Skin and Appendages

Dr. WONG Wai Kai

School of Biomedical Sciences,
Faculty of Medicine, CUHK.
(wongwaikai@cuhk.edu.hk)
Learning Objectives
- Describe the basic architecture of skin, includes the epidermis,
dermis and associated subcutaneous tissues (hypodermis).
- Describe the functions of skin with respect 4 primary cell types
and tissues.
- Distinguish between thick skin and thin skin
- Compare the anatomy and functions of the skin accessory
structures: hair follicle, sweat glands and nails
- the structure of sebaceous glands and sweat glands

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Function of Skin

- Protection: - prevents dehydration by controlling water loss

- prevents infection
- protects inner tissues from UV damage
- Thermoregulation: - superficial vasculature
- sweat glands
- hairs
- Sensation: touch, pressure and pain sensitive receptors
- Vitamin D metabolism
- Fat storage

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 Structures and components of Skin
Sweat pore
Components: Hair follicle
- Skin: (hair roots)
layers: epidermis Hair shaft
dermis Dermal
Epidermis papillae
hypodermis (ridges)
- Appendages: Sebaceous
Dermis gland
hair,
nail, Arrector
pili muscle
glands
Lymph vessel
(sweat, sebaceous)
Nerve
Hypodermis
(Subcutaneous
tissue)

Hair bulb
Adipose tissue
Vein
Artery

Sweat gland

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Epidermis and Dermis
Epidermis

Keratinized stratified squamous

epithelium on a basement
membrane*

4 primary cell types:

keratinocytes, melanocytes,
Langerhans cells and Merkel cells

Basement membrane
Dermis
Papillary layer -
loose areolar connective tissue
contains capillaries.

Reticular layer -
Dense irregular connective tissues
consists of collagen and elastic fibers

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Four Primary Cell Types Within Epidermis

Keratinocytes:
Major cell type (90%), produce keratin
which is waterproofing.

Melanocytes:
About 8%, produce brown pigment.
melanin.

Langerhans cells:
Macrophages, involve in immune
response.

Tactile (Merkel) cells:

Sensory receptor cells for light touch,
but rare in number.

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Epidermis - Keratinocytes
- Most abundant (90%) in epidermis.

- Actively dividing cuboidal shape cells (B

– stratum basale)

- Polyhedral shaped cells with prominent

nucleolus. Tightly connected by
desmosomes which appear as spinous
processes between cells. (S – stratum
spinosum)

- Squamous shaped cells roduce and

deposit keratin granules (G – stratum
granulosum)

- An impermeable layer (thickness varies)

serves as a water barrier (C – stratum
corneum)
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 Epidermis – Melanocytes (UV protection)
Darker skin color/ Lighter skin color/
after UV exposure Low UV exposure
- Melanocyte, which is an oval shaped cell with
cellular processes, locates in the basal layer and in
contact with a group of surrounding 36-40 nearby Keratin layer

keratinocytes, together contribute to the skin color.

Keratinocytes
(granular layer)
- Under UV exposure, melanocytes are excited and
produce melanin granules, then picked up by Melanosome

keratinocytes through endocytosis, as a shield to

Keratinocytes
protect further damage to the basal cells and the (prickle cell

dermis. Thus, the skin become tanned

layer)

Melanocyte

Melanocytes under specific staining

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 Skin Pigmentation and Disease
- Variation of skin color across different ethnic groups
as a result of melanin pigment producing power,
rather than difference in number of melanocytes.

- Vitiligo – irregular patches of skin with

depigmentation (lighter color);
- autoimmune/genetic diseases,
viral infection attack melanocytes

- Melanoma - uncontrolled differentiation

of melanocytes which
becomes malignant tumor
melanocytes melanoma

Brazilian child with vitiligo (1786)

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Epidermis – Langerhans Cells
- Star-shaped macrophages, clear
cytoplasm.

- Rare (<1%) in epidermis, mostly

found in spinous layer (stratum
spinosum).

- Contribute to immune response

(include autoimmune response)

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Epidermis – Merkel Cells
- Oval/cuboidal-shaped cell associated
with tactile disc at the boundary
between dermis and epidermis.

- Light touch receptor

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Sensory Receptors in Skin

Meissner’s corpuscle
(light touch –
low frequency vibration)

Pacinian corpuscle Ruffini organ Merkel cells Free nerve endings

(Strong touch/pressure – (stretch) (light touch) (nociceptor -
High frequency vibration) temperature and pain) 13
Degree of Burning

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Percentage of Burning and Skin Grafting

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Thick and Thin Skin (I)

Thick epidermis Hair shaft

Thick keratin Sweat pore
Thin keratin

Dermal papillae
Superficial vascular
plexus
Dermal papillae

Touch receptor Arrector pili muscle

Sweat duct Sebaceous gland

Deep dermal
vascular plexus

Subcutaneous fat

Hair follicle
Sweat duct
Nerve fibers
Sweat gland
Sweat gland
Pressure receptor
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Thick and Thin Skin (II)

Keratin

Keratin

Thick skin Thin skin

Location palm and sole most of the body surface

Keratin thick thin
Fingerprint present absent
Hair absent hairy
Sebaceous gland absent abundant
Sweat gland more less
Sensory receptors more less
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 Hair and Hair Follicle
- Hair follicle - downward growth of epidermis, with a hair bulb at the terminal
end.
- Hair bulb - an enlarged region for hair growth from germinal matrix, supplied
by blood vessels in connective tissues papilla
- Hair - composed of dead, keratinized cells held together by extracellular
protein

Hair

Epidermis

Dermis

Hypodermis
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 Dermal papilla
Dermal papilla – inward growth of hair germinal matrix into
the hair bulb with vascular supply Medulla
Tip

Cuticle

Glassy membrane Root

Outer root-sheath

Inner root-sheath

Cuticle

Hair Cortex
bulb
DP
Medulla

Longitudinal section Transverse section 19

 Structure of Sebaceous Gland (Holocrine)
Sebaceous gland - produces sebum by necrosis (cell death) of sebaceous cells and
release this oily secretion to nourish the hair (holocrine)

HF

PC
SC

SG
HF
HR

HF: hair follicle; HR: hair root; SG: sebaceous gland; SC: sebaceous cells (secretory);
PC: precursor cells 20
 Arrector Pili Muscles
Arrector pili muscle – attaches to the hair follicle and runs obliquely into upper dermis,
smooth muscle under sympathetic control, contract and erect the hair

* HR

SC
SG

HF

PC

AP

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 Sweat Gland (Eccrine or Merocrine)
Eccrine Sweat gland – a group of simple cuboidal cells are
surrounded by continuous layer of myoepithelial cells,
together formed coiled tubules present in dermis;
secretory cells maintain intact while producing watery excretion
Sweat duct - stratified cuboidal cells (double layers), vertical duct;
directly drain sweat to sweat pore on the epidermal surface;
coiled at two ends - proximal to sweat gland and in epidermal layer

sweat duct

myoepithelial cell

secretory cell

sweat gland

Transverse section of eccrine sweat gland Longitudinal section of sweat gland and sweat duct 22
 Sweat Gland (Apocrine)
Apocrine gland – become active after puberty, find in axillae & perineal region.
similar to eccrine but with larger lumen, cuboidal secretory cells are
surrounded by discontinuous layer of myoepithelial cells;
The apical side of secretory cells are “pinched off” and discharged
Duct – resemble eccrine duct, but opens into upper part of hair follicle unit
underneath epidermal layer, usually above the entrance of sebaceous duct
myoepithelial
cell

secretory cell
with apical side
pinching off

secretory
lumen with
fragment
cell fragment

Transverse sections of apocrine sweat gland 23

 Nail
Nail (Nail plate) - waxy layer of thick keratin produced by the nail matrix,
- slides on the nail bed toward to the tip of finger as the nail grows
Nail matrix – modified stratified squamous epithelium secretes keratin for nail growth

Eponychium Cuticle

Nail matrix Nail plate

Nail bed

Hyponychium

Finger print

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Nail Fold, Nail bed and Nail Matrix
Nail fold Cuticle

Nail plate
Nail bed

Dermis

Nail matrix

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