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Integumentary system (Epidermal derivatives (Nails (Nail bed, Nail root,…

- - - - Entire body surface except lips and part of external genitalia
      - Not associated with hair follicles
      - Temperature regualtion
      - Stimulated by cholinergic transmitter
      - Respond to heat and stress
      - Segments
        
        Secretory segment
        
        Clear cells
        
        Dark cells
        
        Pseudostratified epithelium
        
        Myoepithelial cells
        
        Duct segment
        
        Luminal layer
        
        Basal cell layer
        
        Stratified cuboidal epithelium
        
        No myoepithelial cells
    - - Axilla, areola, nipple, perianal, external genitalia
      - Ceruminous glands of the external meatus
      - Glands of Moll of eyelashes
      - Protein-rich secretion
      - Become functional at puberty
      - Stimulated by adrenergic transmitters
      - Respond to emotional and sensory stimuli
  - - - Isthmus
      - inferior segment
      - Infundibulum
    - - Dermal papilla
      - Connective tissue sheath
    - - Anagen-Growth phase
      - Catagen-Regression phase
      - Telogen-Resting phase
- - - - Cytokines
      - Vit D
      - Hormones
    - - Sweat
      - Sebum
  - - - Free nerve endings
        
        Fine touch, heat and cold sensation
        
        Terminated in stratum granulosum
      - Encapsulated nerve endings
        
        Meissner's corpuscles
        
        At dermal papillae
        
        Respond to low-frequency stimuli, light touch
        
        Ruffini's corpuscles
        
        Respond to skin stretch or torque
        
        Pacinian corpuscles
        
        Detect pressure change and vibration
        
        In deeper dermis, hypodermis
        
        Lost myelination after entering corpuscle
        
        Capsule-tightly packed flattened Schwann cell lamellae
    - - To BV, arrector pili muscles, sweat glands
- - - - Larger keratinocytes
      - Desmosome forms spines (prickle cells)
      - Several layers of cells
    - - Keratohyaline granules
        
        Basophilic
        
        Contain pro-filaggrin
      - 1-3 layers of cells
    - - Cuboidal to low columnar
      - Basophilia
      - Single layer of keratinocytes
      - Contains melanin
      - Cell junctions
        
        Desmosome (to neighboring cells) Pemphigus vulgaris
        
        Hemidesmosome (to underlying basal lamina) Bullous pemphigoid
    - - Most differentiated keratinocytes
      - Flattened, desiccated, anucleate cells
      - Water barrier (bricks and motar)
        
        Keratohyalin granules
        
        Lamellar body
      - Desquamation
        
        Regulation of desmosome proteolytic process
        
        pH dependent
        
        Kallikrein-related serine peptidase (KLK)
        
        Lymphoepithelial kazal-type inhibitor (LEKTI) Netherton syndrome
  - - - Pro-filaggrin➞filaggrin➞tonofibrils
      - pH7.17 in SG➞pH4.5 in SC
    - - Epidermal-melanin unit (1:36)
      - Transfer of pigment granules through long dendritic process
      - Derived from neural crest in embryonic stage
      - Melanocyte stem cells located at hair bulb
      - Disorder
        
        Melanoma
        
        Vitiligo
        
        Freckles
        
        Lentigines
    - - APC
      - Originate from common lymphoid progenitor cells
      - Immunostaining with CD1a
      - Birbeck granules in cytoplasm
    - - Dendritic cells located in SB
      - Neurosecretory granules
      - Closely associated with Merkel's corpuscle