Learning objectives

On completion of this tutorial you will be able

to:

 describe the histological structure of

skin
 list the features of the nerves and
glands found in skin
 list the histological features of
breast

Introduction

The skin is part of the integument (outer covering of the body and all its associated
appendages . In this tutorial, we will examine the histological features of the skin, together
with its associated exocrine secretory units — sweat glands, sebaceous glands and
mammary glands.

Topic 1 — Skin

The skin has several functions, including:

 mechanical protection
 barrier to the external environment: keeping the insides in and the outsides out
 temperature control: sweating, vasodilation, vasoconstriction, hair (pilo) erection
 perception: it contains sensory receptors
 excretion: electrolytes, nitrogenous wastes
 secretion: sebum, breast milk
 synthesis: vitamin D

The skin has two principal layers:

 the epidermis (skin epithelium)

 the dermis

The deep dermis is sometimes referred to as the hypodermis.

Layers of the epidermis

The epidermis is a stratified squamous epithelium. Since one of the functions of skin is mechanical
protection, it stands to reason that the epidermis consists of many layers, and that the surface cells,
which are continually being shed and replaced from below, are flat.

Basal layer 1 of 2

The layer of the epidermis nearest the basement membrane is the basal layer (stratum basale). This
is a single layer of cuboidal or columnar cells with prominent nuclei. Mitotic activity takes place in the
basal layer — newly produced cells migrate superficially and are eventually shed at the surface.

Melanocytes are also present in this layer.

Other layers of the epidermis

Superficially from the basal layer, the other layers are, in order:

 prickle cell, or spinous cell, layer (stratum spinosum): several layers of large polyhedral cells
 granular layer (stratum granulosum): several layers of cells containing keratohyaline
granules that stain deeply
 clear layer (stratum lucidum): several layers of transparent cells with indistinct or no nuclei
 horny layer (stratum corneum): layers of fused flattened cells with no nuclei —mainly soft
keratin

The layers of the epidermis are:

dermis

 basal layer
 prickle cell layer
 granular layer
 clear layer
 horny layer

outer skin layer

Keratin

Epidermal thickness
Epidermal thickness depends on the degree of wear and tear. For example, on the back of the hand
the epidermis is about 0.07 mm thick, but on the sole of the foot it may be as much as 1.5 mm thick.

All five epidermal layers are visible in thick skin, but in thin skin you may only see the basal, prickle
cell, and horny layers.

Keratinised epidermis
In areas where wear and tear is particularly rough (the sole of the foot for example) a layer
of keratin is present for added protection. Epidermal derivatives, such as hair, horns, hooves, and
nails, are principally or entirely made of keratin.

Additional Info

Keratin

Most of the skin, being exposed to air, is keratinised to resist desiccation. Epithelia in moist environments,
such as oral and vaginal epithelia, are not keratinised.

Horns and hooves

Other derivatives of keratinised epithelium include horns, hooves and nails. Nails can become very hoof-
like: onychogryphosis.

Dark circles under the eyes

The skin under your eyes is very thin, so blood vessels and darker pigmentation are more obvious.
Nerves and glands of the skin

Nerves but no blood vessels

Free nerve endings are present in the epidermis. Among other modalities, their function is
temperature perception.

There are no blood vessels in the epidermis — blood vessels do not cross the basement membrane.
Additional receptors are present in the dermis.

Epidermal glands
Sebaceous glands and sweat glands are epidermal derivatives, although they may be situated in the
deeper layers of the skin. Both consist of long coiled tubes with secretory cells and myoepithelial
cells.

Sebaceous glands produce sebum. Most open into hair follicles with some opening on to the skin
surface. Cells of the sebaceous glands are usually vacuolated because the fatty sebum dissolves
out during histological processing.

Common skin conditions

Acne is inflammation/infection of the hair follicle and sebaceous gland.

Blackheads are blocked sweat gland openings.

Psoriasis is of uncertain origin, but it appears to be a dermal disorder that results in increased cell
division and shedding.

Eczema is an inflammatory condition in which inflammatory fluid (an exudate) collects between the
epidermis and the dermis. This may result in the formation of vesicles (blisters). The most common
type is atopic eczema that occurs in people or families with an atopic tendency (asthma and so on).
Atopic tendency causes increased sensitivity to antigens or compounds not normally displayed.

A sebaceous cyst is a swelling caused by sebum building up behind a blocked sebaceous gland
opening.

Keloid scars (keloid= Greek: kelis = blemish.)

Keloids are hypertrophic scars due to excessive collagen formation and excess chondroitin sulphate.
Their margins extend beyond the confines of the original wound, invading the surrounding tissue.
They are more common in black people, but why they arise is not clear.

Sweat glands, not visible in the micrograph above, produce sweat and open at poreson the skin
surface.
Mammary glands are modified sweat glands. They are considered later in this tutorial.

Hair follicles

Even though they may project far down into the deeper parts of the skin, hair and hair follicles are
epidermal derivatives lined by basal cells.

Smooth muscle fibres (arrector pili muscles) are attached to the connective tissue sheath of the hair
follicle.

Smooth muscle fibres alter the position of the hair for:

 temperature regulation
 displays of aggression or stress (in other species more so than in humans)

Goose bumps

Goose bumps are your body's response to cold. The hair on your body 'stands' up to create an
insulation layer of warmer air that acts as insulation from the cold.

Other emotions can give you goose bumps as well such as nervousness, fear or anger. For example,
when a dog gets angry it 'raises' its fur to appear bigger to its enemy.

Hair loss in cancer treatments

Cancer treatments that interfere with cell division stop mitosis in all cells, not just in cancer cells.
Since hair is produced by mitotically active cells, such cancer treatments result in cessation of mitotic
activity in the hair follicle with resultant hair loss. Hair growth will resume when the therapy ceases.
Dermis

The dermis is a connective tissue layer covering the underlying bone or muscle. Its components are
those usually found in connective tissue.

Adipose cells are found in the dermis layer. These add to the insulation properties of the skin and act
as an energy reserve.

The dermis is bounded superficially by the wavy line of the basement membrane to the epidermis
above. The projections of dermis towards the surface are called dermal papillae.

The dermis contains sensory receptors:

 Meissner's corpuscles in the dermal papillae are for tactile sensation.

 Pacinian corpuscles, like concentric onion skins. Pacinian corpuscles, are relatively large
and are found deep in the dermis. Their function is pressure and vibration sensation.

Dermal blood vessels

The dermis has a rich blood supply with many capillaries. These are responsible for changes in skin
colour with temperature — when vessels are dilated, the skin is red; when they are constricted, it is
pale. This mechanism is important in the regulation of body temperature.

Why are lips red?

The lip is red because the epithelium is very thin, and the underlying capillary network particularly
dense.

Langer's lines, fingerprints

The orientation of fibrous and elastic tissue in the skin means that when it is cut in certain planes the
edges will lie together, but when it is cut in other planes, the edges will gape. This is important in
wound healing: a cut whose edges are gaping will heal less well and with more scarring than a cut
whose edges lie together. The (invisible) cleavage lines along which cuts should be made for best
healing are Langer's lines. The patterns of fingerprints are entirely epidermal. They have no
relationship to the dermal papillae.

Papillae--Latin: papilla = small nipple-shaped projection

Topic 2 — Breast (mammary gland)

The breast (mammary gland) is a modified sweat gland. It is a group of 15-25 separate exocrine
glands arranged radially around the nipple. Individual breast lobules are separated
by connective tissue septa. Each lobule is drained by its own lactiferous duct opening at the
areola.

Areolar skin is more deeply pigmented than normal skin. At the edge of the areola are prominent
elevations formed by the openings of the large sebaceous glands (Montgomery's glands).The
subcutaneous tissues around the nipple contain smooth muscle that erects the nipple.

Secretory units are arranged in acini: groups of cells arranged in a partial sphere around the origin of
a duct. The ducts are lined by simple cuboidal epithelium except near the opening, where stratified
squamous epithelium takes over.

Areolar skin

The areola changes from a delicate pink colour to brown early in pregnancy and never quite returns to
its original colour.

Montgomery's glands (William Montgomery, Irish obstetrician 1797-1859.)

Changes in the breast with age

Before puberty in the female, and (more or less) throughout life in the male, the breast consists of a
few ducts, connective tissue and some fat. At puberty in the female, ducts proliferate and fat is
deposited.
Accessory nipples

Breast tissue may be found along a line between axilla and groin, the milk or mammary line.
Accessory nipples, and even accessory breast tissue, can be found in both sexes anywhere along the
mammary lines, most commonly in the thorax and abdomen.

Changes in the breast with lactation

At lactation, there is a marked increase in acinar tissue. Acinar tissue secretes milk, which distends
the acini, and cells lining many of the ducts also become secretory.

Secretory cells at lactation display the characteristics of active secretory cells as they are columnar
with:

 numerous apical microvilli

 abundant rough endoplasmic reticulum
 a well-developed Golgi apparatus
 fat globules and lysosomes
 myoepithelial cells to help express secretions into the ducts

Breast milk

Nutritive components of breast milk include casein, lactose, lipids and vitamins. Breast milk is
particularly rich in calcium and phosphates. It also contains IgG and secretory IgA immunoglobulins
that protect the infant from enteric infections that can cause diarrhoea, dehydration and malnutrition.

Breast cancer

There are different types of breast cancer:

 ductal carcinoma begins in the cells lining the ducts. It accounts for most breast cancer.
 lobular carcinoma begins in the glands

Summary

The skin is part of the integument. There are two principal layers — epidermisand dermis.

Epidermis: stratified squamous epithelium

The epidermis has several layers. From deep to superficial, the most important are:

 basal layer with much mitotic activity. Melanocytes are also present.
 prickle cells
 horny layer (no nuclei, mainly soft keratin)

The epidermis has free nerve endings but no blood vessels. Sebaceous glands produce sebum, and
most open into hair follicles. Sweat glands produce sweat and open at pores on the skin surface. Hair
follicles are epidermal derivatives and are lined by basal cells.

Basal cell carcinoma arises from the basal epidermal layer. Squamous cell carcinoma arises from
more superficial layers.

Dermis
The dermis is a connective tissue layer covering underlying bone or muscle. It consists
of collagen, fibroblasts, macrophages and adipose cells.
Meissner's corpuscles (tactile sensation) are found in dermal papillae. Pacinian
corpuscles (pressure, vibration sensation) are deeper. There is a rich blood supply.

Breast (mammary gland)

The breast consists of 15-25 separate exocrine glands, each drained by its own duct. Secretory acini
and ducts are lined by simple cuboidal epithelium with myoepithelial cells in the acini. At puberty in
the female, ducts proliferate and fat is deposited. At lactation, secretory acinar tissue increases.