Introduction to Medical Dermatology
We're going start with the basic structure in the skin, and as we probably know, your skin consists of two layers: dermis and pores and skin. The epidermis features only one kind of structures which are cells -no blood vessels, zero lymphatics-, and many of those skin cells (about 85% of those cells) are called " keratinocytesвЂќ. The others are called melanocytes, merkel cellular material, and langerhans cells. The cells in the epidermis happen to be arranged in to 4 layers:
* Basal layer: it is where we certainly have mitosis, and then the cellular material will move to the levels above. 2. Prickle cellular layer (spinous or squamous).
* Gekornt layer.
* Horney layer: it's the uppermost part in the epidermis, and it is the layer that individuals see and touch for the surface with the skin, in fact it is composed of lifeless cells that had dropped their nuclei. As you can see in the picture the fact that basophilic structures (the nuclei) are not within this layer. Although the horney layer offers dead cells, it is an important layer inside the epidermis since it forms a physical barrier line to protect the internal environment. Therefore problems and diseases impacting on the horney layer can impair this protecting function leading to attacks, allergiesвЂ¦
This is how the skin looks under the microscopic lense. The bulk of skin is skin; 9/10th with the skin is dermis, plus the bulk of pores and skin consists of collagen (mostly type 1 collagen). The blue things are the nuclei, plus the horney part is devoid of nuclei. And this is the typical basket-weave overall look of the epidermis. Epidermal cellular material:
* Keratinocytes: the majority.
* Melanocytes: they are the color-producing cells in the epidermis that produce melanin which is then transferred to keratinocytes. Melanin absorbs UV lumination and inactivates it, or else we have a risk of having cancer. Therefore western residential areas that have a white pores and skin (low process of melanocytes) are more prone to have skin malignancies, and the most usual type of malignancy in the american community is usually skin cancers; in particular the basal cell carcinoma. 2. Langerhans cellular material: they are the macrophages of the skin area, and the main antigen-presenting cellular material in dermis and pores and skin. And as we know, macrophages will vary names in different tissues; in the liver they are really called kupffer cells, and in the brain they may be called microglial cells. All their function is usually to take the antigens, process all of them, and then present them to Capital t lymphocytes, and then they go to the lymph nodes wherever their action starts. 2. Merkel cells: they are customized transducers to get fine feel.
The dermis consists of many components:
* Materials (collagen and elastin).
* Ground substance (glycosaminoglycans) that hydrates the skin. * Several types of skin cells: Fibroblasts (they produce collagen and elastin), Lymphocytes, Macro, Mast cellsвЂ¦ * And it has appendages; Glands like sebaceous glands that develop sebum that moisturizes the skin, Apocrine and Eccrine glands that create sweat that has a function in the thermoregulation in the body; Hair follicles, and Fingernails or toenails. * Likewise we have supporting structures; nerves, lymphatics, vasculature, smooth muscle tissue. So when a lesion bleeds, then we can say that the pathology is in the skin tone.
Now, exactly how approach individuals with a skin disease?
* Need not shy to introduce yourself as a medical student! Simply few of your previous acquaintances in the school could get in to the medical institution, so be proud to state to the affected person that I'm a medical student: ) * Amazingly, you can establish a connection with the person by taking the first step with saying these few words. So it will be important for you to identify yourself, so that the individual knows a message and sees your face to get a more personal relation. 5. Then you take those permission to touch skin, this is the polite way! Some patients may possibly reject that and say " NOвЂќ, so you should respect might say " thank youвЂќ. * You also should always conserve the patient's...