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Human skin

The human skin is the outer covering of the body and is the largest organ of the integumentary system. The skin has up to seven layers of ectodermal tissue guarding muscles, bones, ligaments and internal organs. Human skin is similar to most of the other mammals' skin, and it is very similar to pig skin. Though nearly all human skin is covered with hair follicles, it can appear hairless. There are two general types of skin: hairy and glabrous skin (hairless). The adjective cutaneous literally means "of the skin".

Structure
Human skin shares anatomical, physiological, biochemical and immunological properties with other mammalian lines. Pig skin especially shares similar epidermal and dermal thickness ratios to human skin: pig and human skin share similar hair follicle and blood vessel patterns; biochemically the dermal collagen and elastin content is similar in pig and human skin; and pig skin and human skin have similar physical responses to various growth factors. Skin has mesodermal cells which produce pigmentation, such as melanin provided by melanocytes, which absorb some of the potentially dangerous ultraviolet radiation (UV) in sunlight. It contains DNA repair enzymes that help reverse UV damage. People lacking the genes for these enzymes have high rates of skin cancer. One form predominantly produced by UV light, melanoma, is particularly invasive, causing it to spread quickly, and can often be deadly. Human skin pigmentation varies substantially between populations; this has led to the classification of people(s) on the basis of skin colour. Epidermis The epidermis, "epi" coming from the Greek language meaning "over" or "upon", is the outermost layer of the skin. It forms the waterproof, protective wrap over the body's surface, which also serves as a barrier to infection and is made up of stratified squamous epithelium with an underlying basal lamina. -tomogram of the skin at the fingertip, depicting the stratum corneum (≈500 μm thick) with the stratum disjunctum on top and the stratum lucidum in the middle. At the bottom are the superficial parts of the dermis. The sweat ducts are clearly visible. (See also: Rotating 3D Version) The epidermis contains no blood vessels, and cells in the deepest layers are nourished almost exclusively by diffused oxygen from the surrounding air Almost 500 genes have an elevated pattern of expression in the skin. There are fewer than 100 genes that are specific for the skin, and these are expressed in the epidermis. An analysis of the corresponding proteins show that these are mainly expressed in keratinocytes and have functions related to squamous differentiation and cornification. Dermis The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbours many nerve endings that provide the sense of touch and heat. It contains the hair follicles, sweat glands, sebaceous glands, apocrine glands, lymphatic vessels and blood vessels. The blood vessels in the dermis provide nourishment and waste removal from its own cells as well as from the stratum basale of the epidermis. The dermis is structurally divided into two areas: a superficial area adjacent to the epidermis, called the papillary region, and a deep thicker area known as the reticular region. Papillary region The papillary region is composed of loose areolar connective tissue. It is named for its finger-like projections called papillae, which extend toward the epidermis. The papillae provide the dermis with a "bumpy" surface that interdigitates with the epidermis, strengthening the connection between the two layers of skin. In the palms, fingers, soles, and toes, the influence of the papillae projecting into the epidermis forms contours in the skin's surface. These epidermal ridges occur in patterns (see: fingerprint) that are genetically and epigenetically determined and are therefore unique to the individual, making it possible to use fingerprints or footprints as a means of identification. Reticular region The reticular region lies deep in the papillary region and is usually much thicker. It is composed of dense irregular connective tissue, and receives its name from the dense concentration of collagenous, elastic, and reticular fibres that weave throughout it. These protein fibres give the dermis its properties of strength, extensibility, and elasticity. Also located within the reticular region are the roots of the hairs, sebaceous glands, sweat glands, receptors, nails, and blood vessels. Tattoo ink is held in the dermis. Stretch marks, often from adolescent growth spurts, weight gain, pregnancy and obesity, are also located in the dermis. Subcutaneous tissue The subcutaneous tissue (also hypodermis and subcutis) is not part of the skin, but lies below the dermis of the cutis. Its purpose is to attach the skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. It consists of loose connective tissue, adipose tissue and elastin. The main cell types are fibroblasts, macrophages and adipocytes (subcutaneous tissue contains 50% of body fat). Fat serves as padding and insulation for the body. Cross-section == Cell count and cell mass ==
Cell count and cell mass
Skin cell table The below table identifies the skin cell count and aggregate cell mass estimates for a 70 kg adult male (ICRP-23; ICRP-89, ICRP-110). Tissue mass is defined at 3.3 kg (ICRP-89, ICRP110) and addresses the skin's epidermis, dermis, hair follicles, and glands. The cell data is extracted from 'The Human Cell Count and Cell Size Distribution', Tissue-Table tab in the Supporting Information SO1 Dataset (xlsx). The 1200 record Dataset is supported by extensive references for cell size, cell count, and aggregate cell mass. Detailed data for below cell groups are further subdivided into all the cell types listed in the above sections and categorized by epidermal, dermal, hair follicle, and glandular subcategories in the dataset and on the dataset's graphical website interface. While adipocytes in the hypodermal adipose tissue are treated separately in the ICRP tissue categories, fat content (minus cell-membrane-lipids) resident in the dermal layer (Table-105, ICRP-23) is addressed by the below interstitial-adipocytes in the dermal layer. ==Development==
Development
Skin colour Human skin shows high skin colour variety from the darkest brown to the lightest pinkish-white hues. Human skin shows higher variation in colour than any other single mammalian species and is the result of natural selection. Skin pigmentation in humans evolved to primarily regulate the amount of ultraviolet radiation (UVR) penetrating the skin, controlling its biochemical effects. These pigments are present at different levels and places. • Melanin: It is brown in colour and present in the basal layer of the epidermis. • Melanoid: It resembles melanin but is present diffusely throughout the epidermis. • Carotene: This pigment is yellow to orange in colour. It is present in the stratum corneum and fat cells of dermis and superficial fascia. • Hemoglobin (also spelled haemoglobin): It is found in blood and is not a pigment of the skin but develops a purple colour. • Oxyhemoglobin: It is also found in blood and is not a pigment of the skin. It develops a red colour. There is a correlation between the geographic distribution of UV radiation (UVR) and the distribution of indigenous skin pigmentation around the world. Areas that highlight higher amounts of UVR reflect darker-skinned populations, generally located nearer towards the equator. Areas that are far from the tropics and closer to the poles have lower concentration of UVR, which is reflected in lighter-skinned populations. is a numerical classification schema for human skin colour developed in 1975 as a way to classify the typical response of different types of skin to ultraviolet (UV) light: Ageing As skin ages, it becomes thinner and more easily damaged. Intensifying this effect is the decreasing ability of skin to heal itself as a person ages. Among other things, skin ageing is noted by a decrease in volume and elasticity. There are many internal and external causes to skin ageing. For example, ageing skin receives less blood flow and lower glandular activity. A validated comprehensive grading scale has categorized the clinical findings of skin ageing as laxity (sagging), rhytids (wrinkles), and the various facets of photoageing, including erythema (redness), and telangiectasia, dyspigmentation (brown discolouration), solar elastosis (yellowing), keratoses (abnormal growths) and poor texture. Cortisol causes degradation of collagen, Cyclobutane pyrimidine dimers formed by two adjacent thymine bases, or by two adjacent cytosine bases, in DNA are the most frequent types of DNA damage induced by UV. Humans, as well as other organisms, are capable of repairing such UV-induced damages by the process of nucleotide excision repair. In humans this repair process protects against skin cancer. == Types ==
Types
Though most human skin is covered with hair follicles, some parts can be hairless. There are two general types of skin, hairy and glabrous skin (hairless). ==Functions==
Functions
Skin performs the following functions: • Protection: an anatomical barrier from pathogens and damage between the internal and external environment in bodily defence; Langerhans cells in the skin are part of the adaptive immune system. • Sensation: contains a variety of nerve endings that react to heat and cold, touch, pressure, vibration, and tissue injury; see somatosensory system and haptics. • Heat regulation: the skin contains a blood supply far greater than its requirements, which allows precise control of energy loss by radiation, convection and conduction. Dilated blood vessels increase perfusion and heat loss, while constricted vessels greatly reduce cutaneous blood flow and conserve heat. • Control of evaporation: the skin provides a relatively dry and semi-impermeable barrier to fluid loss. Microorganisms like Staphylococcus epidermidis colonize the skin surface. The density of skin flora depends on region of the skin. The disinfected skin surface gets recolonized from bacteria residing in the deeper areas of the hair follicle, gut and urogenital openings. ==Clinical significance==
Clinical significance
Diseases of the skin include skin infections and skin neoplasms (including skin cancer). Dermatology is the branch of medicine that deals with conditions of the skin. The skin is also valuable for diagnosis of other conditions, since many medical signs show through the skin. Skin colour affects the visibility of these signs, a source of misdiagnosis in unaware medical personnel. ==Society and culture==
Society and culture
Hygiene and skin care The skin supports its own ecosystems of microorganisms, including yeasts and bacteria, which cannot be removed by any amount of cleaning. Estimates place the number of individual bacteria on the surface of human skin at , though this figure varies greatly over the average of human skin. Oily surfaces, such as the face, may contain over . Despite these vast quantities, all of the bacteria found on the skin's surface would fit into a volume the size of a pea. In general, the microorganisms keep one another in check and are part of a healthy skin. When the balance is disturbed, there may be an overgrowth and infection, such as when antibiotics kill microbes, resulting in an overgrowth of yeast. The skin is continuous with the inner epithelial lining of the body at the orifices, each of which supports its own complement of microbes. Cosmetics should be used carefully on the skin because these may cause allergic reactions. Each season requires suitable clothing in order to facilitate the evaporation of the sweat. Sunlight, water and air play an important role in keeping the skin healthy. Oily skin Oily skin is caused by over-active sebaceous glands, that produce a substance called sebum, a naturally healthy skin lubricant. A high glycemic-index diet and dairy products (except for cheese) consumption increase IGF-1 generation, which in turn increases sebum production. Overwashing the skin does not cause sebum overproduction but may cause dryness. When the skin produces excessive sebum, it becomes heavy and thick in texture, known as oily skin. Oily skin is typified by shininess, blemishes and pimples. The oily-skin type is not necessarily bad, since such skin is less prone to wrinkling, or other signs of ageing, because the oil helps to keep needed moisture locked into the epidermis (outermost layer of skin). The negative aspect of the oily-skin type is that oily complexions are especially susceptible to clogged pores, blackheads, and buildup of dead skin cells on the surface of the skin. Oily skin can be sallow and rough in texture and tends to have large, clearly visible pores everywhere, except around the eyes and neck. ==Permeability==
Permeability
Human skin has a low permeability; that is, most foreign substances are unable to penetrate and diffuse through the skin. Skin's outermost layer, the stratum corneum, is an effective barrier to most inorganic nanosized particles. Nanorods are used in experiments because of their unique fluorescent properties but have shown mediocre penetration. Nanoparticles of different materials have shown skin's permeability limitations. In many experiments, gold nanoparticles 40 nm in diameter or smaller are used and have shown to penetrate to the epidermis. Titanium oxide (TiO2), zinc oxide (ZnO), and silver nanoparticles are ineffective in penetrating the skin past the stratum corneum. The damage of the skin is typically measured by the transepidermal water loss (TEWL), though it may take 3–5 days for the TEWL to reach its peak value. When the TEWL reaches its highest value, the maximum density of nanoparticles is able to permeate the skin. While the effect of increased permeability after UVR exposure can lead to an increase in the number of particles that permeate the skin, the specific permeability of skin after UVR exposure relative to particles of different sizes and materials has not been determined. electroporation increases skin permeability by the application of short pulses of electric fields. The pulses are high voltage and on the order of milliseconds when applied. Charged molecules penetrate the skin more frequently than neutral molecules after the skin has been exposed to electric field pulses. Results have shown molecules on the order of 100 μm to easily permeate electroporated skin. Sunblock and sunscreen Sunblock and sunscreen are different important skin-care products though both offer full protection from the sun. SunblockSunblock is opaque and stronger than sunscreen, since it is able to block most of the UVA/UVB rays and radiation from the sun, and does not need to be reapplied several times in a day. Titanium dioxide and zinc oxide are two of the important ingredients in sunblock. SunscreenSunscreen is more transparent once applied to the skin and also has the ability to protect against UVA/UVB rays, although the sunscreen's ingredients have the ability to break down at a faster rate once exposed to sunlight, and some of the radiation is able to penetrate to the skin. In order for sunscreen to be more effective it is necessary to consistently reapply and use one with a higher sun protection factor. Diet Vitamin A, also known as retinoids, benefits the skin by normalizing keratinization, downregulating sebum production, which contributes to acne, and reversing and treating photodamage, striae, and cellulite. Vitamin D and analogues are used to downregulate the cutaneous immune system and epithelial proliferation while promoting differentiation. Vitamin C is an antioxidant that regulates collagen synthesis, forms barrier lipids, regenerates vitamin E, and provides photoprotection. Vitamin E is a membrane antioxidant that protects against oxidative damage and also provides protection against harmful UV rays. Several scientific studies confirmed that changes in baseline nutritional status affects skin condition. Mayo Clinic lists foods they state help the skin: fruits and vegetables, whole-grains, dark leafy greens, nuts, and seeds. == See also ==
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