The skin is made up of three layers:

Epidermis

Dermis

Hypodermis or subcutaneous fat

EPIDERMIS is a stratified squamous keratinized EPITHELIUM

It consists of five layers:
STRATUM Basale

STRATUM Spinosum

STRATUM Granulesum

STRATUM Lucidum

STRATUM Corneum

There are two types of skin depending on the structure of the epidermis: thin skin and thick skin
Thick skin (pulms and soles)has all five layers of the epidermis, the stratum corneum of this type of skin
is thick, it has no hair!
Thin skin (skin of remaining regions of body) has a four-layer epidermis (no lucidum layer), the stratum
corneum is thinner, there is hair!

The epidermis is made up a variety of cell types. Cell that contain keratin are known as
keratinocytes. These are stratified squamous epithelial cells that are shed from the surface of the
skin daily. They are the progeny of cells in the basal layer.

There are also mature non-keratinocytes that exist in the epidermis.

These include the melanocytes: (which are derived from neural crest), synthesize and store
melanin, which not only contributes to the color of the skin and hair, but also provides
protection against ultraviolet radiation. They appear as clear star shaped cells in the basal layer
with large, round, euchromatic nuclei and melanosomes (granules with melanin). It is possible
for a single melanocyte to provide melanin for approximately 30 keratinocytes via its dendritic
arborisation.

The Langerhans cells that arise from bone marrow. They are MACROPGHAGES of
epidermis! Serve as antigen presenting cells. They are star shaped, distributed throughout the
strata spinosum and basale, sparing only the sweat glands. These cells can be readily identified
by a hallmark tennis racket-like discoid Birbeck granule, in addition to its euchromatic
cytoplasm and Golgi complex.

There are also mechanoreceptors within the epidermis that facilitate sensory perception. The
Merkel cells are clear, ovoid and may occur singly or in clusters in the stratum basale. Free
nerve endings in the form of expanded discs are present at the base of these cells. Merkel cells
may act as a sensory mechanoreceptors and are also thought to function as neuroendocrine
sensory receptors.

Layers:
The stratum basale is the deepest layer of the epidermis (closest to the dermis). It consists of
a single layer of columnar or cuboidal cells which rest on the basement membrane. Basal cells
are the stem cells of the epidermis. Their mitotic activity replenishes the cells in more superficial
layers as these are eventually shed from the epidermis. So, cells of this layer provide
regeneration of epidermis. Keratinocytes contain nucleus,well developed organells, few keratin
tonofilaments. They are connected by desmosomes! And with basal lamina by
hemidesmosomes!

In the stratum spinosum, the keratinocytes become irregularly polygonal and they form 5-
10 layers of cells. The cells are often separated by narrow, translucent clefts. These clefts are
spanned by spine-like cytoplasmatic extensions of the cells (hence the name of the layer and of
its cells: spinous cells), which interconnect the cells of this layer. Spines of cells meet end-to-end
or side-to-side and are attached to each other by desmosomes. In addition to the nucleus, usual
organelles, cells shows membrane-bound lamellar granules in the cytoplasm of the spinous cells.
First thick keratin tonofibrils apper in this layer!

The stratum granulosum consists, in thick skin, of a few layers (3-4) of flattened cells.
Only one layer may be visible in thin skin. In the keratinocytes of this layer, the destruction of
organelles and nuclei begins! Desmosomes are present between cells! Proteins and granules
appear in the cytoplasm! Proteins: fillagrin (combine the remains of organelles into one mass
and promotes the formation of keratin tonofibrils), involucrin (located under the cell membrane
and contributes to its strengthening)! Granules: keratohyaline and lamellar (they contain
ceramides to create a waterproof barrier of the epidermis)! The keratohyalin is not located in
membrane-bound organelles but forms "free" accumulations in the cytoplasm of the cells. The
cells begin to release the contents of the lamellar granules. The lipids contained in the granules
come to fill the entire interstitial space, which is important for the function of the epidermis as a
barrier towards the external environment.

The stratum lucidum consists of several layers of flattened dead cells. No organells, no
nucleus. Nuclei already begin to degenerate in the outer part of the stratum granulosum. In the
stratum lucidum, faint nuclear outlines are visible in only a few of the cells. Cytoplasm is filled
with keratin tionfibrills. Desmosoms still presenr between cells! The stratum lucidum can usually
not be identified in thin skin.

In the stratum corneum, cells are completely filled with keratin filaments (horny cells)
which are embedded in a dense matrix of proteins. Individual cells are difficult to observe
because nuclei can no longer be identified, the cells are very flat and the space between the cells
has been filled with lipids, which cement the cells together into a continuous membrane. The
cells are dead, they have nothing exept keratin! Desmosomes disappear, so the cells are easily
separated from the surface of the epidermis!
DERMIS- is connective tissue! Consist of papillary and reticular layers!
Papillary layer is formed by loose irregular connective tissue!

The more superficial of the two is the papillary layer. It is characterized by dermal papillae,
which are raised irregular projections that interlace with the epidermal ridges of the epidermis.
Apically, the papillae are blunted and can be separated into cusps. They are less abundant and
smaller in thin skin that has minimal mechanical stress, when compared to in areas of thicker
skin (i.e. palms and soles), where they tend to form curved parallel lines.

Fine type III collagen is typically found in throughout this layer (especially in the perivascular
regions) of the dermis. Keratinocytes of the basal layer are attached to the fibrous matrix in the
papillary layer through connections to hemidesmosomes. Subsequently, the hemi-desmosomes
are attached to the type VII collagen fibrils through the anchoring filaments of the basal
membrane. The type VII collagen runs deep in the papillary dermis and therefore provides
mechanical stability to the epidermal substratum. Overall, the papillary layer not only gives
mechanical support to the epidermis, but it also provides metabolic sustenance as well.

Reticular layer is formed by dense irregular connective tissue!

Deep to the papillary layer is the reticular layer of the dermis. There is no clear demarcation
between the two structures. Unlike the papillary layer, the reticular layer contains mostly coarse
type I fibers with variable number of elastic fibers. There is significant interaction between the
type I and type III fibres in both layers to the point where a sturdy, yet malleable, lattice is
formed.

In 1861, Karl Langer (an Austrian anatomist) discovered the now widely accepted Langer’s
lines. These topographical landmarks are used in surgical procedures as guidelines for points of
incisions. Otherwise known as cleavage lines, these markings correspond with the orientation of
dermal collagen fibres. Incision along these lines result in healing with minimal scarring and
subsequently, a less apparent postoperative scar.