皮肤总论英文版

皮肤总论英文版第1页/共66页2ScheduleofDermatology&VenereologyLectureNo.DateContentsTimeTeacher12-26Generalconsideration(1)2hXinsuoDuan23-5Generalconsideration(2)2hXinsuoDuan33-12Generalconsideration(3)2hXinsuoDuan43-19Viraldermatoses&Bacteriadermatoses2hShupingYu53-26Fungaldermatoses2hShupingYu64-2STD(1)syphilis，AIDS2hXinsuoDuan74-9STD(2)gonorrhea,NGU,CA,chancroid2hXinsuoDuan84-16Eczema&Dermatitis(1)2hJinWang94-23Eczema&Dermatitis(2)2hJinWang104-30Drugeruption2hJingliangWu115-7Urticaria2hJingliangWu125-14Papulosquamousdiseases2hBaoqiangLi135-21BullousDermatoses2hBaoqiangLi145-28Cutaneousvasculitis2hBaoqiangLi156-4Skinappendages2hBaoqiangLi166-11Vitiligo&Skintumors2hBaoqiangLi176-18Practice2h

186-25Test2h

第2页/共66页3SectionⅠ

GeneralConsiderationIntroductionStructureofSkinFunctionofSkinSymptom,SignandDiagnosisofDermatosesTreatmentofDermatoses第3页/共66页4IntroductionTheskinisthelargestorganofthebodyTherearemorethan2000kindofskindiseaseinDermatology第4页/共66页ChapterⅠ

Structureofskin第5页/共66页6第6页/共66页71.Epidermis(structure)第7页/共66页81.EpidermiscellskeratinocytemelanocyteLangerhanscellMerkelcell第8页/共66页9（1）Keratinocyte④③②①第9页/共66页10第10页/共66页11Hemi-desmosome第11页/共66页12（1）Keratinocyte④③②①第12页/共66页13desmosomehemi-desmosomeDesmosome&Hemi-desmosome第13页/共66页14Desmosome第14页/共66页15Hemi-desmosome第15页/共66页16desmosomehemi-desmosomeDesmosome&Hemi-desmosome第16页/共66页17（1）Keratinocyte④③②①28d第17页/共66页18（2）Melanocytemelanocytepigment-producingcell第18页/共66页19第19页/共66页20（2）Melanocyte第20页/共66页21第21页/共66页22第22页/共66页23（2）Melanocyte第23页/共66页24(3)Langerhanscell

Langerhanscellantigenpresentingcell第24页/共66页25(3)LangerhanscellLangerhanscells(CD1a)第25页/共66页26(4)Merkelcell

Merkelcellcontainintracytoplasmicneurosecretory-likegranules,and,throughtheirassociationwithneurites,actasslowadaptingtouchreceptors.第26页/共66页27(4)Merkelcellinthebasallayerofthepalmsandsoles,theoralandgenitalmucosa,thenailbed,andthefollicularinfundibula.

第27页/共66页282.Dermiscollagenfiberreticularfiberelasticfibersbasematerial（groundsubstance）：proteoglycanCells:FibroblastmastcellMacrophagedermicarborescentcellLanggerhanscellPigmentophageLymphocyteleukocyte第28页/共66页292.Dermiscollagenfibers第29页/共66页30reticularfiber第30页/共66页312.DermiselasticfibersCorrelatewithtensityofskin第31页/共66页322.Dermisreticularedermispapillarydermis第32页/共66页333.Hypodermis(subcutaneoustissue)Hypodermis第33页/共66页343.Hypodermis(subcutaneoustissue)第34页/共66页354.Appendageshairfolliclesebaceousglandseccrineglandsapocrineglandsnail第35页/共66页36（1）HairandHairfollicleHair：LonghairShorthairWollyhairEpidermisSebaceousglandsHairrootMedullaryHaircuticleCortexInnerrootsheathOuterrootsheathHairmatrixHairpapilla第36页/共66页37DistributionofhairLonghair：scalp,beard,axillaeandpubesShorthair

：eyebrows,eyelids,noseandauditorymeatesSmoothness：vermilionofthelipmammarypapillaPalm,soles,sideofthefingersandtoes,nailbeds,andcertainareasadjacenttomucosalsurface,suchastheglanspenisvellushair(Wollyhair)：

face,neckandtrunk第37页/共66页38Hairgrowthcycle

（speed0.27~0.4mm/d，loss70-100/d）

anagen3-10yGrowingphase

catagen3-4wTransitionalphase

telogen3mRestingphase第38页/共66页39LonghairgirlLength(1000~1500mm)=0.27~0.4mm/d×365d/y×10y第39页/共66页40（2）SebaceousglandsItiscomposedoflobulesofpale-stainingcellswithabundantlipidintheircytoplasm.

第40页/共66页41distributionBefoundingreatestabundanceonthefaceandscalp.Theyaredistributedthroughoutallskinsitesexceptthepalmsandsoles.Theyarealwaysassociatedwithhairfolliclesexceptatthefollowingsites:theeyelids(meibomianglands),thebuccalmucosavermilionborderofthelip(Fordyce'sspots)theprepuce(Tyson'sglands)thefemaleareolas(Montgomery'stubercles).第41页/共66页42（2）sebaceousglandsDiseases:Comedopapulepustulecyst

第42页/共66页43Itopensintotheinfundibularportionofthehairfollicle.Thecoiledsecretoryglandislocatedatthejunctionofthedermisandsubcutaneousfat.（3）Apocrineglands第43页/共66页44（3）ApocrineglandsdecapitationsecretionItiscomposedofadoublelayerofcuboidalepithelialcells.第44页/共66页45Apocrineunitsofthehumanbodyaregenerallyconfinedtothefollowingsites:axillae,areolae,theanogenitalregion,theexternalauditorycanal(ceruminousglands),andtheeyelids(glandsofMoll).

Theglandsdonotbegintofunctionuntilpuberty.（3）Apocrineglands第45页/共66页46（4）eccrineglands第46页/共66页47（4）eccrineglandscellsareoftwotypes:glycogen-rich,largepalecellssmaller,darkerstainingcellsThepaleglycogen-richcellsformsweat第47页/共66页48（4）eccrineglandsThedarkercellsmayactivelyreabsorbsodium,therebymodifyingsweatfromabasicallyisotonicsolutiontoahypotoniconebythetimeitreachestheskinsurface.Sweatissimilarincompositiontoplasma,containingthesameelectrolytes,thoughinamorediluteconcentration.第48页/共66页49RegulationSecretionofsweatoccursasresultofmanyfactorsandis

mediatedbycholinergicinnervation.Heatisaprimestimulustoincreasedsweating,Otherphysiologicstimuli,includingemotionalstress,areimportantaswell.Increasedsweatproductioninresponsetoheatispartofthethermoregulatorysystemofthebody;togetherwithincreasedcutaneousbloodflow,itcaneffectivelydissipateexcessivebodyheat.Atfrictionsurfaces,suchasthepalmsandsoles,eccrinesecretionisthoughttoassisttactilesensibilityandimproveadhesion.第49页/共66页50distributionEccrinesweatunitsarefoundatvirtuallyallskinsitesexceptthevermillionborderofthelips,nailbeds,labiaminora,glanspenis,andinneraspectoftheprepuce.

Theyaremostabundantonthepalms,soles,forehead,axillae.Someeccrineglandsintheaxillae,especiallyinpatientswithhyperhidrosis,mayhavewidelydilatedsecretarycoilsthatcontainapocrine-appearingcells.第50页/共66页51（5）nailnailfoldsnaillunula

nailplatefreemarginofnailnailgroovegrowthvelocity：nailoffinger0.1mm/d，toenail0.1cm/3dnailfoldsnailplatenailbednailrootnailmatrixdigitalbone第51页/共66页52Vasculaturethreeimportantintercommunicatingplexuses:

thesubpapillaryplexusupperhorizontalnetworkThedeeper,lowerhorizontalplexusisfoundatthedermal-subcutaneousinterfaceandiscomposedoflargerbloodvesselsthanthoseofthesuperficialplexus.Thevasculatureofthedermisisparticularlywelldevelopedatsitesofadnexalstructures.Associatedwiththevascularplexusarethedermallymphatics.5.Vasculature,Muscles,andNervesofskin第52页/共66页53第53页/共66页54muscleSmoothmuscleoccursintheskinasarrectorespilorum(erectorsofthehairs),asthetunicadartos(ordartos)ofthescrotum,andintheareolasaroundthenipples.Thearrectorespilorumareattachedtothehairfolliclesbelowthesebaceousglandsand,incontracting,pullthehairfollicleupward,producinggooseflesh.5.Vasculature,Muscles,andNervesofskinmuscle第54页/共66页555.Vasculature,Muscles,andNervesofskinNerves

：

TouchismediatedbyMeissnercorpusclesandinthedermalpapillae,particularlyonthepalmsandsoles

PressureismediatedbyVater-Pacinicorpuscleswhichlocateinthedeeperportionofthedermisofweight-bearingsurfaces.Temperature,pain,anditchsensationaretransmittedbyunmyelinatednervefiberswhichterminateinthepapillarydermisandaroundhairfollicles.

第55页/共66页ChapterⅡ

FunctionofSkin第56页/共66页57Theskin'sfunctionsincludeProtectionAbsorptionSensationsecretionandexcretiontemperatureregulationmetabolismandimmuneFunctionofSkin第57页/共66页581.ProtectionPhysicalProtectionChemicalProtectionProtectionagainstpathogenicmicro-organismsPreventthelossoffluid,electrolyteandnutrientsubstance.第58页/共66页592.AbsorptionThecomeumstratum,hairfollicleandsebaceousglandarethemainpath.Theabsorptioncanbeaffectedbysomefacors:structureandsiteoftheskin,hydrationofthecorneumstratum,natureofthesubstance,environmentfactors第59页/共66页603.SensationThebodyinterpretsexternalstimuliasheat,cold,pain,lighttouch,pressure,itch,andeventickleheatcold第60页/共6