皮肤性病学总论-2013-9 wutu.pptVIP

皮肤性病学大课 总论的概要 Basic biology of the skin- structure and function Diagnosis of skin diseases Symptoms Cutaneous signs * Clinical examination Laboratory tests Skin and other body systems Management * How to approach Dermatology? What does it take to be a dermatologist？ The Skin：Basic structure Gross anatomy： Integument Components: skin and its associated tissues-sweat glands, sebaceous glands, hair, and nails Biggest organ，?16% of body weight, ?1.5m2 Thickness varies, 0.5-4mm Continuous with the digestive, respiratory and urogenital system Surface: grooves （皮沟） ridges （皮嵴） The Skin：Basic structure Histology-Skin： Epidermis ectodermally derived outer layer keratinized stratified squamous epithelium. Dermis mesodermally derived layer dense irregular collagenous connective tissue Hypodermis loose connective tissue containing varying amounts of adipose Epidermis Cornified layer (stratum corneum) Membrane coating granules The high lipid content forms a permeability barrier for water retention and resistence. Transitional layer (stratum lucidum) Only in palm and sole Granular layer (stratum granulosum) Keratohyalin granules-filaggrin Spinous layer (stratum spinosum) Site of pemphigus vulgaris Basal layer (stratum basale) single layer, mitotically active Desmosomes-cadherins Hemidesmosomes-integrins Keratins, type I and II Site of bullous pemphigoid Cell types of epidermis Keratinocytes Langerhans’ cells antigen-presenting cells Birbeck granules Dermis Papillary layer Reticular layer Vasculature and Nerves Vasculature Subpapillary plexus Temperature regulation Lower horizontal plexus Dermal appendages: Adnexa Eccrine, apocrine glands, ducts and pilosebaceous units Sebaceous glands Holocrine secretion Relation to hair follicle, acne and male pattern alopecia Eccrine Thermoregulaion, emotional stress Leprosy, Horner’s syndrome, cystic fibrosis (sweat test: Cl-, Na+ ?) Apocrine Decapitation secretion origin of body odor/scent Hair follicle Type