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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" (from Latin cutis, skin).

Human skin
Skin of a human hand
Details
SystemIntegumentary system
Identifiers
Latincutis
TA98A16.0.00.002
TA27041
THH3.12.00.1.00001
FMA7163
Anatomical terminology
[edit on Wikidata]

Skin plays an important immunity role in protecting the body against pathogens and excessive water loss. Its other functions are insulation, temperature regulation, sensation, synthesis of vitamin D, and the protection of vitamin B folates. Severely damaged skin will try to heal by forming scar tissue. This is often discoloured and depigmented.

In humans, skin pigmentation (affected by melanin) varies among populations, and skin type can range from dry to non-dry and from oily to non-oily. Such skin variety provides a rich and diverse habitat for bacteria that number roughly 1000 species from 19 phyla, present on the human skin.

Structure Edit

Human skin shares anatomical, physiological, biochemical and immunological properties with other mammalian lines, especially pig skin.[1][2] Pig skin shares similar epidermal and dermal thickness ratios to human skin;[1][2] pig and human skin share similar hair follicle and blood vessel patterns;[1][2] biochemically the dermal collagen and elastin content is similar in pig and human skin;[1][2] and pig skin and human skin have similar physical responses to various growth factors.[1][2]

Skin has mesodermal cells, pigmentation, such as melanin provided by melanocytes, which absorb some of the potentially dangerous ultraviolet radiation (UV) in sunlight. It also contains DNA repair enzymes that help reverse UV damage, such that people lacking the genes for these enzymes have high rates of skin cancer. One form predominantly produced by UV light, malignant melanoma, is particularly invasive, causing it to spread quickly, and can often be deadly. Human skin pigmentation varies among populations in a striking manner. This has led to the classification of people(s) on the basis of skin colour.[3]

In terms of surface area, the skin is the second largest organ in the human body (the inside of the small intestine is 15 to 20 times larger). For the average adult human, the skin has a surface area of from 1.5–2.0 square metres (16–22 sq ft). The thickness of the skin varies considerably over all parts of the body, and between men and women and the young and the old. An example is the skin on the forearm which is on average 1.3 mm in the male and 1.26 mm in the female.[4] One average square inch (6.5 cm2) of skin holds 650 sweat glands, 20 blood vessels, 60,000 melanocytes, and more than 1,000 nerve endings.[5][better source needed] The average human skin cell is about 30 micrometres (μm) in diameter, but there are variants. A skin cell usually ranges from 25 to 40 μm2, depending on a variety of factors.

Skin is composed of three primary layers: the epidermis, the dermis and the hypodermis.[4]

 
Layers, Receptors, and Appendages of Human Skin

Epidermis Edit

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.

The epidermis contains no blood vessels, and cells in the deepest layers are nourished almost exclusively by diffused oxygen from the surrounding air[6] and to a far lesser degree by blood capillaries extending to the outer layers of the dermis. The main type of cells that make up the epidermis are Merkel cells, keratinocytes, with melanocytes and Langerhans cells also present. The epidermis can be further subdivided into the following strata (beginning with the outermost layer): corneum, lucidum (only in palms of hands and bottoms of feet), granulosum, spinosum, and basale. Cells are formed through mitosis at the basale layer. The daughter cells (see cell division) move up the strata changing shape and composition as they die due to isolation from their blood source. The cytoplasm is released and the protein keratin is inserted. They eventually reach the corneum and slough off (desquamation). This process is called "keratinization". This keratinized layer of skin is responsible for keeping water in the body and keeping other harmful chemicals and pathogens out, making skin a natural barrier to infection.[7]

 
2D projection of a 3D OCT-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 is nourished by diffusion from the dermis. The main type of cells that make up the epidermis are keratinocytes, melanocytes, Langerhans cells, and Merkel cells. The epidermis helps the skin regulate body temperature.

Layers Edit

The skin has up to seven layers of ectodermal tissue and guards the underlying muscles, bones, ligaments and internal organs.[8] The epidermis is divided into several layers, where cells are formed through mitosis at the innermost layers. They move up the strata changing shape and composition as they differentiate and become filled with keratin. After reaching the top layer stratum corneum they are eventually 'sloughed off', or desquamated. This process is called keratinization and takes place within weeks.

It was previously believed that the stratum corneum was "a simple, biologically inactive, outer epidermal layer comprising a fibrillar lattice of dead keratin".[9] It is now understood that this is not true, and that the stratum corneum should be considered to be a live tissue.[10] While it is true that the stratum corneum is mainly composed of terminally differentiated keratinocytes called corneocytes that are anucleated, these cells remain alive and metabolically functional until desquamated.[citation needed]

Sublayers Edit

The epidermis is divided into the following 5 sublayers or strata:

Blood capillaries are found beneath the epidermis and are linked to an arteriole and a venule. Arterial shunt vessels may bypass the network in ears, the nose and fingertips.

Genes and proteins expressed in the epidermis Edit

About 70% of all human protein-coding genes are expressed in the skin.[11][12] 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.[13] An analysis of the corresponding proteins show that these are mainly expressed in keratinocytes and have functions related to squamous differentiation and cornification.

Dermis Edit

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 Edit

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 Edit

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 pregnancy and obesity, are also located in the dermis.

Subcutaneous tissue Edit

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 Edit

 
Skin layers, of both hairy and hairless skin

Development Edit

Skin colour Edit

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.[14]

The actual skin colour of different humans is affected by many substances, although the single most important substance determining human skin colour is the pigment melanin. Melanin is produced within the skin in cells called melanocytes and it is the main determinant of the skin colour of darker-skinned humans. The skin colour of people with light skin is determined mainly by the bluish-white connective tissue under the dermis and by the haemoglobin circulating in the veins of the dermis. The red colour underlying the skin becomes more visible, especially in the face, when, as consequence of physical exercise or the stimulation of the nervous system (anger, fear), arterioles dilate.[15]

There are at least five different pigments that determine the colour of the skin.[16][17] 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.[18]

In the same population it has been observed that adult human females are considerably lighter in skin pigmentation than males. Females need more calcium during pregnancy and lactation, and vitamin D which is synthesized from sunlight helps in absorbing calcium. For this reason it is thought that females may have evolved to have lighter skin in order to help their bodies absorb more calcium.[19]

The Fitzpatrick scale[20][21] 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:

I Always burns, never tans Pale, Fair, Freckles
II Usually burns, sometimes tans Fair
III May burn, usually tans Light Brown
IV Rarely burns, always tans Olive brown
V Moderate constitutional pigmentation Brown
VI Marked constitutional pigmentation Black

Ageing Edit

 
A typical rash
 
Skin infected with scabies

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.[22]

Cortisol causes degradation of collagen,[23] accelerating skin ageing.[24]

Anti-ageing supplements are used to treat skin ageing.[citation needed]

Photoageing Edit

Photoageing has two main concerns: an increased risk for skin cancer and the appearance of damaged skin. In younger skin, sun damage will heal faster since the cells in the epidermis have a faster turnover rate, while in the older population the skin becomes thinner and the epidermis turnover rate for cell repair is lower, which may result in the dermis layer being damaged.[25]

UV-induced DNA damage Edit

UV-irradiation of human skin cells generates damages in DNA through direct photochemical reactions at adjacent thymine or cytosine residues on the same strand of DNA.[26] 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.[26] In humans this repair process protects against skin cancer.[26]

Types Edit

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).[27] The adjective cutaneous means "of the skin" (from Latin cutis, skin).[28]

Functions Edit

Skin performs the following functions:

  1. 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.[7][29] Perspiration contains lysozyme that break the bonds within the cell walls of bacteria.[30]
  2. Sensation: contains a variety of nerve endings that react to heat and cold, touch, pressure, vibration, and tissue injury; see somatosensory system and haptics.
  3. 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.
  4. Control of evaporation: the skin provides a relatively dry and semi-impermeable barrier to fluid loss.[29] Loss of this function contributes to the massive fluid loss in burns.
  5. Aesthetics and communication: others see our skin and can assess our mood, physical state and attractiveness.
  6. Storage and synthesis: acts as a storage centre for lipids and water, as well as a means of synthesis of vitamin D by action of UV on certain parts of the skin.
  7. Excretion: sweat contains urea, however its concentration is 1/130th that of urine, hence excretion by sweating is at most a secondary function to temperature regulation.
  8. Absorption: the cells comprising the outermost 0.25–0.40 mm of the skin are "almost exclusively supplied by external oxygen", although the "contribution to total respiration is negligible".[6] In addition, medicine can be administered through the skin, by ointments or by means of adhesive patch, such as the nicotine patch or iontophoresis. The skin is an important site of transport in many other organisms.
  9. Water resistance: The skin acts as a water-resistant barrier so essential nutrients are not washed out of the body.[29]

Skin flora Edit

The human skin is a rich environment for microbes.[31][32] Around 1000 species of bacteria from 19 bacterial phyla have been found.[32][31] Most come from only four phyla: Actinomycetota (51.8%), Bacillota (24.4%), Pseudomonadota (16.5%), and Bacteroidota (6.3%). Propionibacteria and Staphylococci species were the main species in sebaceous areas. There are three main ecological areas: moist, dry and sebaceous. In moist places on the body Corynebacteria together with Staphylococci dominate. In dry areas, there is a mixture of species but dominated by Betaproteobacteria and Flavobacteriales. Ecologically, sebaceous areas had greater species richness than moist and dry ones. The areas with least similarity between people in species were the spaces between fingers, the spaces between toes, axillae, and umbilical cord stump. Most similarly were beside the nostril, nares (inside the nostril), and on the back.

Reflecting upon the diversity of the human skin researchers on the human skin microbiome have observed: "hairy, moist underarms lie a short distance from smooth dry forearms, but these two niches are likely as ecologically dissimilar as rainforests are to deserts."[31]

The NIH conducted the Human Microbiome Project to characterize the human microbiota which includes that on the skin and the role of this microbiome in health and disease.[33]

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 Edit

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.[27]

There are seven cervical, twelve thoracic, five lumbar, and five sacral. Certain diseases like shingles, caused by varicella-zoster infection, have pain sensations and eruptive rashes involving dermatomal distribution. Dermatomes are helpful in the diagnosis of vertebral spinal injury levels. Aside from the dermatomes, the epidermis cells are susceptible to neoplastic changes, resulting in various cancer types. [34]

The skin is also valuable for diagnosis of other conditions, since many medical signs show through the skin. Skin color affects the visibility of these signs, a source of misdiagnosis in unaware medical personnel.[35][36]

Society and culture Edit

Hygiene and skin care Edit

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 6.5 square centimetres (1 sq in) of human skin at 50 million, though this figure varies greatly over the average 1.9 square metres (20 sq ft) of human skin. Oily surfaces, such as the face, may contain over 78 million bacteria per square centimetre (500 million per square inch). Despite these vast quantities, all of the bacteria found on the skin's surface would fit into a volume the size of a pea.[37] 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 Edit

Oily skin is caused by over-active sebaceous glands, that produce a substance called sebum, a naturally healthy skin lubricant.[8][38] A high glycemic-index diet and dairy products (except for cheese) consumption increase IGF-1 generation, which in turn increases sebum production.[38] Overwashing the skin does not cause sebum overproduction but may cause dryness.[38]

When the skin produces excessive sebum, it becomes heavy and thick in texture, known as oily skin.[38] Oily skin is typified by shininess, blemishes and pimples.[8] The oily-skin type is not necessarily bad, since such skin is less prone to wrinkling, or other signs of ageing,[8] 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.[8] Oily skin can be sallow and rough in texture and tends to have large, clearly visible pores everywhere, except around the eyes and neck.[8]

Permeability Edit

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.[39][40] This protects the body from external particles such as toxins by not allowing them to come into contact with internal tissues. However, in some cases it is desirable to allow particles entry to the body through the skin. Potential medical applications of such particle transfer has prompted developments in nanomedicine and biology to increase skin permeability. One application of transcutaneous particle delivery could be to locate and treat cancer. Nanomedical researchers seek to target the epidermis and other layers of active cell division where nanoparticles can interact directly with cells that have lost their growth-control mechanisms (cancer cells). Such direct interaction could be used to more accurately diagnose properties of specific tumours or to treat them by delivering drugs with cellular specificity.

Nanoparticles Edit

Nanoparticles 40 nm in diameter and smaller have been successful in penetrating the skin.[41][42][43] Research confirms that nanoparticles larger than 40 nm do not penetrate the skin past the stratum corneum.[41] Most particles that do penetrate will diffuse through skin cells, but some will travel down hair follicles and reach the dermis layer.

The permeability of skin relative to different shapes of nanoparticles has also been studied. Research has shown that spherical particles have a better ability to penetrate the skin compared to oblong (ellipsoidal) particles because spheres are symmetric in all three spatial dimensions.[43] One study compared the two shapes and recorded data that showed spherical particles located deep in the epidermis and dermis whereas ellipsoidal particles were mainly found in the stratum corneum and epidermal layers.[44] 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.[40][45] Cadmium selenide (CdSe) quantum dots have proven to penetrate very effectively when they have certain properties. Because CdSe is toxic to living organisms, the particle must be covered in a surface group. An experiment comparing the permeability of quantum dots coated in polyethylene glycol (PEG), PEG-amine, and carboxylic acid concluded the PEG and PEG-amine surface groups allowed for the greatest penetration of particles. The carboxylic acid coated particles did not penetrate past the stratum corneum.[44]

Increasing permeability Edit

Scientists previously believed that the skin was an effective barrier to inorganic particles. Damage from mechanical stressors was believed to be the only way to increase its permeability.[46]

Recently, simpler and more effective methods for increasing skin permeability have been developed. Ultraviolet radiation (UVR) slightly damages the surface of skin and causes a time-dependent defect allowing easier penetration of nanoparticles.[47] The UVR's high energy causes a restructuring of cells, weakening the boundary between the stratum corneum and the epidermal layer.[47][46] 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.[47]

There are other methods to increase nanoparticle penetration by skin damage: tape stripping is the process in which tape is applied to skin then lifted to remove the top layer of skin; skin abrasion is done by shaving the top 5–10 μm off the surface of the skin; chemical enhancement applies chemicals such as polyvinylpyrrolidone (PVP), dimethyl sulfoxide (DMSO), and oleic acid to the surface of the skin to increase permeability;[48][49] 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.[49]

Applications Edit

A large area of interest in nanomedicine is the transdermal patch because of the possibility of a painless application of therapeutic agents with very few side effects. Transdermal patches have been limited to administer a small number of drugs, such as nicotine, because of the limitations in permeability of the skin. Development of techniques that increase skin permeability has led to more drugs that can be applied via transdermal patches and more options for patients.[49]

Increasing the permeability of skin allows nanoparticles to penetrate and target cancer cells. Nanoparticles along with multi-modal imaging techniques have been used as a way to diagnose cancer non-invasively. Skin with high permeability allowed quantum dots with an antibody attached to the surface for active targeting to successfully penetrate and identify cancerous tumours in mice. Tumour targeting is beneficial because the particles can be excited using fluorescence microscopy and emit light energy and heat that will destroy cancer cells.[50]

Sunblock and sunscreen Edit

Sunblock and sunscreen are different important skin-care products though both offer full protection from the sun.[51][52]

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.[53]

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 Edit

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. [54]

Several scientific studies confirmed that changes in baseline nutritional status affects skin condition. [55]

The Mayo Clinic lists foods they state help the skin: fruits and vegetables, whole-grains, dark leafy greens, nuts, and seeds.[56]

See also Edit

References Edit

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External links Edit

  •   Media related to Human skin at Wikimedia Commons
  • MedlinePlus Skin Conditions National Library of Medicine retrieved 12 November 2013.

human, skin, this, article, about, skin, humans, other, mammals, skin, human, skin, outer, covering, body, largest, organ, integumentary, system, skin, seven, layers, ectodermal, tissue, guarding, muscles, bones, ligaments, internal, organs, similar, most, oth. This article is about skin in humans For other mammals see 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 from Latin cutis skin Human skinSkin of a human handEpidermis dermis and subcutis showing a hair follicle gland and sebaceous glandDetailsSystemIntegumentary systemIdentifiersLatincutisTA98A16 0 00 002TA27041THH3 12 00 1 00001FMA7163Anatomical terminology edit on Wikidata Skin plays an important immunity role in protecting the body against pathogens and excessive water loss Its other functions are insulation temperature regulation sensation synthesis of vitamin D and the protection of vitamin B folates Severely damaged skin will try to heal by forming scar tissue This is often discoloured and depigmented In humans skin pigmentation affected by melanin varies among populations and skin type can range from dry to non dry and from oily to non oily Such skin variety provides a rich and diverse habitat for bacteria that number roughly 1000 species from 19 phyla present on the human skin Contents 1 Structure 1 1 Epidermis 1 1 1 Layers 1 1 2 Sublayers 1 1 3 Genes and proteins expressed in the epidermis 1 2 Dermis 1 2 1 Papillary region 1 2 2 Reticular region 1 3 Subcutaneous tissue 1 4 Cross section 2 Development 2 1 Skin colour 2 2 Ageing 2 2 1 Photoageing 2 3 UV induced DNA damage 3 Types 4 Functions 4 1 Skin flora 5 Clinical significance 6 Society and culture 6 1 Hygiene and skin care 6 1 1 Oily skin 7 Permeability 7 1 Nanoparticles 7 2 Increasing permeability 7 3 Applications 7 4 Sunblock and sunscreen 7 5 Diet 8 See also 9 References 10 External linksStructure EditHuman skin shares anatomical physiological biochemical and immunological properties with other mammalian lines especially pig skin 1 2 Pig skin shares similar epidermal and dermal thickness ratios to human skin 1 2 pig and human skin share similar hair follicle and blood vessel patterns 1 2 biochemically the dermal collagen and elastin content is similar in pig and human skin 1 2 and pig skin and human skin have similar physical responses to various growth factors 1 2 Skin has mesodermal cells pigmentation such as melanin provided by melanocytes which absorb some of the potentially dangerous ultraviolet radiation UV in sunlight It also contains DNA repair enzymes that help reverse UV damage such that people lacking the genes for these enzymes have high rates of skin cancer One form predominantly produced by UV light malignant melanoma is particularly invasive causing it to spread quickly and can often be deadly Human skin pigmentation varies among populations in a striking manner This has led to the classification of people s on the basis of skin colour 3 In terms of surface area the skin is the second largest organ in the human body the inside of the small intestine is 15 to 20 times larger For the average adult human the skin has a surface area of from 1 5 2 0 square metres 16 22 sq ft The thickness of the skin varies considerably over all parts of the body and between men and women and the young and the old An example is the skin on the forearm which is on average 1 3 mm in the male and 1 26 mm in the female 4 One average square inch 6 5 cm2 of skin holds 650 sweat glands 20 blood vessels 60 000 melanocytes and more than 1 000 nerve endings 5 better source needed The average human skin cell is about 30 micrometres mm in diameter but there are variants A skin cell usually ranges from 25 to 40 mm2 depending on a variety of factors Skin is composed of three primary layers the epidermis the dermis and the hypodermis 4 nbsp Layers Receptors and Appendages of Human SkinEpidermis Edit Main article 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 The epidermis contains no blood vessels and cells in the deepest layers are nourished almost exclusively by diffused oxygen from the surrounding air 6 and to a far lesser degree by blood capillaries extending to the outer layers of the dermis The main type of cells that make up the epidermis are Merkel cells keratinocytes with melanocytes and Langerhans cells also present The epidermis can be further subdivided into the following strata beginning with the outermost layer corneum lucidum only in palms of hands and bottoms of feet granulosum spinosum and basale Cells are formed through mitosis at the basale layer The daughter cells see cell division move up the strata changing shape and composition as they die due to isolation from their blood source The cytoplasm is released and the protein keratin is inserted They eventually reach the corneum and slough off desquamation This process is called keratinization This keratinized layer of skin is responsible for keeping water in the body and keeping other harmful chemicals and pathogens out making skin a natural barrier to infection 7 nbsp 2D projection of a 3D OCT 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 is nourished by diffusion from the dermis The main type of cells that make up the epidermis are keratinocytes melanocytes Langerhans cells and Merkel cells The epidermis helps the skin regulate body temperature Layers Edit The skin has up to seven layers of ectodermal tissue and guards the underlying muscles bones ligaments and internal organs 8 The epidermis is divided into several layers where cells are formed through mitosis at the innermost layers They move up the strata changing shape and composition as they differentiate and become filled with keratin After reaching the top layer stratum corneum they are eventually sloughed off or desquamated This process is called keratinization and takes place within weeks It was previously believed that the stratum corneum was a simple biologically inactive outer epidermal layer comprising a fibrillar lattice of dead keratin 9 It is now understood that this is not true and that the stratum corneum should be considered to be a live tissue 10 While it is true that the stratum corneum is mainly composed of terminally differentiated keratinocytes called corneocytes that are anucleated these cells remain alive and metabolically functional until desquamated citation needed Sublayers Edit The epidermis is divided into the following 5 sublayers or strata Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale also called stratum germinativum Blood capillaries are found beneath the epidermis and are linked to an arteriole and a venule Arterial shunt vessels may bypass the network in ears the nose and fingertips Genes and proteins expressed in the epidermis Edit About 70 of all human protein coding genes are expressed in the skin 11 12 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 13 An analysis of the corresponding proteins show that these are mainly expressed in keratinocytes and have functions related to squamous differentiation and cornification Dermis Edit Main article 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 Edit 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 Edit 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 pregnancy and obesity are also located in the dermis Subcutaneous tissue Edit 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 Edit nbsp Skin layers of both hairy and hairless skinDevelopment EditFurther information Human embryogenesis Integumentary system Skin colour Edit Main article Human 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 14 The actual skin colour of different humans is affected by many substances although the single most important substance determining human skin colour is the pigment melanin Melanin is produced within the skin in cells called melanocytes and it is the main determinant of the skin colour of darker skinned humans The skin colour of people with light skin is determined mainly by the bluish white connective tissue under the dermis and by the haemoglobin circulating in the veins of the dermis The red colour underlying the skin becomes more visible especially in the face when as consequence of physical exercise or the stimulation of the nervous system anger fear arterioles dilate 15 There are at least five different pigments that determine the colour of the skin 16 17 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 18 In the same population it has been observed that adult human females are considerably lighter in skin pigmentation than males Females need more calcium during pregnancy and lactation and vitamin D which is synthesized from sunlight helps in absorbing calcium For this reason it is thought that females may have evolved to have lighter skin in order to help their bodies absorb more calcium 19 The Fitzpatrick scale 20 21 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 I Always burns never tans Pale Fair FrecklesII Usually burns sometimes tans FairIII May burn usually tans Light BrownIV Rarely burns always tans Olive brownV Moderate constitutional pigmentation BrownVI Marked constitutional pigmentation BlackAgeing Edit Further information senescence Further information Intrinsic and extrinsic ageing nbsp A typical rash nbsp Skin infected with scabiesAs 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 22 Cortisol causes degradation of collagen 23 accelerating skin ageing 24 Anti ageing supplements are used to treat skin ageing citation needed Photoageing Edit Main article Photoageing Photoageing has two main concerns an increased risk for skin cancer and the appearance of damaged skin In younger skin sun damage will heal faster since the cells in the epidermis have a faster turnover rate while in the older population the skin becomes thinner and the epidermis turnover rate for cell repair is lower which may result in the dermis layer being damaged 25 UV induced DNA damage Edit UV irradiation of human skin cells generates damages in DNA through direct photochemical reactions at adjacent thymine or cytosine residues on the same strand of DNA 26 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 26 In humans this repair process protects against skin cancer 26 Types EditThis section needs expansion You can help by adding to it March 2022 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 27 The adjective cutaneous means of the skin from Latin cutis skin 28 Functions EditSkin 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 7 29 Perspiration contains lysozyme that break the bonds within the cell walls of bacteria 30 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 29 Loss of this function contributes to the massive fluid loss in burns Aesthetics and communication others see our skin and can assess our mood physical state and attractiveness Storage and synthesis acts as a storage centre for lipids and water as well as a means of synthesis of vitamin D by action of UV on certain parts of the skin Excretion sweat contains urea however its concentration is 1 130th that of urine hence excretion by sweating is at most a secondary function to temperature regulation Absorption the cells comprising the outermost 0 25 0 40 mm of the skin are almost exclusively supplied by external oxygen although the contribution to total respiration is negligible 6 In addition medicine can be administered through the skin by ointments or by means of adhesive patch such as the nicotine patch or iontophoresis The skin is an important site of transport in many other organisms Water resistance The skin acts as a water resistant barrier so essential nutrients are not washed out of the body 29 Skin flora Edit Main article Skin flora The human skin is a rich environment for microbes 31 32 Around 1000 species of bacteria from 19 bacterial phyla have been found 32 31 Most come from only four phyla Actinomycetota 51 8 Bacillota 24 4 Pseudomonadota 16 5 and Bacteroidota 6 3 Propionibacteria and Staphylococci species were the main species in sebaceous areas There are three main ecological areas moist dry and sebaceous In moist places on the body Corynebacteria together with Staphylococci dominate In dry areas there is a mixture of species but dominated by Betaproteobacteria and Flavobacteriales Ecologically sebaceous areas had greater species richness than moist and dry ones The areas with least similarity between people in species were the spaces between fingers the spaces between toes axillae and umbilical cord stump Most similarly were beside the nostril nares inside the nostril and on the back Reflecting upon the diversity of the human skin researchers on the human skin microbiome have observed hairy moist underarms lie a short distance from smooth dry forearms but these two niches are likely as ecologically dissimilar as rainforests are to deserts 31 The NIH conducted the Human Microbiome Project to characterize the human microbiota which includes that on the skin and the role of this microbiome in health and disease 33 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 EditFurther information skin disease 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 27 There are seven cervical twelve thoracic five lumbar and five sacral Certain diseases like shingles caused by varicella zoster infection have pain sensations and eruptive rashes involving dermatomal distribution Dermatomes are helpful in the diagnosis of vertebral spinal injury levels Aside from the dermatomes the epidermis cells are susceptible to neoplastic changes resulting in various cancer types 34 The skin is also valuable for diagnosis of other conditions since many medical signs show through the skin Skin color affects the visibility of these signs a source of misdiagnosis in unaware medical personnel 35 36 Society and culture EditHygiene and skin care Edit See also Exfoliation cosmetology 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 6 5 square centimetres 1 sq in of human skin at 50 million though this figure varies greatly over the average 1 9 square metres 20 sq ft of human skin Oily surfaces such as the face may contain over 78 million bacteria per square centimetre 500 million per square inch Despite these vast quantities all of the bacteria found on the skin s surface would fit into a volume the size of a pea 37 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 Edit Oily skin is caused by over active sebaceous glands that produce a substance called sebum a naturally healthy skin lubricant 8 38 A high glycemic index diet and dairy products except for cheese consumption increase IGF 1 generation which in turn increases sebum production 38 Overwashing the skin does not cause sebum overproduction but may cause dryness 38 When the skin produces excessive sebum it becomes heavy and thick in texture known as oily skin 38 Oily skin is typified by shininess blemishes and pimples 8 The oily skin type is not necessarily bad since such skin is less prone to wrinkling or other signs of ageing 8 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 8 Oily skin can be sallow and rough in texture and tends to have large clearly visible pores everywhere except around the eyes and neck 8 Permeability EditHuman 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 39 40 This protects the body from external particles such as toxins by not allowing them to come into contact with internal tissues However in some cases it is desirable to allow particles entry to the body through the skin Potential medical applications of such particle transfer has prompted developments in nanomedicine and biology to increase skin permeability One application of transcutaneous particle delivery could be to locate and treat cancer Nanomedical researchers seek to target the epidermis and other layers of active cell division where nanoparticles can interact directly with cells that have lost their growth control mechanisms cancer cells Such direct interaction could be used to more accurately diagnose properties of specific tumours or to treat them by delivering drugs with cellular specificity Nanoparticles Edit Nanoparticles 40 nm in diameter and smaller have been successful in penetrating the skin 41 42 43 Research confirms that nanoparticles larger than 40 nm do not penetrate the skin past the stratum corneum 41 Most particles that do penetrate will diffuse through skin cells but some will travel down hair follicles and reach the dermis layer The permeability of skin relative to different shapes of nanoparticles has also been studied Research has shown that spherical particles have a better ability to penetrate the skin compared to oblong ellipsoidal particles because spheres are symmetric in all three spatial dimensions 43 One study compared the two shapes and recorded data that showed spherical particles located deep in the epidermis and dermis whereas ellipsoidal particles were mainly found in the stratum corneum and epidermal layers 44 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 40 45 Cadmium selenide CdSe quantum dots have proven to penetrate very effectively when they have certain properties Because CdSe is toxic to living organisms the particle must be covered in a surface group An experiment comparing the permeability of quantum dots coated in polyethylene glycol PEG PEG amine and carboxylic acid concluded the PEG and PEG amine surface groups allowed for the greatest penetration of particles The carboxylic acid coated particles did not penetrate past the stratum corneum 44 Increasing permeability Edit Scientists previously believed that the skin was an effective barrier to inorganic particles Damage from mechanical stressors was believed to be the only way to increase its permeability 46 Recently simpler and more effective methods for increasing skin permeability have been developed Ultraviolet radiation UVR slightly damages the surface of skin and causes a time dependent defect allowing easier penetration of nanoparticles 47 The UVR s high energy causes a restructuring of cells weakening the boundary between the stratum corneum and the epidermal layer 47 46 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 47 There are other methods to increase nanoparticle penetration by skin damage tape stripping is the process in which tape is applied to skin then lifted to remove the top layer of skin skin abrasion is done by shaving the top 5 10 mm off the surface of the skin chemical enhancement applies chemicals such as polyvinylpyrrolidone PVP dimethyl sulfoxide DMSO and oleic acid to the surface of the skin to increase permeability 48 49 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 mm to easily permeate electroporated skin 49 Applications Edit A large area of interest in nanomedicine is the transdermal patch because of the possibility of a painless application of therapeutic agents with very few side effects Transdermal patches have been limited to administer a small number of drugs such as nicotine because of the limitations in permeability of the skin Development of techniques that increase skin permeability has led to more drugs that can be applied via transdermal patches and more options for patients 49 Increasing the permeability of skin allows nanoparticles to penetrate and target cancer cells Nanoparticles along with multi modal imaging techniques have been used as a way to diagnose cancer non invasively Skin with high permeability allowed quantum dots with an antibody attached to the surface for active targeting to successfully penetrate and identify cancerous tumours in mice Tumour targeting is beneficial because the particles can be excited using fluorescence microscopy and emit light energy and heat that will destroy cancer cells 50 Sunblock and sunscreen Edit Sunblock and sunscreen are different important skin care products though both offer full protection from the sun 51 52 Sunblock Sunblock 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 53 Sunscreen Sunscreen 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 Edit 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 54 Several scientific studies confirmed that changes in baseline nutritional status affects skin condition 55 The Mayo Clinic lists foods they state help the skin fruits and vegetables whole grains dark leafy greens nuts and seeds 56 See also EditAcid mantle Adam and Eve Anthropodermic bibliopegy Artificial skin Callus thick area of skin List of cutaneous conditions Cutaneous structure development Fingerprint skin on fingertips Human body Hyperpigmentation about excess skin colour Intertriginous Meissner s corpuscle Nude beaches Nude swimming Nudity Pacinian corpuscle Polyphenol antioxidant Sexual intercourse Skin cancer Skin lesion Skin repair SunbathingReferences Edit a b c d e Herron AJ 5 December 2009 Pigs as Dermatologic Models of Human Skin Disease PDF ivis org DVM Center for Comparative Medicine and Department of Pathology Baylor College of Medicine Houston Texas Retrieved 27 January 2018 pig skin has been shown to be the most similar to human skin Pig skin is structurally similar to human epidermal thickness and dermal epidermal thickness ratios Pigs and humans have similar hair follicle and blood vessel patterns in the skin Biochemically pigs contain dermal collagen and elastic content that is more similar to humans than other laboratory animals Finally pigs have similar physical and molecular responses to various growth factors a b c d e Liu J Kim D Brown L Madsen T Bouchard GF Comparison of Human Porcine and Rodent Wound Healing With New Miniature Swine Study Data PDF sinclairresearch com Sinclair Research Centre Auxvasse MO USA Veterinary Medical Diagnostic Laboratory Columbia MO USA Archived from the original PDF on 27 January 2018 Retrieved 27 January 2018 Pig skin is anatomically physiologically biochemically and immunologically similar to human skin Maton A Hopkins J McLaughlin CW Johnson S Warner MQ LaHart D Wright JD 1893 Human Biology and Health Englewood Cliffs New Jersey USA Prentice Hall ISBN 978 0 13 981176 0 a b Wilkinson PF Millington R 2009 Skin Digitally printed version ed Cambridge Cambridge University Press pp 49 50 ISBN 978 0 521 10681 8 Bennett H 25 May 2014 Ever wondered about your skin The Washington Post Retrieved 27 October 2014 a b Stucker M Struk A Altmeyer P Herde M Baumgartl H Lubbers DW February 2002 The cutaneous uptake of atmospheric oxygen contributes significantly to the oxygen supply of human dermis and epidermis The Journal of Physiology 538 Pt 3 985 94 doi 10 1113 jphysiol 2001 013067 PMC 2290093 PMID 11826181 a b Proksch E Brandner JM Jensen JM December 2008 The skin an indispensable barrier Experimental Dermatology 17 12 1063 72 doi 10 1111 j 1600 0625 2008 00786 x PMID 19043850 S2CID 31353914 a b c d e f Skin care analysis Health Cares net 2007 webpage HCcare Archived 12 December 2007 at the Wayback Machine Del Rosso JQ Levin J September 2011 The clinical relevance of maintaining the functional integrity of the stratum corneum in both healthy and disease affected skin The Journal of Clinical and Aesthetic Dermatology 4 9 22 42 doi 10 1111 j 1365 2133 1990 tb06268 x PMC 3175800 PMID 21938268 Kligman A 2006 A brief history of how the dead stratum corneum became alive Skin Barrier New York Taylor amp Francis pp 35 44 ISBN 9780429163470 The human proteome in skin The Human Protein Atlas www proteinatlas org Uhlen M Fagerberg L Hallstrom BM Lindskog C Oksvold P Mardinoglu A et al January 2015 Proteomics Tissue based map of the human proteome Science 347 6220 1260419 doi 10 1126 science 1260419 PMID 25613900 S2CID 802377 Edqvist PH Fagerberg L Hallstrom BM Danielsson A Edlund K Uhlen M Ponten F February 2015 Expression of human skin specific genes defined by transcriptomics and antibody based profiling The Journal of Histochemistry and Cytochemistry 63 2 129 41 doi 10 1369 0022155414562646 PMC 4305515 PMID 25411189 Muehlenbein M 2010 Human Evolutionary Biology Cambridge University Press pp 192 213 ISBN 978 1139789004 Jablonski NG 2006 Skin a Natural History Berkeley University of California Press ISBN 978 0520954816 Handbook of General Anatomy by B D Chaurasia ISBN 978 81 239 1654 5 Pigmentation of Skin Mananatomy com Archived from the original on 7 October 2012 Retrieved 3 June 2019 Webb AR September 2006 Who what where and when influences on cutaneous vitamin D synthesis Progress in Biophysics and Molecular Biology 92 1 17 25 doi 10 1016 j pbiomolbio 2006 02 004 PMID 16766240 Jablonski NG Chaplin G July 2000 The evolution of human skin coloration Journal of Human Evolution 39 1 57 106 doi 10 1006 jhev 2000 0403 PMID 10896812 The Fitzpatrick Skin Type Classification Scale Skin Inc November 2007 28 May 2009 Retrieved 7 January 2014 Fitzpatrick Skin Type PDF Australian Radiation Protection and Nuclear Safety Agency Archived from the original PDF on 31 March 2016 Retrieved 7 January 2014 Alexiades Armenakas Macrene R Dover Jeffrey S Arndt Kenneth A 2008 The spectrum of laser skin resurfacing Nonablative fractional and ablative laser resurfacing Journal of the American Academy of Dermatology 58 5 719 737 doi 10 1016 j jaad 2008 01 003 PMID 18423256 Cutroneo KR Sterling KM May 2004 How do glucocorticoids compare to oligo decoys as inhibitors of collagen synthesis and potential toxicity of these therapeutics Journal of Cellular Biochemistry 92 1 6 15 doi 10 1002 jcb 20030 PMID 15095399 S2CID 24160757 subscription required Oikarinen A 2004 Connective tissue and aging International Journal of Cosmetic Science 26 2 107 doi 10 1111 j 1467 2494 2004 213 6 x ISSN 0142 5463 subscription required Gilchrest BA April 1990 Skin aging and photoaging Dermatology Nursing 2 2 79 82 PMID 2141531 a b c Lee Jihoon W Ratnakumar Kajan Hung Kai Feng Rokunohe Daiki Kawasumi Masaoki 2020 Deciphering UV induced DNA Damage Responses to Prevent and Treat Skin Cancer Photochemistry and Photobiology 96 3 478 499 doi 10 1111 php 13245 PMC 7651136 PMID 32119110 a b Marks James G Miller Jeffery 2006 Lookingbill and Marks Principles of Dermatology 4th ed Elsevier Inc ISBN 1 4160 3185 5 Definition of CUTANEOUS www merriam webster com Retrieved 4 March 2022 a b c Madison KC August 2003 Barrier function of the skin la raison d etre of the epidermis PDF The Journal of Investigative Dermatology 121 2 231 41 doi 10 1046 j 1523 1747 2003 12359 x PMID 12880413 Todar K Immune Defense against Bacterial Pathogens Innate Immunity textbookofbacteriology net Retrieved 19 April 2017 a b c Grice EA Kong HH Conlan S Deming CB Davis J Young AC et al May 2009 Topographical and temporal diversity of the human skin microbiome Science 324 5931 1190 2 Bibcode 2009Sci 324 1190G doi 10 1126 science 1171700 PMC 2805064 PMID 19478181 a b Pappas S 2009 Your Body Is a Wonderland of Bacteria ScienceNOW Daily News Archived 2 June 2009 at the Wayback Machine NIH Human Microbiome Project Hmpdacc org Retrieved 3 June 2019 Yousef Hani Alhajj Mandy Sharma Sandeep 2023 Anatomy Skin Integument Epidermis StatPearls Treasure Island FL StatPearls Publishing PMID 29262154 retrieved 28 September 2023 Color awareness A must for patient assessment American Nurse 11 January 2011 McCue D 21 July 2020 Medical student creates handbook for diagnosing conditions in Black and brown skin As It Happens CBC Radio Retrieved 15 December 2020 Theodor Rosebury Life on Man Secker amp Warburg 1969 ISBN 0 670 42793 4 a b c d Sakuma TH Maibach HI 2012 Oily skin an overview Skin Pharmacology and Physiology 25 5 227 35 doi 10 1159 000338978 PMID 22722766 S2CID 2446947 Baroli B January 2010 Penetration of nanoparticles and nanomaterials in the skin fiction or reality Journal of Pharmaceutical Sciences 99 1 21 50 doi 10 1002 jps 21817 PMID 19670463 a b Filipe P Silva JN Silva R Cirne de Castro JL Marques Gomes M Alves LC et al 2009 Stratum corneum is an effective barrier to TiO2 and ZnO nanoparticle percutaneous absorption Skin Pharmacology and Physiology 22 5 266 75 doi 10 1159 000235554 PMID 19690452 S2CID 25769287 a b Vogt A Combadiere B Hadam S Stieler KM Lademann J Schaefer H et al June 2006 40 nm but not 750 or 1 500 nm nanoparticles enter epidermal CD1a cells after transcutaneous application on human skin The Journal of Investigative Dermatology 126 6 1316 22 doi 10 1038 sj jid 5700226 PMID 16614727 Sonavane G Tomoda K Sano A Ohshima H Terada H Makino K August 2008 In vitro permeation of gold nanoparticles through rat skin and rat intestine effect of particle size Colloids and Surfaces B Biointerfaces 65 1 1 10 doi 10 1016 j colsurfb 2008 02 013 PMID 18499408 a b Ryman Rasmussen JP Riviere JE Monteiro Riviere NA May 2006 Penetration of intact skin by quantum dots with diverse physicochemical properties Toxicological Sciences 91 1 159 65 doi 10 1093 toxsci kfj122 PMID 16443688 a b Ryman Rasmussen Jessica P Riviere Jim E Monteiro Riviere Nancy A 2006 Penetration of Intact Skin by Quantum Dots with Diverse Physicochemical Properties Toxicological Sciences 91 1 159 165 doi 10 1093 toxsci kfj122 PMID 16443688 Larese FF D Agostin F Crosera M Adami G Renzi N Bovenzi M Maina G January 2009 Human skin penetration of silver nanoparticles through intact and damaged skin Toxicology 255 1 2 33 7 doi 10 1016 j tox 2008 09 025 PMID 18973786 a b Mortensen LJ Oberdorster G Pentland AP Delouise LA September 2008 In vivo skin penetration of quantum dot nanoparticles in the murine model the effect of UVR Nano Letters 8 9 2779 87 Bibcode 2008NanoL 8 2779M doi 10 1021 nl801323y PMC 4111258 PMID 18687009 a b c Mortensen L Zheng H Faulknor R De Benedetto A Beck L DeLouise LA 2009 Osinski M Jovin TM Yamamoto K eds Increased in vivo skin penetration of quantum dots with UVR and in vitro quantum dot cytotoxicity Colloidal Quantum Dots for Biomedical Applications IV 7189 718919 718919 12 Bibcode 2009SPIE 7189E 19M doi 10 1117 12 809215 ISSN 0277 786X S2CID 137060184 Sokolov K Follen M Aaron J Pavlova I Malpica A Lotan R Richards Kortum R May 2003 Real time vital optical imaging of precancer using anti epidermal growth factor receptor antibodies conjugated to gold nanoparticles Cancer Research 63 9 1999 2004 PMID 12727808 a b c Prausnitz MR Mitragotri S Langer R February 2004 Current status and future potential of transdermal drug delivery Nature Reviews Drug Discovery 3 2 115 24 doi 10 1038 nrd1304 PMID 15040576 S2CID 28888964 Gao X Cui Y Levenson RM Chung LW Nie S August 2004 In vivo cancer targeting and imaging with semiconductor quantum dots Nature Biotechnology 22 8 969 76 doi 10 1038 nbt994 PMID 15258594 S2CID 41561027 Sunscreen or sunblock Retrieved 1 July 2015 permanent dead link An update on Suncreens 2007 P 23 29 Available at www aocd org resource resmgr jaocd 2007aug pdf Nanotechnology Information Center Properties Applications Research and Safety Guidelines American Elements Shapiro SS Saliou C October 2001 Role of vitamins in skin care Nutrition 17 10 839 44 doi 10 1016 S0899 9007 01 00660 8 PMID 11684391 Boelsma E van de Vijver LP Goldbohm RA Klopping Ketelaars IA Hendriks HF Roza L February 2003 Human skin condition and its associations with nutrient concentrations in serum and diet The American Journal of Clinical Nutrition 77 2 348 55 doi 10 1093 ajcn 77 2 348 PMID 12540393 Foods for healthy skin Mayo Clinic External links Edit nbsp Look up human skin in Wiktionary the free dictionary nbsp Media related to Human skin at Wikimedia Commons MedlinePlus Skin Conditions National Library of Medicine retrieved 12 November 2013 Retrieved from https en wikipedia org w index php title Human skin amp oldid 1181846710, wikipedia, wiki, book, books, library,

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