https://www.innerbody.

com/anatomy/integumentary
By: Tim Barclay, PhD
Medically reviewed by: Stephanie Curreli, MD, PhD
Jul 16, 2019

INTEGUMENTARY SYSTEM
- The integumentary system is an organ system consisting of the skin, hair, nails, and
exocrine glands. The skin is only a few millimeters thick yet is by far the largest organ in the
body.

FUNCTIONS
· Protects the body's internal living tissues and organs
· Protects against invasion by infectious organisms
· Protects the body from dehydration
· Protects the body against abrupt changes in temperature
· Helps dispose of waste materials
· Acts as a receptor for touch, pressure, pain, heat, and cold
· Stores water and fat
http://sciencenetlinks.com/student-teacher-sheets/integumentary-system/

PARTS ( Anatomy of the Integumentary System )

Epidermis
- The epidermis is the most superficial layer of the skin that covers almost the entire body
surface. The epidermis rests upon and protects the deeper and thicker dermis layer of the
skin.

Dermis
- The dermis is the deep layer of the skin found under the epidermis. The dermis is mostly
made of dense irregular connective tissue along with nervous tissue, blood, and blood vessels.
The dermis is much thicker than the epidermis and gives the skin its strength and elasticity.
Within the dermis there are two distinct regions: the papillary layer and the reticular layer

Hypodermis
- Deep to the dermis is a layer of loose connective tissues known as the hypodermis, subcutis,
or subcutaneous tissue. The hypodermis serves as the flexible connection between the skin
and the underlying muscles and bones as well as a fat storage area.

Hair
- Hair is an accessory organ of the skin made of columns of tightly packed dead keratinocytes
found in most regions of the body. Hair helps to protect the body from UV radiation by
preventing sunlight from striking the skin. Hair also insulates the body by trapping warm air
around the skin.

Nails
- Nails are accessory organs of the skin made of sheets of hardened keratinocytes and found
on the distal ends of the fingers and toes. Fingernails and toenails reinforce and protect the
end of the digits and are used for scraping and manipulating small objects.

Sudoriferous Glands
- Sudoriferous glands are exocrine glands found in the dermis of the skin and commonly
known as sweat glands. There are 2 major types of sudoriferous glands: eccrine sweat glands
and apocrine sweat glands.

Eccrine sweat glands are found in almost every region of the skin and produce a secretion
of water and sodium chloride. Eccrine sweat is delivered via a duct to the surface of the skin
and is used to lower the body’s temperature through evaporative cooling.

Apocrine sweat glands are found in mainly in the axillary and pubic regions of the body.
Apocrine sweat glands are inactive until puberty, at which point they produce a thick, oily
liquid that is consumed by bacteria living on the skin. The digestion of apocrine sweat by
bacteria produces body odor.

Sebaceous Glands
- Sebaceous glands are exocrine glands found in the dermis of the skin that produce an oily
secretion known as sebum. Sebum acts to waterproof and increase the elasticity of the skin.
Sebum also lubricates and protects the cuticles of hairs as they pass through the follicles to
the exterior of the body.

Ceruminous Glands
- Ceruminous glands are special exocrine glands found only in the dermis of the ear canals.
Ceruminous glands produce a waxy secretion known as cerumen to protect the ear canals and
lubricate the eardrum. Cerumen protects the ears by trapping foreign material such as dust
and airborne pathogens that enter the ear canal.

Physiology of the Integumentary System

Keratinization
- Keratinization, also known as cornification, is the process of keratin accumulating within
keratinocytes.Keratinocytes begin their life as offspring of the stem cells of the stratum basale.
Young keratinocytes have a cuboidal shape and contain almost no keratin protein at all. As the
stem cells multiply, they push older keratinocytes towards the surface of the skin and into the
superficial layers of the epidermis.

Temperature Homeostasis
- Being the body’s outermost organ, the skin is able to regulate the body’s temperature by
controlling how the body interacts with its environment. In the case of the body entering a
state of hyperthermia, the skin is able to reduce body temperature through sweating and
vasodilation. In the case of the body entering a state of hypothermia, the skin is able to raise
body temperature through the contraction of arrector pili muscles and through
vasoconstriction.
Vitamin D Synthesis
- Vitamin D, an essential vitamin necessary for the absorption of calcium from food, is
produced by ultraviolet (UV) light striking the skin. When UV light present in sunlight or
tanning bed lights strikes the skin, it penetrates through the outer layers of the epidermis and
strikes some of the molecules of 7-dehydrocholesterol, converting it into vitamin D3. Vitamin
D3 is converted in the kidneys into calcitriol, the active form of vitamin D. When our skin is
not exposed to sufficient amounts of sunlight, we can develop vitamin D deficiency,
potentially leading to serious health concerns.

Protection
- The skin provides protection to its underlying tissues from pathogens, mechanical damage,
and UV light. Pathogens, such as viruses and bacteria, are unable to enter the body through
unbroken skin due to the outermost layers of epidermis containing an unending supply of
tough, dead keratinocytes. This protection explains the necessity of cleaning and covering cuts
and scrapes with bandages to prevent infection.

Skin Color
- Human skin color is controlled by the interaction of 3 pigments: melanin, carotene, and
hemoglobin.
Melanin is a brown or black pigment produced by melanocytes to protect the skin from UV
radiation. Melanin gives skin its tan or brown coloration and provides the color of brown or
black hair.
Carotene is another pigment present in the skin that produces a yellow or orange cast to
the skin and is most noticeable in people with low levels of melanin.
Hemoglobin is the red pigment found in red blood cells, but can be seen through the
layers of the skin as a light red or pink color. Hemoglobin is most noticeable in skin coloration
during times of vasodilation when the capillaries of the dermis are open to carry more blood
to the skin’s surface.

Cutaneous Sensation
- The skin allows the body to sense its external environment by picking up signals for touch,
pressure, vibration, temperature, and pain. Merkel disks in the epidermis connect to nerve
cells in the dermis to detect shapes and textures of objects contacting the skin. The density of
these sensory receptors in the skin varies throughout the body, resulting in some regions of
the body being more sensitive to touch, temperature, or pain than other regions.

Excretion
In addition to secreting sweat to cool the body, eccrine sudoriferous glands of the skin also
excrete waste products out of the body. Sweat produced by eccrine sudoriferous glands
normally contains mostly water with many electrolytes and a few other trace chemicals.
https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

https://www.medicalnewstoday.com/articles/154322.php

https://www.cancer.org/cancer/melanoma-skin-cancer/treating/by-stage.html

MELANOMA
Melanoma is a form of skin cancer that arises when pigment-producing cells—known as
melanocytes—mutate and become cancerous.
Melanomas can develop anywhere on the skin, but certain areas are more prone than
others. In men, it is most likely to affect the chest and the back. In women, the legs are the
most common site. Other common sites are the neck and face.
According to the National Cancer Institute, about 87,110 new melanomas were expected
to be diagnosed in 2017, and about 9,730 people were expected to die of melanoma.

SIGNS & SYMPTOMS

The first melanoma signs and symptoms often are:
- A change in an existing mole
- The development of a new pigmented or unusual-looking growth on your skin
- Melanoma doesn't always begin as a mole. It can also occur on otherwise normal-appearing
skin.

Unusual moles that may indicate melanoma

- To help you identify characteristics of unusual moles that may indicate melanomas or other
skin cancers, think of the letters ABCDE:
A is for asymmetrical shape. Look for moles with irregular shapes, such as two very
different-looking halves.
B is for irregular border. Look for moles with irregular, notched or scalloped borders —
characteristics of melanomas.
C is for changes in color. Look for growths that have many colors or an uneven distribution
of color.
D is for diameter. Look for new growth in a mole larger than 1/4 inch (about 6
millimeters).
E is for evolving. Look for changes over time, such as a mole that grows in size or that
changes color or shape. Moles may also evolve to develop new signs and symptoms, such as
new itchiness or bleeding.
- Cancerous (malignant) moles vary greatly in appearance. Some may show all of the changes
listed above, while others may have only one or two unusual characteristics.

CAUSES
As with all cancers, research is ongoing into the causes of melanoma.
People with certain types of skin are more prone to developing melanoma, and the following
factors are associated with an increased incidence of skin cancer:
- high freckle density or tendency to develop freckles after sun exposure
- high number of moles
- five or more atypical moles
- presence of actinic lentigines, small gray-brown spots, also known as liver spots, sun spots,
or age spots
 - giant congenital melanocytic nevus, brown skin marks that present at birth, also called birth
marks
- pale skin that does not tan easily and burns, plus light-colored eyes
red or light-colored hair
- high sun exposure, particularly if it produces blistering sunburn, and especially if sun
exposure is intermittent rather than regular
- age, as risk increases with age
- family or personal history of melanoma
- having an organ transplant
- Of these, only high sun exposure and sunburn are avoidable.

The World Health Organization (WHO) estimates that around 60,000 early deaths occur each
year worldwide because of excessive exposure to the sun's ultraviolet (UV) radiation. An
estimated 48,000 of these deaths are from malignant melanoma.

Avoiding overexposure to the sun and preventing sunburn can significantly lower the risk of
skin cancer. Tanning beds are also a source of damaging UV rays.
TREATMENT
Treatment of Melanoma Skin Cancer, by Stage
The type of treatment(s) your doctor recommends will depend on the stage and location of
the melanoma and on your overall health.

Treating stage 0 melanoma

- Stage 0 melanomas have not grown deeper than the top layer of the skin (the epidermis).
They are usually treated by surgery (wide excision) to remove the melanoma and a small
margin of normal skin around it. For melanomas in sensitive areas on the face, some doctors
may use Mohs surgery or even imiquimod cream if surgery might be disfiguring, although not
all doctors agree with these uses.

Treating stage I melanoma

 - Stage I melanoma is treated by wide excision (surgery to remove the melanoma as well as a
margin of normal skin around it). Some doctors may recommend a sentinel lymph node
biopsy, especially if the melanoma is stage IB or has other characteristics that make it more
likely to have spread to the lymph nodes. Some doctors may recommend adjuvant (additional)
treatment with interferon after the lymph node surgery. Other drugs or perhaps vaccines
might be options as part of a clinical trial to try to lower the chance the melanoma will come
back.

Treating stage II melanoma

- Wide excision (surgery to remove the melanoma and a margin of normal skin around it) is
the standard treatment for stage II melanoma. The amount of normal skin removed depends
on the thickness and location of the melanoma.

Treating stage III melanoma

- These cancers have already reached the lymph nodes when the melanoma is first
diagnosed. Surgical treatment for stage III melanoma usually requires wide excision of the
primary tumor as in earlier stages, along with lymph node dissection. Some patients might
benefit from newer treatments being tested in clinical trials. Many patients with stage III
melanoma might not be cured with current treatments, so they may want to think about
taking part in a clinical trial.

Treating stage IV melanoma

- Stage IV melanomas are often hard to cure, as they have already spread to distant lymph
nodes or other areas of the body. Skin tumors or enlarged lymph nodes causing symptoms can
often be removed by surgery or treated with radiation therapy. Because stage IV melanoma is
hard to cure with current treatments, patients may want to think about taking part in a clinical
trial. Many studies are now looking at new targeted drugs, immunotherapies, chemotherapy
drugs, and combinations of different types of treatments.
Even though stage IV melanoma is often hard to cure, a small portion of people respond very
well to treatment and survive for many years after diagnosis

Treating recurrent melanoma

Treatment of melanoma that comes back after initial treatment depends on the stage of the
original melanoma, what treatments a person has already had, where the melanoma comes
back, and other factors. Melanoma that comes back in the brain can be hard to treat. Single
tumors can sometimes be removed by surgery. Radiation therapy to the brain (stereotactic
radiosurgery or whole brain radiation therapy) may help as well. Systemic treatments
(immunotherapy, targeted therapy, or chemo) might also be tried.

WAYS TO TAKE CARE INTEGUMENTARY SYSTEM

- Limit exposure to hot water

- Avoid long soaks in hot bath or spa
- Keep shower time short
- Apply cream or lotion while skin is still damp
- Getting enough sleep
- Exercising
- Find ways to reduce stress
- Gentle exfoliation once a week
- Avoid rubbing eyes
- Apply warm cloth to area with pimples
- When outdoors, seek shade, use umbrella, wear wide-brimmed hat, shades, loose and
light-colored clothing
- Learn to read labels
- Drinking enough water
- Eat foods that are high in antioxidants
- Brush as you only need to style the hair
- Don't constrict hair with tight bands
- Apply hand lotion
- Use sunscreen and reapply often
- “Rest and self-care are so important. When you take time to replenish your spirit, it allows
you to serve others from the overflow. You cannot serve from an empty vessel.”