Anatomi Kulit

Fungsi Kulit

• Proteksi
• Absorbsi
• Ekskresi
• Persepsi
• Pengaturan suhu tubuh
• Pembentukan Pigmen
• Keratinisasi
• Pembentukan vit.D
Anatomi Kulit
• Epidermis
• S.Basale
• S.Spinosum
• S.Granulosum
• S.Lucidum
• S.Corneum
• Dermis
• Pars Papilare
• Pars Retikulare
• Subkutis
• Jar.Ikat Longgar
• Panikulus Adiposa
Epidermis
1. S.Basale (Germinativum)
• Sel berbentuk kubus (kolumnar) yang tersusun vertikal pada
perbatasan dermo-epidermal berbasis seperti pagar (Palisade)
• Mengadakan mitosis dan berfungsi reproduktif.
• Terdiri dari 2 jenis sel:
• Sel kolumnar dengan protoplasma basofilik inti lonjong dan besar,
dihubungkan satu dengan lain oleh jembatan antar sel.
• Sel pembentuk melanin (melanosit) atau clear cell
• Sel berwarna muda, dengan sitoplasma basofilik dan inti gelap, dan mengandung
butir pigmen (melanoplasma)
1. Stratum Basale
• Contains Mitotically active, collumnar-shaped keratinocytes that attach via
keratin filamens to yhe basement membrane zone at hemidesmosomes
• Membrane bound vacuoles that containes pigmented melanosomes are
transferred from melanocytes to phagocytosis
• Cell kinetic studies shows that basal layer cells exhibit different proliferatives
potentials
• 1. Stem cells
• 2. Transit amplifying cells
• 3.Post mitotic cells
• Youngest keratinocytes - this is the germ layer. These cells give rise to
the other layers. Single layer of cuboidal or columnar cells lying on
the basal lamina. The cells are attached to each other by desmosomes
and to the basal lamina by hemidesmosomes. The cells in this layer
secrete Type VII collagen, the main component of anchoring fibrils
which reinforce the connection of this layer with the underlying
dermis.

• Key Point: This layer contains the STEM CELLS from which new cells
(keratinocytes) arise by mitotic division.

Side Note: Defects in Type VII collagen underlie several kinds of

epidermolysis bullosa, a family of genetic blistering diseases.
 2. S. Spinosum (Malphigi)

• Pickle cell layer (Lapisan Akanta)

• Terdiri dari beberapa lapis sel yang berbentuk poligonal yang besarnya
berbeda-beda karena adanya proses mitosis.
• Protoplasma jernih karena mengandung glikogen dan inti terletak di
tengah-tengah.
• Semakin mendekati permukaan akan semkin gepeng bentuknya.
• Di antara sel terdapat jembatan antar sel (intercellular bridges) yang
terdiri atas protoplasma dan tonofibril atau keratin. Perlekatan
intercellular brigdes membentuk nodulus Bizzozero.
• Diantara sel spinosum terdapat sel Langerhans.
S. Spinosum
• Suprabasal spious cells are polyhedral in shapes with round nucleus
that becomes progressively flatter as it moves upward and develop
organelles known as lamellar granules.
• Spinous cells also contain large bundles of keratin filaments, organized
around the nucleus and inserted into desmosomes peripherally.
• The “spines” of spinous cells are abundant desmosomes, calcium-
dependent cell surface modifications that promote adhesion of
epidermal cells and resis- tance to mechanical stress
• Composed of cells that migrated up from the basal layer and
differentiated into keratinocytes called prickle cells because during
fixation, the cells shrink, but desmosomes remain attached - the
resulting cells have a spiny appearance.

They form large numbers of DESMOSOMES with adjacent cells, and

are reinforced internally by bundles of tonofibrils made up of keratin
filaments.

Side note: Vitamin D is synthesized in the plasma membranes of the

keratinocytes in this layer in response to UV light.
 Where do lamellar bodies reside in the epidermis and what is their function?

• They are membrane bound vesicles contained w/in the cells of

the granular layer that secrete the glycolipid, acylceramide, via
exocytosis. It is an important factor in waterproofing of the skin at the
granular layer/cornified layer junction.

Lamellar Bodies = membrane-coating granules

NOTE: only visible at the EM level

Describe the cell-cell and cell-substrate junctions that attach keratinocytes to each
other and to the dermis.

• Desmosomes attach keratinocytes to each other via intermediate

filaments (keratin) in the cell.

Hemidesmosomes attach keratinocytes in the stratum basale to the

basal lamina, also via intermediate filaments (keratin).
How do we know that Desmosomes and Hemidesmosomes are
different structures w/ different protein compositions (since they
are so similar in appearance)?
• Because they are each a target of separate autoimmune diseases:
• Pemphigus vulgaris attacks desmosomes.
• Bullous pemphigoid attacks hemidesmosomes.

Both diseases cause severe blistering (WBC infiltrate and separation

of epidermal layers)
3. S. Granulosum
• Lapisan keratohialin
• Merupakan 2 atau 3 lapis sel gepeng dengan sitoplasma berbutir
kasar dan terdapat inti di antaranya.
• Butir kasar ini terdiri atas keratohialin.
• Mukosa biasa tidak memiliki lapisan ini.
• Tampak jelas di telapak tangan dan kaki.
S. Granulosum
• Contains:
• Profilagrin
• Keratin Filaments
• Loricrin (cystein-rich protein that forms the cornified envelop)
• In this layer, Cornified cells envelop begins to form with the
conversion of Profilaggrin to Fillagrin.
• Filaggrin then degraded into molecules :
• Urocantic acid
• Pyrrolidone carboxylic acid
• Which contributes to hydration of the S.corneum and helped filter the UV
radiation.
• This layer is only about 1-3 cells thick, and consists of flattened cells
containing KERATOHYALIN GRANULES. The basophilic granules
contain PROFILAGGRIN, a precursor of FILAGGRIN.

Cells in this layer also contain membrane bound vesicles

called LAMELLAR BODIES that contain a glycolipid (acylceramide) that
is an important factor in waterproofing of the skin.
 What are the contents of keratohyalin granules?
• Profilaggrin. Converts to filaggrin which cross-links keratin filaments
and organizes them into, reinforced bundles in corneocytes (cells of
the cornified layer). Filaggrin is a hygroscopic molecule that acts as a
natural moisturizer and helps to keep overlying keratinocytes of the
cornified layer hydrated.
4.S. Lucidum (clear layer)
• Sel gepeng tanpa inti dengan protoplasma yang berubah menjadi
protein yang disebut eleidin

• As cells from the granular layer migrate outward, they die and lose
their nuclei. This process is evident in this thin transparent layer
usually only seen in thick skin.
5. S.Corneum
• Lapisan tanduk terdiri atas beberapa lapisan sel gepeng mati yang tidak
berinti, dan protoplasmanya telah berubah menjadi keratin (zat tanduk)

• Complete differentiation of granular cells results in stacked layers of

anucleate, flattened cornified cells that form the stratum corneum. It is
this layer that pro- vides mechanical protection to the skin and a barrier
to water loss and permeation of soluble substances from the
environment.
• The stratum corneum bar- rier is formed by a two-compartment system
of lipid- depleted, protein-enriched corneocytes surrounded by a
continuous extracellular lipid matrix.
• Layer of keratinized cells that is in contact with the air.

Made of flattened keratinocytes that have lost their nuclei and

organelles, and what remains is a layer of linked (via desmosomes)
dead cells containing cross-linked soft KERATIN.
Non Keratinocytes of the Epidermis
• Melanocytes
• Neural Crest-derived, pigment-synthesizing dendritic cells that resides primarily in the basal layer.
• Merkel Cells
• Slow adapting type I mechanoreceptors located in the sites of high-tactile sensitifity.
• Presents among:
• Basal keratinocytes in hairy skin
• Basal Keratinocytes in glabrous skin : Digits, Lips, Regions of oral cavity, the outer root-sheath of the hair folicles.
• Langerhans Cells
• Langerhans cells are dendritic antigen-processing and antigen-presenting cells in the epidermis
• The cytoplasm of the Langerhans cells contains char- acteristic small rod- or racket-shaped
structures called Langerhans cell granules or Birbeck granules
• Langerhans cells principally function to sample and present antigens to T cells of the epidermis.
Because of these functions, they are implicated in the pathologic mechanisms underlying allergic
contact dermatitis, cutaneous leishmaniasis, and human immunodefi- ciency virus infection.
What are melanocytes?
• They are located in the basal
layer and are the source of skin
pigmentation; they synthesize
melanin which then enters
keratinocytes via cytocrine
secretion, wherin keratinocytes
engulf melanocyte processes
that contain melanin. They
originate in neural crest and
migrate to the skin during
development
What is melanin?
• A brown pigment that absorbs and protects against potentially
injurious ultraviolet (UV) radiation in sunlight.

What produces the variability in skin tone seen in the human

population?

The amount of melanin production from melanocytes.

NOTE: It is NOT the number of melanocytes, which is fairly constant
throughout the population.
What are Merkel cells?
• Mechanoreceptors seen in the
epidermis.

They are present mainly in the

stratum basale of the thick skin of
the palms of the hand and soles of
the feet. They contain keratin
filaments and are bound to
keratinocytes by desmosomes.
They are intimately associated
with free nerve endings in the
epidermis, and play a role
in mechanoreception.
What are Langerhans cells?
• Dendritic cells (antigen-
presenting immune cells) of
the epidermis produced in
the bone marrow (from the
monocyte-macrophage
lineage). They phagocytose
particles, then migrate to a
lymphoid follicle for antigen
presentation. The cells have
long dendritic processes
and are not attached to
surround cells.
DERMAL-EPIDERMAL JUNTION
• The dermal–epidermal junction (DEJ) is a basement membrane zone that forms the
interface between the epidermis and dermis.
• The major functions of the DEJ :
• To attach the epidermis and dermis to each other
• To provide resistance against external shearing forces.
• It serves as a support for the epidermis, determines the polarity of growth,
• Directs the organization of the cytoskeleton in basal cells,
• Provides developmental signals,
• And serves as a semipermeable barrier.
• The DEJ can be subdivided into three supramo- lecular networks:
• (1) the hemidesmosome-anchoring filament complex,
• (2) the basement membrane itself, and
• (3) the anchoring fibrils.
• The critical role of this region in maintaining skin structural integrity is revealed by the
large number of mutations in DEJ components that cause blistering diseases of
varying severity.
Lapisan Dermis
Lapisan
Dermis
• Terdiri atas lapisan elastik dan fibrosa padat dengan elemen-elemen seluler dan
folikel rambut.
• Secara garis besar terdiri dari:
• Pars Papilare
• Bagian yang menonjol ke epidermis, berisi ujung serabut saraf dan pembuluh darah.
• Pars Retikulare
• Bagian di bawahnya yang menonjol ke subkutan, terdiri atas serabut-serabut penunjang,
seperti kolagen, elastin, dan retikulin.
• Dasar (matriks) lapisan ini terdiri atas cairan kental asam hialuronat dan kondroitin sulfat,
di bagian ini terdapat pula fibroblas.
• Serabut kolagen di bentuk oleh fibroblas, membentuk ikatan yang mengandung
hidroksiprolin dan hidroksisilin.
Dermis
• The dermis is an integrated system of fibrous, filamentous, diffuse,
and cellular connective tissue elements that accommodates nerve
and vascular networks, epidermally derived appendages, and contains
many resident cell types, including fibroblasts, macrophages, mast
cells, and transient circulating cells of the immune system.
• The dermis makes up the majority of skin and provides its pliability,
elasticity, and tensile strength. It protects the body from mechanical
injury, binds water, aids in thermal regulation, and includes receptors
of sensory stimuli.
 What is the dermis and what is it composed of?
• The dermis is a layer of CT that underlies the
epidermis, supports it mechanically, & supplies
it w/ blood vessels, lymphatic vessels, & nerves.

It is composed of:
• Types I & III collagen & elastic fibers
• CTs: fibroblasts, mast cells, and macrophages
• Small blood vessels & lymphatic capillaries
• Has a rich nerve supply
• Sensory structures: receptors for
temperature,
pressure, & pain
The connective tissue matrix of the dermis is comprised primarily of:
• Collagenous fibrous tissue and Elastic fibrous tissue.
• Collagen forms the bulk of the acellular portions of the dermis (75% of the dry weight of the dermis)
• Collagen:
• Type I :
• Most abundant protein in the body, everywhere
• Mechanical/structural support
• 80%-90%
• Type III :
• Found in endothelium and provides structural support
• 8% - 12%
• Type IV :
• Binds to laminin/ basal lamina of DEJ
• Parts of basal layer
• Type VII :
• Secreted by basal keratinocytes
• The main component of anchoring fibrils which reinforces the connection of epidermal basal lamina with underlying
dermis.
• Defects in this underlie several kinds of epidermolysis bullosa, a family of genetic blistering diseases
Nonfibrous connective tissue molecular
• Including:
• Finely filamentous glycoproteins
• Proteoglycans (PGs)
• Glycosaminoglycans (GAGs) of the ”ground substance”
• PGs and GAGs can bind water up to 1000x its own volume
• Roles:
• Regulationof water binding and compresibility of the dermis
• Increase local concentrations of growth factors through binding (e.g. Basic fibroblast growth
factor)
• Link cells with the fibrillar and filamentous matrix, including proliferation, differentiation, tissue
repair and morphogenesis.
• The major PGs in the adult dermis are :
• Chondroitin sulfates/dermatan sulfate,
• including biglycan, decorin, and versican;
• Heparan/heparan sulfate PGs,
• including perlecan and syndecan; and
• Chondroitin-6 sulfate PGs,
• which are components of the DEJ.
• Glycoproteins interact with other matrix components via integrin receptors.
• They facilitate cell migration, adhesion, morphogenesis, and differentiation.
• Fibronectin is synthesized by both epithelial and mesenchymal cells, and it covers
collagen bundles and the elastic network.
• Vitronectin is present on all elastic fibers except for oxytalan.
• Tenascin is found around the smooth muscle of blood vessels, arrector pili muscles,
and appendages such as sweat glands.
What are the two layers of the dermis and how do they interact with the epidermis?

• The layers are papillary dermis and reticular layer. The papillary

dermis interdigitates w/ the rete ridges of the epidermis.
 Papillary dermis (structure & function)
• Lies directly under the epidermis. This layer forms
the dermal papillae, which are projections of the
dermis into the epidermis. These interdigitate w/
epidermal rete ridges to increase surface area, both
for adhesion, and for metabolic exchange between
the epithelium and the dermal capillaries.

Its function is to provide mechanical,

immunological and metabolic support to the
epithelium. CT cells in this layer of the dermis
produce signaling molecules that determine the
phenotype of the overlying epidermis, and of
epidermal derivatives such as hair and nails.
Reticular dermis (structure & function)
• This layer lies deep to the papillary layer, is much thicker, and has
coarser collagen bundles.
Cellular components of Dermis
1. Fibroblast
• Mesenchymally derived cell that migrates through the tissue
• Is responsible for the synthesis and degradation of fibrous and nonfibrous
connective tissue matrix proteins and a number of soluble factors.
• These cells are also instrumental in wound healing and scarring, increasing
their proliferative and synthetic activity during these processes.
2. Monocytes, macrophages, and dermal dendrocytes
• Constitute the mononuclear phagocytic system of cells in the skin.
• Macrophages are derived from precursors in the bone marrow, differentiate
into circulating monocytes, and then migrate into the dermis to differ- entiate.
• These cells are phagocytic; process and present antigen to immunocompetent
lymphoid cells; are microbicidal, tumoricidal, secretory, and hematopoi-etic
• Are involved in coagulation, atherogenesis, wound healing, and tissue
remodeling.
3. Mast cells
• specialized secretory cells
• In skin, are present in greatest density :
• Papillary dermis,
• Near the DEJ, in sheaths of epidermal appendages, and
• Around blood vessels and nerves of the subpapillary plexus.
• The surface of dermal mast cells is coated with fibronectin, which probably assists
in securing cells within the connective tissue matrix.
• Mast cells are secretory cells that are responsible for immediate-type
hypersensitivity reaction in skin
• Involved in the production of subacute and chronic inflammatory disease.
• They synthesize secretory granules composed of histamine, heparin, tryptase,
chymase, carboxypeptidase, neutrophil chemotactic factor, and eosinophilic
chemotactic factor of anaphy- laxis, which are mediators in these processes.
• Mast cells can become hyperplastic and hyperproliferative in mastocytosis.
4. The dermal dendrocyte is a dendritic,
• highly phagocytic fixed connective tissue cell in the dermis of normal skin.
• Dermal dendrocytes express factor XIIIa and CD45,
• Lack typical markers of fibroblasts.
• These cells are particularly abundant in the papillary dermis and upper reticular
dermis, frequently in the proximity of vessels of the subpapillary plexus.
• Dermal dendrocytes function in the afferent limb of an immune response as
antigen presenting cells.
• They are also likely the cells of origin of a number of benign fibrotic proliferative
conditions in the skin, such as dermatofibromas and fibroxanthomas
CUTANEOUS VASCULATURE
BLOOD VESSELS
• Special cells, known as veil cells, surround the cutaneous microcir-
culation, defining a domain for the vessels within the dermis while
remaining separate from the vessel walls.
• In the adult, the cutaneous vasculature normally remains quiescent,
in part due to inhibition of angio- genesis by factors such as
thrombospondin.
LYMPHATICS
• Regulate pressure of the interstitial fluid by resorption of fluid
released from vessels and in clearing the tissues of cells, proteins,
lipids, bacteria, and degraded substances.
What are the two plexuses of the dermis?
• Sub-papillary plexus,
just under papillary
dermis. Cutaneous
plexus where the
dermis meets the
hypodermis. Blood will
be shunted to sub-
papillary plexus when
body temperature rises.
CUTANEOUS NERVES AND RECEPTORS
• The nerve networks of the skin contain
• somatic sensory and
• sympathetic autonomic fibers.
Somatic Sensory
• The sensory fibers alone (free nerve endings) or in conjunction with specialized structures
(corpuscular receptors) function as
• receptors of touch,
• pain,
• temperature,
• itch, and
• mechanical stimuli.
• The density and types of receptors are regionally variable, accounting for the variation in acuity
at different sites of the body.
• Receptors are particularly dense in hairless areas such as the areola, labia, and glans penis.
Sympathetic motor fibers
• Are codistributed with the sensory nerves in the dermis until they branch to innervate the sweat
glands, vascular smooth muscle, the arrector pili muscle of hair follicles, and sebaceous glands.
Sweat glands (structure & function)
• Structure:
Consist of eccrine and apocrine sweat glands. Eccrine sweat glands are found
deep in the dermis (hypodermis). They produce fluid that contains water, ions,
urea, ammonia, and uric acid. The secretory portion is a coiled tube that
contains secretory cells and myoepithelial cells (contract to push sweat out of
the duct).

Function:
They function in response to heat stress in thin skin and in excretion; in thick
skin they react to stress and emotional stimuli. Appocrine sweat glands are
coiled tubular glands with myoepithelial cells, with larger lumens and a
proteinaceous secretion. The ducts open into the upper part of hair follicles
and begin secretion after puberty. They are located in the axilla, the areola,
and the circumanal region. Bacteria metabolize the secretion, causing the
scent. Possible role in pheromones.
What are sweat glands coiled with and why?
• They are surrounded by myoepithelial cells which contract to force
the sweat product to the skin surface.
Sebaceous glands (structure & function)
• Structure:
These glands are situated in the dermis, typically associated with hair follicles.
Invagination of the epidermis along the side of the hair shaft. They contain a
lobular secretory portion with rapidly dividing basal cells. Their progeny, the
sebaceous cells, fill the lobule and are gradually pushed out of the duct.

Function:
The secretion mainly contains lipid but also contains dead cell remnants. Serves
as a natural emollient and has a small role in preventing dehydration. Prevents
cracking of the skin. Size varies depending on location in the body. Responsive
to sex hormones and become active after puberty.
Where are eccrine sweat glands located in the
skin?
• The sweat gland typically resides in the hypodermis. The duct travels
from the hypodermis through the dermis and out the epidermis to
the skin surface.
What are apocrine sweat glands?
• These glands are located on the areola, axilla and groin. Glycoproteins
are secreted, which are metabolized by bacteria on the skin surface,
producing an odor. The odor can be considered a pheromone.
 What are two sensory organs seen in the skin?
• • Meissner's corpuscles (touch, under epidermis)

• Pacinian corpuscles (pressure, hypodermis)

What is the hair matrix?

A cellular mass at the base of the follicle where the external root
sheath merges w/ the internal root sheath. The bottom layer of the
hair matrix gives rise to the cells of the matrix and differentiate into
all of the cells of the follicle, including hair.
HYPODERMIS
• The tissue of the hypodermis
• insulates the body,
• serves as a reserve energy supply,
• cushions and protects the skin, and
• allows for its mobility over underlying structures.
• Adipocytes form the bulk of the cells in the hypodermis.
• They are organized into lobules defined by septa of fibrous connective
tissue. Nerves, vessels, and lymphatics are located within the septa
and supply the region.