The document discusses the anatomy and physiology of skin, describing the epidermis, dermis, and hypodermis layers. It then examines common skin conditions like rashes, dermatitis, eczema, psoriasis, skin cancers, infections, and fungal infections. Pathological features and histological findings are provided for several skin diseases.
The document discusses the anatomy and physiology of skin, describing the epidermis, dermis, and hypodermis layers. It then examines common skin conditions like rashes, dermatitis, eczema, psoriasis, skin cancers, infections, and fungal infections. Pathological features and histological findings are provided for several skin diseases.
The document discusses the anatomy and physiology of skin, describing the epidermis, dermis, and hypodermis layers. It then examines common skin conditions like rashes, dermatitis, eczema, psoriasis, skin cancers, infections, and fungal infections. Pathological features and histological findings are provided for several skin diseases.
The document discusses the anatomy and physiology of skin, describing the epidermis, dermis, and hypodermis layers. It then examines common skin conditions like rashes, dermatitis, eczema, psoriasis, skin cancers, infections, and fungal infections. Pathological features and histological findings are provided for several skin diseases.
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Skin pathology
Dr. Saira Jahan
Lecturer SKIN ANATOMY AND PHYSIOLOGY SKIN:LARGEST EXTERNAL ORGAN EPIDERMIS DERMIS DERMAL-EPIDERMAL JUNCTION HYPODERMIS (LOOSE CONNECTIVE TISSUE) EPIDERMIS • Thin, avascular layer that regenerates itself every 4 to 6 weeks • Divided into 5 layers or strata • Stratum corneum—consists of dead keratinocyte cells; flakes and sheds; is easily removed during bathing activities and more efficiently by scrubbing the surface of the skin. • Stratum granulosum—also contains Langerhans cells in addition to keratinocytes • Stratum spinosum—contains keratinocytes and Langerhans cells. • • Stratum basale or germinativum—single layer of epidermal cells (keratinocytes); contains melanocytes; can regenerate. • the stratum lucidum, lies between the stratum corneum and the stratum granulosum. This packed translucent line of cells is found only on the palms and soles and is not seen in thin skin. DERMIS Matrix that serves to support the epidermis papillary dermis reticular dermis • The papillary dermis is composed of collagen and reticular fibers. • fingerprint identification • It contains capillaries for skin nourishment • pain touch receptors (pacinian corpuscles and Meissner’s corpuscles) • The reticular dermis is composed of collagen bundles that anchor the skin to the subcutaneous tissue. • Sweat glands, hair follicles, nerves, and blood vessels can be found in this layer. Cont.. • The main function of the dermis is to • provide tensile strength, support, moisture retention, and blood and oxygen to the skin protects the underlying muscles, bones, and organs. • Sebaceous glands that secrete sebum- lubricates skin HYPODERMIS • The subcutaneous tissue, or hypodermis, attaches the dermis to underlying structures. • function is to promote an ongoing blood supply to the dermis for regeneration. It’s primarily composed of adipose tissue, which provides a cushion between skin layers, muscles, and bones. It promotes skin mobility, molds body contours, and insulates the body. SKIN FUNCTIONS Functions of the skin include: • protection • temperature regulation • metabolism • sensation • synthesis • communication. The normal range of skin pH is 4 to 6.5 in healthy people Skin pathology • Skin diseases are common and diverse, ranging from irritating acne to life-threatening melanoma.
• Either intrinsic to skin, or systemic diseases
involving many tissues, or genetic syndromes such as neurofibromatosis. Terms for Macroscopic Lesions • Excoriation: Trauma breaking the epidermis; a red linear mark (i.e., a deep scratch) • Lichenification: Thickened and rough skin; usually the result of repeated scratching • Macule: Flat, circumscribed area, (<5 mm), distinguished by color. If >5 mm= a patch. • Papule: Elevated dome- or flat-topped lesion (< 5 mm). If >5 mm = a nodule. • Plaque: Elevated flat-topped lesion, (>5 mm) • Pustule: Discrete, pus-filled raised lesion. • Scale: Dry excrescence • Vesicle: Fluid-filled raised area (<5 mm). If >5 mm = a bulla. • Blister is common term for both vesicles and bullae Microscopic Terms • Acantholysis: • Acanthosis: • Hyperkeratosis: • Papillomatosis: • Parakeratosis: • Spongiosis: Skin Conditions
• Rash: Nearly any change in the skin’s
appearance can be called a rash. Most rashes are from simple skin irritation; others result from medical conditions. • Dermatitis: A general term for inflammation of the skin. Atopic dermatitis (a type of eczema) is the most common form. • Eczema: Skin inflammation (dermatitis) causing an itchy rash. Most often, it’s due to an overactive immune system. • Psoriasis: An autoimmune condition that can cause a variety of skin rashes. Silver, scaly plaques on the skin are the most common form. . • Cellulitis: Inflammation of the dermis and subcutaneous tissues, usually due to an infection. A red, warm, often painful skin rash generally results. • Skin abscess (boil or furuncle): A localized skin infection creates a collection of pus under the skin. Some abscesses must be opened and drained by a doctor in order to be cured • Melanoma: The most dangerous type of skin cancer, melanoma results from sun damage and other causes. A skin biopsy can identify melanoma. • Basal cell carcinoma: The most common type of skin cancer. Basal cell carcinoma is less dangerous than melanoma because it grows and spreads more slowly. • Actinic keratosis: A crusty or scaly bump that forms on sun-exposed skin. Actinic keratoses can sometimes progress to cancer. • Squamous cell carcinoma: A common form of skin cancer, squamous cell carcinoma may begin as an ulcer that won’t heal, or an abnormal growth. It usually develops in sun- exposed areas. • Herpes: The herpes viruses HSV-1 and HSV-2 can cause periodic blisters or skin irritation around the lips or the genitals. • Hives: Raised, red, itchy patches on the skin that arise suddenly. Hives usually result from an allergic reaction. • Tinea versicolor: A benign fungal skin infection creates pale areas of low pigmentation on the skin. • Viral exantham: Many viral infections can cause a red rash affecting large areas of the skin. This is especially common in children INFECTIOUS DERMATOSES • Bacterial Infections • Numerous; range from superficial (e.g. impetigo), to deeper abscesses • Impetigo: characterized by an accumulation of neutrophils under stratum corneum a subcorneal pustule. • one of the most common bacterial infections of the skin • seen primarily in children • causative organism: m/c Staph. Aureus; then Strept. pyogenes • Treatment: Microbiologic culture and antibiotics Fungal infections of skin • simple (e.g. Tinea or Candida spp); or life-threatening in immunosuppressed persons (e.g. Aspergillus spp). • superficial (e.g. stratum corneum, hair, and nails); deep; or systemic (hematogenous spread in immunocompromised pts) • Histologic appearance: • Superficial infections neutrophilic infiltrate in the epidermis. • Deep infections greater tissue damage; a granulomatous response • Periodic acid-Schiff (PAS) and Gomori methenamine silver stains can be helpful in identifying the fungal organisms Verrucae (Warts) • common lesions of children and adolescents. • caused by human papillomavirus (HPV) • self-limited, most often regressing spontaneously within 6 months to 2 years. • most warts are caused by low-risk HPV subtypes (6 and 11) that lack transforming potential. • Morphology: • Verruca vulgaris, the most common type of wart, is found most frequently on the hands, particularly on the dorsal surfaces and periungual (around fingernail or toenail) areas, where it appears as a gray-white to tan, flat to convex, 0.1- to 1-cm papule with a rough, pebble-like surface. • Verruca plana, or flat wart, is common on the face or dorsal surfaces of the hands; are flat, smooth, tan macules.
• Verruca plantaris and verruca palmaris occur on
the soles and palms, respectively. These rough, scaly lesions may reach 1 to 2 cm in diameter • Condyloma acuminatum (venereal wart) occurs on the male and female genitalia, urethra, and perianal areas Verrucae (Warts)