James 4:6
But he gives us more grace.
That is why Scripture says:
“God opposes the proud but
shows favor to the humble.
EPIDERMIS
Initially, the embryo is covered by
a single layer of ectodermal cells.
=5 weeks
At second month, this epithelium
divides, and the periderm, a layer
of flattened cells, is laid down on
the surface. =7 weeks
With further proliferation of cells
in the basal layer, a third,
intermediate zone is formed.
=4 months
> At the end of the fourth
month, = four layers can be
distinguished.
> The basal layer, or
germinative layer, =
responsible for production of
new cells = later forms ridges
and hollows, which are
reflected on the surface of the
skin in the fingerprint.
> A thick spinous layer
consists of large
polyhedral cells
containing fine
tonofibrils.
> The granular layer
contains small
keratohyaline granules in
its cells.
> The horny layer,
forming the tough scale-
like surface of the
epidermis, is made up of
closely packed dead cells
containing keratin.
Cells of the periderm are
usually cast off during the
second part of intrauterine
life and can be found in the
amniotic fluid.
During the first 3 months of
development, the epidermis
is invaded by cells arising
from the neural crest.
These cells synthesize melanin
pigment in melanosomes.
As melanosomes accumulate,
they are transported down
dendritic processes of
melanocytes and are transferred
intercellularly to keratinocytes of
the skin and hair bulb.
In this manner, pigmentation of
the skin and hair is acquired.
DERMIS
• Dermis is derived from mesenchyme that
has three sources:
– lateral plate mesoderm (limbs and body wall),
– paraxial mesoderm (back), and
– neural crest cells (face and neck)
• The Corium forms dermal papillae which
project upward into the epidermis, containing
a capillary or a sensory nerve end organ.
= (third and fourth months)
> At birth, the skin is
covered by a whitish
paste, the vernix caseosa,
formed by secretions from
sebaceous glands and
degenerated epidermal
cells and hairs.
> It protects the skin
against the macerating
action of amniotic fluid.
CLINICAL CORRELATES
Piebaldísm [patchy absence of hair pigment]
Waardenburg syndrome (ws), which feature patches of white skin
and hair.
= The defects arise because of faulty migration or proliferation of
neural crest cells
> absence of melanocytes derived from these cells in the stria
vascularis in the cochlea accounts for deafness in these diseases).
Albinísm characterized by globally reduced or absent
pigmentation in the skin, hair, and eyes.
VitÍligo results from a loss of melanocytes due to an autoimmune
disorder. There is patchy loss of pigment from affected areas,
inciuding the skin and overiying hair and the oral mucosa. VitÍligo
is aiso associated with other autoimmune diseases, particularly of
the thyroid.
CLINICAL CORRELATES
DISORDERS: PIGMENTATION
• Classified as diseases of
– Melanocyte development:
• Piebaldism
• Waardenburg syndrome
• Albinism
– Melanocyte survival:
• Vitiligo
DISORDERS: KERATINIZATION
• Ichthyosis –
AR excess keratinization
• Harlequin fetus
Ichthyosis, excessive keratinization
of the skin, is characteristic of a
group of hereditary disorders that
are usually inherited as an
autosomal recessive trait but may
also be X-linked.
> Hairs begin development as
solid epidermal proliferations
from the germinative layer
that penetrates the
HAIR
underlying dermis.
At their terminal ends,
hair buds invaginate,
rapidly filled with
mesoderm in which
vessels and nerve endings
develop.
Then, cells in the center of
the hair buds become
spindle-shaped and
keratinized, forming the
hair shaft, whereas
peripheral cells become
cuboidal, giving rise to the
epithelial hair sheath. *
The dermal root sheath is formed by the surrounding
mesenchyme. A small smooth muscle, also derived from
mesenchyme, is usually attached to the dermal root sheath. The
muscle is the erector pili muscle.
Continuous proliferation of epithelial cells at the base of the shaft
pushes the hair upward, and by the end of the third month, the
first hairs appear on the surface in the region of the eyebrow and
upper lip.
The first hair that appears, lanugo hair, is shed at about the time
of birth and is later replaced by coarser hairs arising from new
hair follicles.
> The epithelial wall of the hair follicle usually shows a small bud
penetrating the surrounding mesoderm to form the sebaceous
glands.
CLINICAL CORRELATES
DISORDERS: HAIR
• Hypertrichosis
• Atrichia
> Hypertrichosis [excessive hairiness]
is caused by an unusual abundance of
hair follicles. It may be localized to
certain areas of the body, especially
the lower lumbar región covering a
spina bifida occulta defect or may
cover the entire body
> Atrichia, the congenital absence of
hair, is usually associated with
abnormalities of other ectodermal
derivatives, such as teeth and naíls
NAILS
> By the end of the third month, thickenings in the epidermis
appear at the tips of the digits to form the nail fields.
From this location, these fields migrate to the dorsal side of
each digit and grow proximally, forming the nail root, whereas
proliferation of tissue surrounding each nail field creates a
shallow depression for each nail.
From the nail root, epidermis differentiates into fingernails and
toenails that do not reach the tips of the digits until the ninth
month of development.
NAILS
NAILS
SWEAT GLANDS
• two types of sweat glands
Apocrine sweat glands develop anywhere there is body
hair, including the face, axillae, and pubic region.
They begin to develop during puberty and arise from the
same epidermal buds that produce hair follicles.
Hence, these sweat glands open onto hair follicles instead
of skin.
The sweat produced by these glands contains lipids,
proteins, and pheromones, and odor originating from this
sweat is due to bacteria that break down these products.
It should be noted that these glands are classified as
apocrine because a portion of the secretory cells is shed
and incorporated into the secretion.
> Eccrine sweat glands form in the skin over most parts of the body
beginning as buds from the germinative layer of the epidermis.
These buds grow into the dermis, and their end coils to form the secretory
parts of the glands. Smooth muscle cells associated with the glands also
develop from the epidermal buds.
These glands function by merocrine mechanisms (exocytosis) and are
involved in temperature control.
MAMMARY GLAND
Mammary glands are modified sweat glands and first appear
as bilateral bands of thickened epidermis called the mammary
lines or mammary ridges.
By the end of prenatal life, the epithelial sprouts are canalized
and form the lactiferous ducts.
Initially, the lactiferous ducts open into a small epithelial pit.
Shortly after birth, this pit is transformed into the nipple by
proliferation of the underlying mesenchyme.
At birth, lactiferous ducts have no alveoli and therefore no
secretory apparatus.
At puberty, however, increased concentrations of estrogen and
progesterone stimulate branching from the ducts to form
alveoli and secretory cells.
In a 7-week embryo, these lines extend on each side of the
body from the base of the forelimb to the region of the hind
limb.
Although the major part of each mammary line disappears
shortly after it forms, a small portion in the thoracic region
persists and penetrates the underlying mesenchyme.
Here it forms 16 to 24 sprouts, which in turn give rise to small,
solid buds. Positions of accessory nipples [blue line, mammary
line).
CLINICAL CORRELATES
DISORDERS MAMMARY GLANDS
CLINICAL CORRELATES
Polythelia is a condition in which accessory nipples have
formed resulting from the persistence of fragments of
the mammary line.
Accessory nipples may develop anywhere along the
original mammary line but usually appear in the
axillary region.
CLINICAL CORRELATES
Polymastia occurs when a remnant
of the mammary line develops into
a complete breast.
CLINICAL CORRELATES
Inverted nipple is a condition in which the lactiferous ducts open
into the original epithelial pit that has failed to evert.
