皮肤总论英文版课件.pptx

1、1Schedule of Dermatology&Venereology LectureNo.DateContentsTimeTeacher12-26General consideration(1)2hXinsuo Duan 23-5General consideration(2)2hXinsuo Duan 33-12General consideration(3)2hXinsuo Duan 43-19Viral dermatoses&Bacteria dermatoses 2hShuping Yu 53-26Fungal dermatoses2hShuping Yu 64-2STD(1)sy

2、philis，AIDS2hXinsuo Duan 74-9STD(2)gonorrhea,NGU,CA,chancroid2hXinsuo Duan 84-16Eczema&Dermatitis(1)2hJin Wang 94-23Eczema&Dermatitis(2)2hJin Wang 104-30Drug eruption2hJingliang Wu115-7Urticaria 2hJingliang Wu125-14Papulosquamous diseases2hBaoqiang Li 135-21Bullous Dermatoses2hBaoqiang Li 145-28Cuta

3、neous vasculitis2hBaoqiang Li 156-4Skin appendages2hBaoqiang Li 166-11Vitiligo&Skin tumors2hBaoqiang Li 176-18Practice2h186-25Test2h2Section General Consideration Introduction Structure of Skin Function of Skin Symptom,Sign and Diagnosis of Dermatoses Treatment of Dermatoses3 Introduction The skin i

4、s the largest organ of the body There are more than 2000 kind of skin disease in Dermatology Structure of skin561.Epidermis(structure)71.Epidermis cells keratinocyte melanocyte Langerhans cell Merkel cellGeneral consideration(3)nail of finger 0.Hemi-desmosomeIntroduction（4）eccrine glands（2）Melanocyt

5、eCorrelate with tensity of skin(3)Langerhans cellnail of finger 0.Shuping Yuthe buccal mucosaThe deeper,lower horizontal plexus is found at the dermal-subcutaneous interface and is composed of larger blood vessels than those of the superficial plexus.vermilion border of the lip(Fordyces spots)vermil

6、ion border of the lip(Fordyces spots)The coiled secretory gland is located at the junction of the dermis and subcutaneous fat.Smoothness：AbsorptionThe pale glycogen-rich cells form sweat4mm/d365d/y10ythe buccal mucosa8（1）Keratinocyte910Hemi-desmosome11（1）Keratinocyte12desmosomehemi-desmosomeDesmosom

7、e&Hemi-desmosome13Desmosome14Hemi-desmosome15desmosomehemi-desmosomeDesmosome&Hemi-desmosome16（1）Keratinocyte28dIt opens into the infundibular portion of the hair follicle.Short hair：eyebrows,eyelids,nose and auditory meatesWater metabolismXinsuo DuanFunction of SkinThey are always associated with h

8、air follicles except at the following sites:Increased sweat production in response to heat is part of the thermoregulatory system of the body;together with increased cutaneous blood flow,it can effectively dissipate excessive body heat.vermilion of the lipOther physiologic stimuli,including emotiona

9、l stress,are important as well.contain intracytoplasmic neurosecretory-like granules,and,through their association with neurites,act as slow adapting touch receptors.the external auditory canal(ceruminous glands),distributionthe prepuce(Tysons glands)The glands do not begin to function until puberty

10、.Papulosquamous diseasesantigen presenting cellCutaneous vasculitisJingliang WuHypodermis(subcutaneous tissue)metabolism and immuneThe deeper,lower horizontal plexus is found at the dermal-subcutaneous interface and is composed of larger blood vessels than those of the superficial plexus.17（2）Melano

11、cytemelanocytepigment-producing cell 18They are distributed throughout all skin sites except the palms and soles.Section General ConsiderationResting phaseAssociated with the vascular plexus are the dermal lymphatics.The skin also plays an important role in immunization of the body.Sweat is secreted

12、 by the sweat glands and gives a function of discipating heat.vermilion of the lipThey are most abundant on theAbsorptionprotein metabolismthe external auditory canal(ceruminous glands),4mm/d，loss70-100/d）mammary papillathe prepuce(Tysons glands)hair follicleBaoqiang Limetabolism and immuneThey are

13、distributed throughout all skin sites except the palms and soles.reticulare dermisJin Wangthe external auditory canal(ceruminous glands),19（2）Melanocyte202122（2）Melanocyte23(3)Langerhans cell Langerhans cellantigen presenting cell24(3)Langerhans cellLangerhans cells (CD1a)25(4)Merkel cell Merkel cel

14、lcontain intracytoplasmic neurosecretory-like granules,and,through their association with neurites,act as slow adapting touch receptors.26(4)Merkel cellin the basal layer of the palms and soles,the oral and genital mucosa,the nail bed,and the follicular infundibula.Be found in greatest abundance on

15、the face and scalp.Xinsuo Duan4mm/d365d/y10yResting phasethe external auditory canal(ceruminous glands),Resting phaseThe pale glycogen-rich cells form sweat（4）eccrine glandssebaceous glandsLength(10001500mm)=0.vermilion border of the lip(Fordyces spots)Langerhans cells (CD1a)MetabolismIncreased swea

16、t production in response to heat is part of the thermoregulatory system of the body;together with increased cutaneous blood flow,it can effectively dissipate excessive body heat.They are distributed throughout all skin sites except the palms and soles.elastic fiberssecretion and excretion（4）eccrine

17、glandsdecapitation secretion272.Dermis collagen fiber reticular fiber elastic fibers base material（ground substance）：proteoglycan Cells:Fibroblast mast cell Macrophage dermic arborescent cell Langgerhans cell Pigmentophage Lymphocyte leukocyte282.Dermis collagen fibersthe female areolas(Montgomerys

18、tubercles).A significant amount of metabolic wastes and salts is disposed from the sweat.The pale glycogen-rich cells form sweatSkin appendagesthe external auditory canal(ceruminous glands),eccrine glandseccrine glandscarbohydrate and salt metabolismregulation of cutaneous blood flow,reticular fiber

19、（4）eccrine glandsSebum is excreted by the sebaceous gland through the orifice of hair follicle,the sebum may lubricate the skin and hair,and give a function of antibacterial and antifungal properities.Drug eruptionSkin appendagesDesmosome&Hemi-desmosomecarbohydrate and salt metabolismWater metabolis

20、mAssociated with the vascular plexus are the dermal lymphatics.Pigmentophagemetabolism and immune(4)Merkel cellnail grooveSecretion and ExcretionIt is composed of a double layer of cuboidal epithelial cells.Skin appendagesBaoqiang LiInner root sheath(4)Merkel cellPressure is mediated by Vater-Pacini

21、 corpuscles which locate in the deeper portion of the dermis of weight-bearing surfaces.Long hair girldistributiondistribution1mm/d，toenail 0.Heat is a prime stimulus to increased sweating,(3)Langerhans cell（1）Keratinocyte（2）sebaceous glandsCorrelate with tensity of skindistributionIt is composed of

22、 a double layer of cuboidal epithelial cells.the external auditory canal(ceruminous glands),The pale glycogen-rich cells form sweat29reticular fiber302.Dermis elastic fibersCorrelate with tensity of skin312.Dermisreticulare dermispapillary dermis323.Hypodermis(subcutaneous tissue)HypodermisHypodermi

23、s333.Hypodermis(subcutaneous tissue)344.Appendages hair follicle sebaceous glands eccrine glands apocrine glands nail35（1）Hair and Hair follicleHair：Long hairShort hairWolly hairEpidermisSebaceous glandsHair rootMedullaryHair cuticleCortexInner root sheathOuter root sheathHair matrixHair papilla36Di

24、stribution of hair Long hair：scalp,beard,axillae and pubes Short hair：eyebrows,eyelids,nose and auditory meates Smoothness：vermilion of the lip mammary papilla Palm,soles,side of the fingers and toes,nail beds,and certain areas adjacent to mucosal surface,such as the glans penis vellus hair(Wolly ha

25、ir)：face,neck and trunk37Hair growth cycle（speed 0.270.4mm/d，loss70-100/d）anagen3-10yGrowing phase catagen3-4wTransitional phase telogen3mResting phase38Long hair girlLength(10001500mm)=0.270.4mm/d365d/y10y39（2）Sebaceous glandsIt is composed of lobules of pale-staining cells with abundant lipid in t

26、heir cytoplasm.40distributionBe found in greatest abundance on the face and scalp.They are distributed throughout all skin sites except the palms and soles.They are always associated with hair follicles except at the following sites:the eyelids(meibomian glands),the buccal mucosa vermilion border of

27、 the lip(Fordyces spots)the prepuce(Tysons glands)the female areolas(Montgomerys tubercles).41（2）sebaceous glandsDiseases:Comedopapulepustulecyst 42 It opens into the infundibular portion of the hair follicle.The coiled secretory gland is located at the junction of the dermis and subcutaneous fat.（3

28、）Apocrine glands43（3）Apocrine glandsdecapitation secretion It is composed of a double layer of cuboidal epithelial cells.metabolism and immuneThe pale glycogen-rich cells form sweatProtectionIt is composed of a double layer of cuboidal epithelial cells.（3）Apocrine glandsUrticariametabolism and immun

29、e(4)Merkel cellFunction of Skinprotein metabolismLength(10001500mm)=0.It opens into the infundibular portion of the hair follicle.(3)Langerhans cellprotein metabolism(4)Merkel cellImmune Functionsebaceous glandsLangerhans cells (CD1a)Baoqiang LiShuping YuGeneral consideration(1)Water metabolism44Apo

30、crine units of the human body are generally confined to the following sites:axillae,areolae,the anogenital region,the external auditory canal(ceruminous glands),and the eyelids(glands of Moll).The glands do not begin to function until puberty.（3）Apocrine glands45（4）eccrine glands46（4）eccrine glands

31、cells are of two types:glycogen-rich,large pale cells smaller,darker staining cells The pale glycogen-rich cells form sweat47（4）eccrine glands The darker cells may actively reabsorb sodium,thereby modifying sweat from a basically isotonic solution to a hypotonic one by the time it reaches the skin s

32、urface.Sweat is similar in composition to plasma,containing the same electrolytes,though in a more dilute concentration.48RegulationSecretion of sweat occurs as result of many factors and is mediated by cholinergic innervation.Heat is a prime stimulus to increased sweating,Other physiologic stimuli,

33、including emotional stress,are important as well.Increased sweat production in response to heat is part of the thermoregulatory system of the body;together with increased cutaneous blood flow,it can effectively dissipate excessive body heat.At friction surfaces,such as the palms and soles,eccrine se

34、cretion is thought to assist tactile sensibility and improve adhesion.49 distributionEccrine sweat units are found at virtually all skin sites except the vermillion border of the lips,nailbeds,labia minora,glans penis,and inner aspect of the prepuce.They are most abundant on the palms,soles,forehead

35、,axillae.Some eccrine glands in the axillae,especially inpatients with hyperhidrosis,may have widely dilated secretary coils that contain apocrine-appearing cells.50（5）nailnail foldsnail lunula nail platefree margin of nailnail groovegrowth velocity：nail of finger 0.1mm/d，toenail 0.1cm/3dnail foldsn

36、ail platenail bednail rootnail matrixdigital bone51Vasculature three important intercommunicating plexuses:the subpapillary plexus upper horizontal network The deeper,lower horizontal plexus is found at the dermal-subcutaneous interface and is composed of larger blood vessels than those of the super

37、ficial plexus.The vasculature of the dermis is particularly well developed at sites of adnexal structures.Associated with the vascular plexus are the dermal lymphatics.5.Vasculature,Muscles,and Nerves of skin 5253 muscle Smooth muscle occurs in the skin as arrectores pilorum(erectors of the hairs),a

38、s the tunica dartos(or dartos)of the scrotum,and in the areolas around the nipples.The arrectores pilorum are attached to the hair follicles below the sebaceous glands and,in contracting,pull the hair follicle upward,producing gooseflesh.5.Vasculature,Muscles,and Nerves of skin muscle545.Vasculature

39、,Muscles,and Nerves of skin Nerves：Touch is mediated by Meissner corpuscles and in the dermal papillae,particularly on the palms and soles Pressure is mediated by Vater-Pacini corpuscles which locate in the deeper portion of the dermis of weight-bearing surfaces.Temperature,pain,and itch sensation a

40、re transmitted by unmyelinated nerve fibers which terminate in the papillary dermis and around hair follicles.AppendagesResting phaseCutaneous vasculitisHair growth cycle（speed 0.The comeum stratum,hair follicle and sebaceous gland are the main path.Vasculature,Muscles,and Nerves of skindecapitation

41、 secretionThe pale glycogen-rich cells form sweatthe female areolas(Montgomerys tubercles).There are more than 2000 kind of skin disease in DermatologyBaoqiang LiShort hair：eyebrows,eyelids,nose and auditory meatesIt is composed of a double layer of cuboidal epithelial cells.Desmosome&Hemi-desmosome

42、vermilion border of the lip(Fordyces spots)and muscle activity,including shivering(resulting in warmth).It is composed of a double layer of cuboidal epithelial cells.（4）eccrine glandsEccrine sweat units are found at virtually all skin sites except the vermillion border of the lips,nailbeds,labia min

43、ora,glans penis,and inner aspect of the prepuce.nail grooveThe comeum stratum,hair follicle and sebaceous gland are the main path.the buccal mucosa56 The skins functions include Protection Absorption Sensation secretion and excretion temperature regulation metabolism and immuneFunction of Skin571.Pr

44、otection Physical Protection Chemical Protection Protection against pathogenic micro-organisms Prevent the loss of fluid,electrolyte and nutrient substance.582.Absorption The comeum stratum,hair follicle and sebaceous gland are the main path.The absorption can be affected by some facors:structure an

45、d site of the skin,hydration of the corneum stratum,nature of the substance,environment factors593.Sensation The body interprets external stimuli as heat,cold,pain,light touch,pressure,itch,and even tickle heatcold604.Secretion and Excretion Sweat is secreted by the sweat glands and gives a function

46、 of discipating heat.A significant amount of metabolic wastes and salts is disposed from the sweat.Sebum is excreted by the sebaceous gland through the orifice of hair follicle,the sebum may lubricate the skin and hair,and give a function of antibacterial and antifungal properities.615.Temperature r

47、egulation Cutaneous mechanisms of temperature control include insulation(primarily subcutaneous fat),regulation of cutaneous blood flow,eccrine sweat activity(resulting in cooling through evaporation),and muscle activity,including shivering(resulting in warmth).626.Metabolism Water metabolism carboh

48、ydrate and salt metabolism protein metabolism lipid and vitamin metabolism melanin metabolism 63 7.Immune Function The skin also plays an important role in immunization of the body.6465 Introduction The skin is the largest organ of the body There are more than 2000 kind of skin disease in Dermatolog

49、y metabolism and immune4mm/d365d/y10yImmune FunctionThe pale glycogen-rich cells form sweatprotein metabolismBaoqiang LiBaoqiang LiBaoqiang LidistributionThe pale glycogen-rich cells form sweatSection General Considerationsecretion and excretionThey are always associated with hair follicles except a

50、t the following sites:protein metabolismcarbohydrate and salt metabolismvellus hair(Wolly hair)：face,neck and trunkelastic fibersThe vasculature of the dermis is particularly well developed at sites of adnexal structures.Associated with the vascular plexus are the dermal lymphatics.The skin also pla