THE

INTEGUMENTARY SYSTEM

DR AISHA MOHD DIN

Department of Basic Sciences
The Skin
 epithelial and
connective tissues
working together for
specific purposes

 the largest organ of the

body
 1.5 - 2 square meters
 4 - 5 kg

 variable thickness: 1.5

mm to 4 mm
Skin Physiology - Many Functions
 regulation of body temperature – insulator, radiator by
thermoreceptors
 protection – a physical barrier and for water conservation
 sensation - varied sensory nerve endings (heat, cold, touch,
texture, pressure, vibration, and tissue injury)
 communication – to other humans by signals/expressions
and by touch
 excretion – in sweat = H2O, salts, small organic compounds
(a minor contribution to excretion)
 immunity – certain phagocytes in the epidermis are
important from the immune system for defense
 synthesis of Vitamin D –UV convert provitamin D3 to
previtamin D3 for calcium absorption
 The Structure of the Skin
2 Principal portions

1. Epidermis - epithelium

2. Dermis – areolar and

dense irregular fibrous
connective tissue

Hypodermis
 “beneath the dermis”
 the subcutaneous layer
next to:
 adipose layer or
 muscle or
 bone
 The Epidermis
 Stratified Squamous
Epithelium

 4 cell types
1. Keratinocytes - 90%
 filled with keratin (protein)
 waterproof barrier
2. Melanocytes - 8%
 produce melanin (pigment)
 pass melanin to keratinocytes
3. Langerhans cells
 phagocytes (from immune system)
 easily damaged by UV light
4. Merkel cells
 in deepest layer of hairless skin
 sensory transduction - touch
Epidermal Cell Layers
 Stratum basale
 A single layer of
cuboidal/columnar cells
 Stem cells, melanocytes,
Merkel cells
 Stratum spinosum
 8 to 10 layers of closely
packed keratinocyte cells
 Langerhan’s cells
 Epidermal Cell Layers
 Stratum granulosum
 3-5 layers of flattened, with
keratohyaline granules
 beginning breakdown of
nucleus, cell death initiated
 Stratum lucidum
 only in thick skin (palms, feet)
 3-5 layers of clear, flat dead
cells with keratin
 Stratum corneum
 20-30 layers of flattened, dead,
keratin-filled cells
 continuously shed and replaced
 2-4 weeks for each cell to
form and to move from the
stratum basale to the surface
 Epidermal Histology

 Stratum Corneum

 Stratum Granulosum
 Stratum Spinosum

 Stratum Basale
The Dermis - General
 primarily irregular dense fibrous conn. tissue
 variable thickness - thicker on palms and
soles; thicker on dorsal surfaces rather than
on ventral; thicker on lateral surfaces than on
medial surfaces
 few cells present - fibroblasts, macrophages,
adipocytes
 matrix thick with many protein fibers:
collagen, elastin, reticular
 the location for blood vessels, nerves and
sensory receptors, glands, hair follicles
 Dermis - Structure
 Papillary region
(layer) - outer layer
- 20%
 areolar connective
tissue, elastic fibers
 dermal papillae –
mound-like
projections to
increase the surface
area for nutrition
from capillaries
 some papillae
contain Meissner's
corpuscles (for light
touch)
 Dermis – Structure (cont.)
 Reticular region -
80%
 dense, irregular
connective tissue
 collagen, elastic
fibers in a network
surrounding the
various cells
 fibers give strength,
elasticity,
extensibility
 tears in reticular
region - "stretch
marks“ - long
straight red or
white streaks
Skin Pigment
Melanin - yellow to black
 Made by melanocytes
 Common in mucous membranes, penis, nipples, areolas,
face, extremities
 The number of melanocytes is similar in all races – but the
amount and type of melanin produced and distributed to
the keratinocytes varies
 Freckles, age spots - melanocyte clusters
 Melanin is synthesized from tyrosine (amino acid)
 UV radiation increases enzyme activity (negative feedback)
 melanin production protects the body against UV radiation
Skin Pigments

albino
vitiligo

Melanin Pathologies
 Albinism - inability to produce melanin; cannot
breakdown tyrosine, no melanin, inborn error of
metabolism; recessive trait
 Vitiligo - partial/complete loss of melanocytes from
skin patches
Skin Color – Clinical Terminology
 Erythema
 skin redness
 exercise, embarrassment,
high blood pressure,
certain drugs,
inflammation, etc.
 Pallor Erythema: Parvovirus /
“fifth disease”
 pale
 cold temperatures, stress
or anemia
 Cyanosis Pernicious anemia
 bluish, no oxygen
 babies not breathing,
heavy
smokers/emphysema Cyanosis
Skin Color – Clinical Terminology
 Jaundice
 yellow/orange
 after internal hemorrhage
 liver problems disturbing
the breakdown & removal
of RBC's
 Bronzing
 Metallic appearance of skin
 Addisons disease –
hypofunction of adrenal
cortex
 Black and blue marks,
bruises (contusions)
Skin Pathologies
 Basal cell carcinoma
 From stratum basale
 Least malignant - 99% full cure

 Squamous cell carcinoma

 From stratum spinosum
 Prognosis is good if removed early

 Melanoma
 Melanocyte cancer
 Highly metastatic
 Resistant to chemotherapy

 ABCD Rule
 Asymmetry
 Border irregularity
 Color: several present
 Diameter: greater than 6 mm
Skin Grafts
 Sometimes when the is skin severely
damaged, it cannot regenerate itself
 Success is dependent on the site of origin of
the transplanted tissue
 autograft
 from the same person
 donated from a different site
 can be tissue cultured first

 isograft - identical twins Autograft to knee

 homograft - skin from another human
 heterograft - skin from an animal
Epidermal Derivatives: Hair = Pili
 Hair functions
 protection
 increase surface area for evaporative heat loss;
 increased length (scalp) for sunburn and heatstroke
 eyebrows, eyelashes - insects, foreign particles
 nostril hair – same
 ear hair - same
 mechanical dry lubricant for limb movements
 secondary sexual characteristic to attract mates
 touch receptors respond to changes in position
 rate of growth & replacement affected by many
things: heredity, diet, illness, fever, blood loss,
surgery, drugs, chemotherapy
 Hair Anatomy
 Shaft
 medulla - inner layer
 cortex - middle layer, pigments, air
spaces
 cuticle - outermost layer, hard keratin
 Root
 similar to shaft, but within dermis
 Follicle - surrounds root
 Sheath - supports shaft & root
 Bulb - enlarged layered structure
at base where hair is generated
 papilla - areolar connective tissue,
blood vessels supply nutrients
 matrix - germination layer of papilla
(stratum basale) builds hair shaft
 Sebaceous glands – release oil
 Arrector Pili – smooth muscle
Hair Follicle
Hair Color
 Brown, black - melanin deposited from the
matrix of the bulb into the shaft

 Red, blond - variants of melanin with iron,

sulfur in the molecule

 Grey – some loss of melanocytes reduces

melanin deposition

 White - air bubbles accumulate in the cortex

Hair and Hormones
Testosterone
 Secretion increases at
puberty
 Male pattern of hair
growth and distribution
begins
 Hirsutism
 excess testosterone
production, tumor or
hormonal imbalance
 excess hair production
in females or pre-
pubertal males
Hair and Hormones
 Male pattern baldness
 Genetic predisposition – sex-linked trait –
testosterone inhibits scalp hair growth in these
individuals
 Finasteride (Propecia) - anti-testosterone agent
 must be taken for remainder of life

 Minoxidil (Rogaine)
 anti-hypertensive medicine
 widens blood vessels, increases blood flow
 topically (daily) promotes growth in people with reduced
hair growth (not much but some); but not in truly bald
individuals
Male Pattern Baldness
Skin Glands
Sebaceous (Oil) Glands
Sudoriferous (Sweat) Glands
 1. Sebaceous (Oil) Glands
 Connected to hair follicles;
located in the dermis
 Most secrete directly into
follicles; some directly onto
the skin
 Gland shape differs
depending on location
 Holocrine gland
 Secrete sebum (oil)
 fats, cholesterol, proteins,
inorganic salts
 keeps hair from drying
 prevents water evaporation
from skin
 keeps skin soft, supple
 inhibits growth of many
bacteria
2. Sudoriferous (Sweat) Glands
Two types of typical glands
1. eccrine sweat glands
 the majority; especially
abundant on the palms and
soles and the forehead

 the secretory portion of the

gland is located in the dermis
Sudoriferous (Sweat) Glands
Two types of typical glands
2. apocrine sweat glands
 located mainly in the axillary
and anogenital regions, and the
areolae of the breast
 secretory portion is located in
the dermis or the subcutaneous
region; secrete into hair follicles
 secrete more during emotional
stress, sexual arousal
 a merocrine process

http://faculty.une.edu/com/abell/histo/histolab3g.htm
Modified Sudoriferous (Sweat) Glands
Two types of modified sweat glands

1. Ceruminous glands – protect against ectoparasites

(bugs)
 produce a bitter waxy secretion (cerumen)
 open into the external auditory meatus (ear canal) or
into local sebaceous glands

2. Mammary glands – highly specialized for milk

production
 hormonally regulated by estrogens, prolactin, and
oxytocin
Sweat
 produced primarily by the eccrine glands
 water, salts, urea, uric acid, amino acids,
ammonia, sugar lactic acid, ascorbic acid – a
plasma filtrate
 pheromones for sexual attraction
 pH between 4 and 6
 salty and acidic solution inhibits most
bacterial growth
 maintain body temperature, but insignificant
for waste removal
Nails
 tightly packed, hard,
keratinized cells
 nail matrix - under
root of nail
 site of nail growth
 transforms normal skin
cells into nail cells
which push forward
 1mm/week in fingers;
slower in toes
 the longer the finger
the greater the growth
rate