皮肤性病学教学课件：01 皮肤的结构和功能

DermatologyandvenereologyPurposeofgeneralintroduction1.Grasp：StructureofskinFunctionofskinPrimaryandsecondarylesionofskindiseasesPrinciplesfortopicalapplicationofdermatoses2.Familiar：FormoftopicaldrugsTypeandmechanismofantihistaminedrugsSkincareandcosmetology3.understand：EtiologyofdermatosesMedicalhistorywritingandphysicalexaminationofdermatosesPreventionofdermatosesChapter1

Introductionofdermatologyandvenereology1.DefinitionofDematovenerologyDermatovenerology:

IncludeingDermatologyandVenereology.Dermatology：Researchonskinandappendagesandotherrelevantsubjects.Studyonthestructureandfunctionofnormalskinandappendagesandetiology,pathogenesis,clinicalmanifestation,diagnosis,preventionandtreatmentofvariousdermatosesandappendagesdiseases.1.DefinitionofDematovenerologyVenereology:Includingetiology,pathogenesis,clinicalmanifestations,diagnosisandpreventionofvarioussexuallytransmitteddiseases(STD).2.HistoryofDematovenerologyIsdermatovenerologyasmalldepartment?Dermatovenerologybelongedtointernalmedicineandsurgicaldepartmentattheearliest;Dermatovenerologyhasbecomeanindependentdepartmentsince20thCentury;Dermatovenerologydevelopedrapidlyandformedmanynewbranchesduringthesecondhalfof20thCentury.3.CharacteristicsofDematovenerologySkinisthelargestorganofthehuman,withhighincidencerate；Therearemanykindsofdermatoses:Morethan2000species；Theetiologyiscomplex:Exogenous,endogenous；Clinicalmanifestationisintuitive；Impactonthepatients’qualityoflife－5DInfluencepattern(Disfigurement,discomfort,depression,death,disablement).Howtolearndermatology?SeriousobservationSummary,classification；Combinationofmacroscopicandmicroscopicview；Learnbasicknowledge,graspkeydiseases；Comprehensiveknowledgesystem.Chapter2:StructureandfunctionofskinStructureofskin

1.OutlineSkiniscoveredonthebodysurface,whichhasimportantfunction；Skiniscomposedofthreelayers:theepidermis,ermis,andsubcutaneousfatIncludingbloodvessels,nervesandlymphvessels,musclesandskinappendagessuchashair,sebaceousglands,sweatglands,nails.1.OutlineSkinisthelargestorganofthehumanbody,accountingfor16%ofone’sweight,andthetotalareaofskinis1.5m2inadult;Thethicknessofskinis0.5-4mm,differencesvariesinindividuals,age,location；Skingrooves,skinridgesvariesinindividualsHairythinskinandhairlessthickskin;Thecolorofskinvariesinrace,age,sex,nutrition,andlocation.Epidermis

Epidermisisstratifiedsquamousepithelium，andiscomposedofkeratinocytes,melanocytes,LangerhanscellandMerkelcell.Therearedesmosomesandhemidesmosomesjuncturebetweencells.Basementmembranezone(BMZ)establishestheboundarybetweenepidermisanddermis.(1)Epidermis(Structure)1.Keratinocyte（80%oftotalepidermalcells）5

.Stratumcorneum4

.Stratumspinosum3.Stratumgranulosun2

.Stratumspinosum1.StratumbasaleEpidermalreplacementtime：28days.2.Melanocytelocatedinthebasallayer,thenumberofwhichisabout10%ofthebasalcells,therearemelaningranules,tyrosinasesynthesizer;3)Onemelanocyteprovidesmelanin(epidermalmelaninunit)to36to10keratinocytesbydendriticprocesses;4)ProtectskinanddeeptissuesfromdamagethroughblockingandreflectingUV.3.Langerhanscell

Derivedfrombonemarrowmonocyte-macrophage；

Locatedintheepidermisandhairfollicles,accountingfor3-5%ofepidermalcells；

Importantimmuneactivecells,antigenpresentingcells；4.MerkelcellLocatedbetweenbasalcells；Meckelcell-axoncomplex,whichisakindofsensorynervecell.5.Connectionbetweenepidermisanddermis

Desmosome：themainstructuretoconnectbetweenkeratinocytes.5.ConnectionbetweenepidermisanddermisHemi-desmosome：Themainstructureconnectbetweenthebasalcellandthebasementmembranezone.5.Connectionbetweenepidermisanddermis

Basementmembranezone（BMZ)：ItcanbeseenbyPASstaining,0.5－1µmthick；Function：Tightjunctions;barriertopermeation;Formationofasub-epidermalblisterduetodermisandepidermisseparatewhenabnormityhappened.DermisCollagenfiberReticularfiberElasticfiberMatrix:proteoglycanCells:Fibroblast,Mastcell,Macrophage,Dermicarborescentcell,Langerhanscell,Pigmentophage,Lymphocyte,Leukocyte.Chorionitis3.Hypodermis(subcutaneoustissue)Locatedunderthedermis;connectedwithfascia；Alsoknownassubcutaneousfatlayer；bloodvessels,lymphaticvessels，eccrineglands,apocrineglands；Thethicknessoffatvariesinageandsex,location.4.AppendagesHairSebaceousglandsEccrineglandsApocrineglandsNail(1)HairTheyaredistributedthroughoutallkinsites；Longhair,

shorthair,vellushair；Hairshaft,hairroot,hairbulb；haircuticleandcortexandmedulla;airgrowthcycle:Anagen（3y),Catagen（3w),Telogen（3m）；Speed0.27～0.4mm/d;Thetraitsandgrowthofhairareaffectedbygenetic,healthstatus,hormones,drugs,andclimate.Hairgrowthcycle

Anagen3yGrowingphaseCatagen3wTransitionalphaseTelogen3mRestingphase（2）SebaceousglandsItiscomposedoflobulesofpale-staningcellswithabundantlipidintheircytoplasm；Befoundingreatestabundanceontheface,scalpandback;Theyaredistributedthroughoutallskinsitesexpectthepalmsandsoles;Mainlyregulatedbyhormones.（3）SweetglandsEccrineglandsarefoundatvirtuallyallskinsites,andareinnervatedbysympatheticnerve；Apocrineglandsdistributeinthearmpit,umbilicus,perianalandareolaarea.(4)NailGrowthspeed:Nailoffinger1cm/3month,toenail1cm/9month(5)Vasculature,Muscles,NervesoftheskinNervesNervesiscomprisedbysensoryandmotorfibers.Sensorynerveisdividedintonervecorpusclesandterminationesnervorumliberae,themechanismofsensoryisverycomplex；Motornerveisderivedfromsympatheticpostganglionicfibers,dominantingactivitiesofadnexal.VascularDermalmicrovascularandmicroveinsconstitutethesubpapillaryplexus(superficialplexus)andsubdermalvascularplexus(deepvascularplexus)Thebloodvesselsarelayered,paralleltothesurfaceoftheskin,formingawiderangeofanastomotic;ProvidenourishmenttoskinandregulatetemperatureLymphaticvesseland

musclesSkinlymphaticvesselsareparalleltoseveralmajorvascularvessels；Immunefunction.Arrectorespilorumisthemainskinmuscle；FunctionofskinFunctions

ofskinProtectionAbsorptionSensationSecretionandexcretionTemperatureregulationMetabolismandimmue(1)Protection

Physicalprotection;

Chemicalprotection;

Protectionagainstpathogenicmicro-organisms;

Preventthelossoffluid,electrolyteandnutrientsubstance.(2)

AbsorptionThecorneumstratum,hairfollicleandsebaceousglandarethemainpath