Hair Structure and Pathogenesis Filipa Osório, MD; Antonella Tosti, Phd
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Nail Anatomy and Physiology for the Clinician 1
Nail Anatomy and Physiology for the Clinician 1 The nails have several important uses, which are as they are produced and remain stored during easily appreciable when the nails are absent or growth. they lose their function. The most evident use of It is therefore important to know how the fi ngernails is to be an ornament of the hand, but healthy nail appears and how it is formed, in we must not underestimate other important func- order to detect signs of pathology and understand tions, such as the protective value of the nail plate their pathogenesis. against trauma to the underlying distal phalanx, its counterpressure effect to the pulp important for walking and for tactile sensation, the scratch- 1.1 Nail Anatomy ing function, and the importance of fi ngernails and Physiology for manipulation of small objects. The nails can also provide information about What we call “nail” is the nail plate, the fi nal part the person’s work, habits, and health status, as of the activity of 4 epithelia that proliferate and several well-known nail features are a clue to sys- differentiate in a specifi c manner, in order to form temic diseases. Abnormal nails due to biting or and protect a healthy nail plate [1 ]. The “nail onychotillomania give clues to the person’s emo- unit” (Fig. 1.1 ) is composed by: tional/psychiatric status. Nail samples are uti- • Nail matrix: responsible for nail plate production lized for forensic and toxicology analysis, as • Nail folds: responsible for protection of the several substances are deposited in the nail plate nail matrix Proximal nail fold Nail plate Fig. -
The Integumentary System, but Shares Some of Skin’S Properties
PowerPoint® Lecture Slides The Skin and the Hypodermis prepared by Leslie Hendon University of Alabama, Birmingham • Skin—our largest organ • Accounts for 7% of body weight • Varies in thickness from 1.5–4.4mm C H A P T E R 5 • Divided into two distinct layers • Epidermis The • Dermis Integumentary • Hypodermis—lies deep to the dermis • Composed of areolar and adipose tissues System • Not part of the integumentary system, but shares some of skin’s properties Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. Skin Structure The Skin and Hypodermis • Functions 1. Protection—cushions organs and protects from Hair shaft bumps, chemicals, water loss, UV radiation Dermal papillae Epidermis Subpapillary vascular 2. Regulation of body temperature---Capillary Papillary plexus network and sweat glands regulate heat loss layer Pore Appendages of skin 3. Excretion—urea, salts, and water lost through Dermis Reticular Eccrine sweat gland sweat layer Arrector pili muscle Sebaceous (oil) gland Hair follicle 4. Production of vitamin D---Epidermal cells use Hair root UV radiation to synthesize vitamin D Hypodermis (superficial fascia) 5. Sensory reception—Contains sense organs Nervous structures Sensory nerve fiber Dermal vascular plexus associated with nerve endings Lamellar (Pacinian) corpuscle Adipose tissue Hair follicle receptor (root hair plexus) Copyright © 2011 Pearson Education, Inc. Figure 5.1 Copyright © 2011 Pearson Education, Inc. Figure 5.2 Gross structure of skin and underlying tissues. Epidermis • Is composed of keratinized stratified squamous epithelium • Contains four main cell types • Keratinocytes • Location—stratum spinosum; produce keratin a fibrous protein Epidermis • Melanocytes • Location—basal layer; manufacture and secrete the pigment melanin Dermis • Tactile epithelial cells (Merkel cells) Hypodermis • Location—basal layer; attached to sensory nerve endings Deep fascia • Dendritic cells (Langerhans cells) • Location—stratum spinosum; part of immune system; Muscle macrophage-like Copyright © 2011 Pearson Education, Inc. -
Curling Cuticles of the Great Toenails: a Case Report of Eponychogryphosis
Open Access Case Report DOI: 10.7759/cureus.3959 Curling Cuticles of the Great Toenails: A Case Report of Eponychogryphosis Philip R. Cohen 1 1. Dermatology, San Diego Family Dermatology, San Diego, USA Corresponding author: Philip R. Cohen, [email protected] Abstract The cuticle, also referred to as the eponychium, creates a seal between the proximal nail fold and the nail plate. It is derived from both the ventral and dorsal portions of the proximal nail fold. In addition to its principle function as a barrier preventing allergens, irritants and pathogens from entering the nail cul-de- sac, the cuticle can play a role as a model for evaluating the etiology and management of diseases that affect capillary microcirculation, provide a source of solid tissue for genetic disorder studies, and aid in the evaluation of patients in whom the diagnoses of either systemic scleroderma or dermatomyositis is being entertained. Curling cuticle is a distinctive and unique occurrence. The clinical features of a man with curling cuticles on the lateral portion of both great toes is described. Although a deficiency in personal hygiene may partially account for the clinical finding, the pathogenesis of this observation remains to be established. The term ‘eponychogryphosis’ is proposed to describe the alteration of the patient’s cuticles. Categories: Dermatology, Internal Medicine, Rheumatology Keywords: curl, curling, cuticle, eponychium, eponychogryphosis, fold, great, onychogryphosis, nail, toe Introduction The cuticle, also known as the eponychium, is an extension of the stratum corneum from the proximal nail fold [1-3]. It forms a seal that prevents allergens, irritants, and pathogens from entering the potential space between the distal skin of the digit and the nail plate [4-5]. -
Basic Biology of the Skin 3
© Jones and Bartlett Publishers, LLC. NOT FOR SALE OR DISTRIBUTION CHAPTER Basic Biology of the Skin 3 The skin is often underestimated for its impor- Layers of the skin: tance in health and disease. As a consequence, it’s frequently understudied by chiropractic students 1. Epidermis—the outer most layer of the skin (and perhaps, under-taught by chiropractic that is divided into the following fi ve layers school faculty). It is not our intention to present a from top to bottom. These layers can be mi- comprehensive review of anatomy and physiol- croscopically identifi ed: ogy of the skin, but rather a review of the basic Stratum corneum—also known as the biology of the skin as a prerequisite to the study horny cell layer, consisting mainly of kera- of pathophysiology of skin disease and the study tinocytes (fl at squamous cells) containing of diagnosis and treatment of skin disorders and a protein known as keratin. The thick layer diseases. The following material is presented in prevents water loss and prevents the entry an easy-to-read point format, which, though brief of bacteria. The thickness can vary region- in content, is suffi cient to provide a refresher ally. For example, the stratum corneum of course to mid-level or upper-level chiropractic the hands and feet are thick as they are students and chiropractors. more prone to injury. This layer is continu- Please refer to Figure 3-1, a cross-sectional ously shed but is replaced by new cells from drawing of the skin. This represents a typical the stratum basale (basal cell layer). -
Anatomy and Physiology of the Nail
Anatomy and physiology of the nail Christian Dumontier Institut de la Main & hôpital saint Antoine, Paris Anatomy of the nail • The osteo-ligamentous support • Nail plate • All surrounding tissues, i.e. the perionychium The distal phalanx • Is reinforced laterally by the the Flint’s ligament • Which protect the neuro-vascular structures Flint’s ligament The ligamentous support • The nail is fixed onto the bone through a highly vascularized dermis • The nail is fixed onto the bone through two strong ligaments The ligamentous structures • All the ligaments merge together with • The extensor tendon • The flexor tendon • The collateral ligaments • Flint’s ligament • Guero’s dorsal ligament • (Hyponychial ligament) Clinical implications • A normal nail cannot grow on an abnormal support +++ • Large phalanx = racket nails • bony malunion = nail dystrophy • arthrosis = Pincer nail,... The nail plate • Is produced by the germinal matrix • ItsKeratinic shape depends structure, on the bonypartiall supporty transparent and the and integritycurved both of the longitudinall soft-tissuesy arandound transv it ersally • Three different layers • 0,5 mm thickness, 20% of water Clinical applications • The nail plate is often intact in crushing trauma due to its flexibility • And must be removed in order to explore all the lesions +++ The perionychium • Include all the soft- tissues located under the nail plate • Nail (germinal) matrix, • Nail bed, • Hyponychium The perionychium • Soft-tissues aroud the plate (paronychium) proximal and lateral nail wall (fold) -
The Nail Bed, Part I. the Normal Nail Bed Matrix, Stem Cells, Distal Motion and Anatomy
Central Journal of Dermatology and Clinical Research Review Article *Corresponding author Nardo Zaias, Department of Dermatology Mount Sinai Medical Center, Miami Beach, FL. 33140, 4308 The Nail Bed, Part I. The Normal Alton rd. Suite 750, USA, Email: [email protected] Submitted: 25 November 2013 Nail Bed Matrix, Stem Cells, Distal Accepted: 28 December 2013 Published: 31 December 2013 Copyright Motion and Anatomy © 2014 Zaias Nardo Zaias* OPEN ACCESS Department of Dermatology Mount Sinai Medical Center, USA Abstract The nail bed (NB) has its own matrix that originates from distinctive stem cells. The nail bed matrix stem cells (NBMSC) lie immediately distal to the nail plate (NP) matrix cells and are covered by the keratogenous zone of the most distal NPM (LUNULA). The undivided NBMS cells move distally along the NB basement membrane toward the hyponychium; differentiating and keratinizing at various locations, acting as transit amplifying cells and forming a thin layer of NB corneocytes that contact the overlying onychocytes of the NP, homologous to the inner hair root sheath. At the contact point, the NB corneocytes express CarcinoEmbryonic Antigen (CEA), a glycoprotein-modulating adherence which is also found in hair follicles and tumors. Only when both the NP and the NB are normal do they synchronously move distally. The normal NB keratinizes, expressing keratin K-5 and K-17 without keratohyaline granules. However, during trauma or disease states, it reverts to keratinization with orthokeratosis and expresses K-10, as seen in developmental times. Psoriasis is the only exception. Nail Bed epidermis can express hyperplasia and giant cells in some diseases. -
Hair Structure Cuticle
Structure of Hair Hair Structure Hair is composed of three principal parts: Cuticle – outer coating composed of overlapping scales Cortex – protein-rich structure around Medulla – central core the medulla that contains pigment (may be absent) The structure of hair has been compared to that of a pencil with the medulla being the lead, the cortex being the wood and the cuticle being the paint on the outside. http://library.thinkquest.org/04oct/00206/lesson.htm#t_hair Structure of Hair Hair under the microscope • Basic components: keratin (a protein), melanin (a pigment), and trace quantities of metallic elements (Cu, Fe, Mn,etc). • Elements are deposited in hair during growth and absorbed by the hair from external environment. Hair Structure Cuticle The cuticle varies in: • Its scales, How many there are per centimeter, How much they overlap, Their overall shape, and How much they protrude from the surface • Its thickness, and • Whether or not it contains pigment. Characteristics of the cuticle may be important in distinguishing between hairs of different species but are often not useful in distinguishing between different people. Info: http://library.thinkquest.org/04oct/00206/lesson.htm#t_hair Image: http://www.hairdressersus.com/micro/Image5b.jpg HAIR SHAFT Cuticle – First Layer • The cuticle is a translucent outer layer of the hair shaft consisting of scales that cover the shaft. • The cuticle scales always point AWAY from the root end - toward the tip of the hair. • The cuticle is a GOOD WAY to tell species apart The Cuticle of Human Hair is rough --- which is why we use Conditioner Cuticle under the microscope Cuticle Scales: Coronal • Scales show crown- shaped pattern • Found in small rodents and bats • Coronal pattern is NEVER seen in human hair FREE-TAILED BAT HAIR CUTICLE SCALES: SPINOUS • Spinous - petal-like scales are triangular in shape and protrude from the hair shaft. -
•Nail Structure •Nail Growth •Nail Diseases, Disorders, and Conditions
•Nail Structure Nail Theory •Nail Growth •Nail Diseases, Disorders, and Conditions Onychology The study of nails. Nail Structure 1. Free Edge – Extends past the skin. 2. Nail Body – Visible nail area. 3. Nail Wall – Skin on both sides of nail. 4. Lunula – Whitened half-moon 5. Eponychium – Lies at the base of the nail, live skin. 6. Mantle – Holds root and matrix. Nail Structure 7. Nail Matrix – Generates cells that make the nail. 8. Nail Root – Attached to matrix 9. Cuticle – Overlapping skin around the nail 10. Nail Bed – Skin that nail sits on 11. Nail Grooves – Tracks that nail slides on 12. Perionychium – Skin around nail 13. Hyponychium – Underneath the free edge Hyponychium Nail Body Nail Groove Nail Bed Lunula Eponychium Matrix Nail Root Free Edge Nail Bed Eponychium Matrix Nail Root Nail Growth • Keratin – Glue-like protein that hardens to make the nail. • Rate of Growth – 4 to 6 month to grow new nail – Approx. 1/8” per month • Faster in summer • Toenails grow faster Injuries • Result: shape distortions or discoloration – Nail lost due to trauma. – Nail lost through disease. Types of Nail Implements Nippers Nail Clippers Cuticle Pusher Emery Board or orangewood stick Nail Diseases, Disorders and Conditions • Onychosis – Any nail disease • Etiology – Cause of nail disease, disorder or condition. • Hand and Nail Examination – Check for problems • Six signs of infection – Pain, swelling, redness, local fever, throbbing and pus Symptoms • Coldness – Lack of circulation • Heat – Infection • Dry Texture – Lack of moisture • Redness -
Science of the Nail Apparatus David A.R
1 CHAPTER 1 Science of the Nail Apparatus David A.R. de Berker 1 and Robert Baran 2 1 Bristol Dermatology Centre , Bristol Royal Infi rmary , Bristol , UK 2 Nail Disease Center, Cannes; Gustave Roussy Cancer Institute , Villejuif , France Gross anatomy and terminology, 1 Venous drainage, 19 Physical properties of nails, 35 Embryology, 3 Effects of altered vascular supply, 19 Strength, 35 Morphogenesis, 3 Nail fold vessels, 19 Permeability, 35 Tissue differentiation, 4 Glomus bodies, 20 Radiation penetration, 37 Factors in embryogenesis, 4 Nerve supply, 21 Imaging of the nail apparatus, 37 Regional anatomy, 5 Comparative anatomy and function, 21 Radiology, 37 Histological preparation, 5 The nail and other appendages, 22 Ultrasound, 37 Nail matrix and lunula, 7 Phylogenetic comparisons, 23 Profi lometry, 38 Nail bed and hyponychium, 9 Physiology, 25 Dermoscopy (epiluminescence), 38 Nail folds, 11 Nail production, 25 Photography, 38 Nail plate, 15 Normal nail morphology, 27 Light, 40 Vascular supply, 18 Nail growth, 28 Other techniques, 41 Arterial supply, 18 Nail plate biochemical analysis, 31 Gross anatomy and terminology with the ventral aspect of the proximal nail fold. The intermediate matrix (germinative matrix) is the epithe- Knowledge of nail unit anatomy and terms is important for lial structure starting at the point where the dorsal clinical and scientific work [1]. The nail is an opalescent win- matrix folds back on itself to underlie the proximal nail. dow through to the vascular nail bed. It is held in place by The ventral matrix is synonymous with the nail bed the nail folds, origin at the matrix and attachment to the nail and starts at the border of the lunula, where the inter- bed. -
The Structure of Hair and Follicles of Mice Carrying the Naked ( N) Gene
Genet. Res., Camb. (1982), 39, pp. 139-148 139 Printed in Great Britain The structure of hair and follicles of mice carrying the naked (N) gene BY KATHRYN A. RAPHAEL*, R. E. CHAPMANf, PENELOPE A. FRITHt AND PAMELA R. PENNYCUIK* *CSIRO, Genetics Research Laboratories, P.O. Box 184, North Ryde, N.S.W., 2113, Australia. -fCSIRO, Division of Animal Production, P.O. Box 239, Blacktown, N.S.W., 2148, Australia (Received 8 September 1981) SUMMARY The hairs and follicles from mice carrying the naked (N) gene have been examined using both scanning and transmission electron microscopy in addition to light microscopy. Fibre cuticle cells and occasionally cortical cells were absent from the follicles of N/ + mice when the base of the hair was growing. In N/N follicles there was a frequent lack of both cuticle and cortical cells throughout the growth phase of the follicles. Abnormal- ities were also observed in the manner in which the synthesized keratin was deposited in the fibres. The possible mode of action of the N gene is discussed in the light of these results. 1. INTRODUCTION The hairs of mice carrying the naked (N) gene are affected by varying degrees of fragility. In heterozygous naked (N/ +) mice, the hairs exhibit little abnormality until near the end of each cycle of growth, at which time most hairs break off just above the skin surface, leaving the skin bare until the eruption of the next hair coat. In homozygous naked (N/N) mice, few if any hairs erupt during the first hair cycle, although the follicles are active. -
What's New in Nail Anatomy? the Latest Facts
What’s New in Nail Anatomy? The Latest Facts! by Doug Schoon April 2019: The Internet is filled with confusing and competing misinformation about nail anatomy. I’ve been on a multi-year quest to determine all the facts but finding them has been very difficult. Many doctors and scientists are also confused by the various “schools of thought.” To get to the root of the issue, I’ve worked with many world-class medical experts and internationally known nail educators, in addition to reviewing dozens of scientific reports. I’d like to explain some new information in hopes of ending the confusion. It is agreed that the proximal nail fold (PNF) is the entire flap of skin covering the matrix, extending from the edge of the visible nail plate to the first joint of the finger. However, there is continuing disagreement about the eponychium. I’ve researched all sides of this debate and I hope this information will clear up confusion. Eponychium literally means “upon the nail”. This is the tissue that covers the new growth of nail plate. Why is there so much confusion about the location of the eponychium? Here’s why. Strangely, in some medical literature, another type of tissue is also identified as eponychium, which creates confusion. Of course, it is confusing with two different types of tissue having the same name. The eponychium creates the cuticle and covers the new growth of nail plate, this other tissue does not. To avoid confusion, we should only refer to the eponychium as the underside portion of the proximal nail fold that covers the new growth of nail plate and creates the cuticle. -
Epidermis : Composed of a Keratinized Stratified Squamous Epithelium
INTEGUMENTARY The skin (integument , cutis ) and its derivatives constitute the integumentary system . It form the external covering of the body and is the largest organ of the body. The skin consists of two main layers : 1-Epidermis : composed of a keratinized stratified squamous epithelium. 2-Dermis: composed of a dense connective tissue. The epidermal derivatives of the skin include the following organ structures and integumentary products : • Hair and hair follicles • sweat gland • sebaceous gland • nail • mammary glands Structure of thick and thin skin • The thickness of the skin varies over the surface of the body , • thick skin is found in palm of hands and feet while the • thin skin (which contains hair follicles) found in the most of the body for example the skin of scalp . • The skin consists of the following layers :- I- Epidermis The epidermis is composed of stratified squamous epithelium in which four distinct layers can be identified . In the case of thick skin , a fifth layer is observed . Beginning with the deepest layer , these are : . Stratum basale , also called Stratum germinativum . Stratum spinosum . Stratum granulosum . Stratum lucidum (limited to thick skin) . Stratum corneum Stratum basale . • The stratum basale is represented by a single layer of cells that rests on the basal lamina stratum germinativum . • The cells are small and are cuboidal to low columnar in shape . They have less cytoplasm than the cells in the layer above ; consequently , their nuclei are more closely spaced . This , in combination with the basophilic cytoplasm of these cells , imparts a noticeable basophilia to the stratum basale . Stratum spinosum . • Is at least several cells thick.