noticed in the affected area. Dryness of the skin makes it less supple and
skin may crack on repeated movement of the joint.

Mecahnism of squamous
There are two possibilities which could form squamous based on the scenario:
1. Melanin biosynthesis occurs within melanosomes, under genetic influences and can be affected
also by external stimuli such as sunlight. There are two forms of melanin namely eumelanin
which gives dark color (black-coklkat) and pheomelanin give a bright color (yellow-reddish).
Both are in synthesis of tyrosine oxidation by tyrosinase enzymes, through a path known as
Raper Mason Pathway. Tyrosine is converted to DOPA and quinon DOPA first before it
becomes eumelanin (via indole quinon) or pheomelanin (via cysteinyl DOPA). If the synthesis
is reduced or there is a decrease in the transfer rate melanosomes from melanocytes to
keratinocytes as well as increased desquamation of the stratum corneum cause a hypopigmented
state of the skin or vice versa.
2. The living cells of the basal stratum undergo differentiation, then move upwards (stratum
corneum) into dead cells containing keratin. In the stratum corneum the horn cells produce
keratocyte cells undergoing keratinization. But because of an inflammatory process that causes
the process of keratinization disturbed. The dead horn cells undergo a buildup and then cause
the formation of skuama on the skin.
References:
Graham-Brown, Robin. 2005. Lecture Notes: Dermatologi. Edisi VIII. Jakarta: Erlangga. Hal. 126-128
Karosentoro, Harijono. 2013. Kelainan Pigmentasi Kulit dan Penuaan serta Peran Pendidikan
Kedokteran Dibidang Ilmu Kesehatan Kulit dan Kelamin. UNS Press