TheskinandSkinRegenerativeMedicine再生醫(yī)學(xué)LujunYangBurnsandPlasticsuregeryCenterforTranslationalmedicine2ndHospitalofShantouUniversityKayiName?skin

thelargestorganinthebodyprotectsenseregulatetemperatureProductionofVitaminDClininiansDermatology-----dermatologistPlasticandestheticsurgery------plasticsurgeonKeratinocytefibroblastOBJECTIVEMaster

skinstructureandfunction

epidermis-----keratinization角化作用:proliferation增殖/differentiation分化AcquaitanceAnomalies異?，F(xiàn)象

ofskin----commonskindiseases

AdvanceSkinregenerativemedicine皮膚再生醫(yī)學(xué)INTRODUCTIONepidermisdermishypodermisskindermis真皮papillarylayer乳頭層reticularlayer網(wǎng)織層appendages附屬器hair毛sebaceousgland皮脂腺sweatgland汗腺THESTRUCTUREOFSKINepidermis表皮stratumcorneum角質(zhì)層stratumlucidum(透明層)stratumgranulosum顆粒層stratumspinosum棘層stratumbasale基底層nail指(趾)甲（一）EpidermalstratificationanddifferentiationLangerhanscell(郞格漢斯細(xì)胞)Langerhanscellsaredendriticcells(antigen-presentingimmunecells)oftheskinandmucosa,andcontainlargegranulescalledBirbeckgranules.Theyarepresentinalllayersoftheepidermis,butaremostprominentinthestratumspinosum.Inskin

infections,thelocalLangerhanscellstakeupandprocessmicrobial

antigenstobecomefullyfunctionalantigen-presentingcells.Langerhanscellsderivefromthecellulardifferentiationofmonocyteswiththemarker"Gr-1"(alsoknownas"Ly-6G/Ly-6C").Thisdifferentiationrequiresstimulationbycolonystimulatingfactor(CSF)-1.6Theyaresimilarinmorphologyandfunctiontomacrophages.Albinoslackanenzymecalledtyrosinase絡(luò)氨酸酶.Tyrosinaseisrequiredformelanocytestoproducemelaninfromtheaminoacid

tyrosine

melanocyte(黑素細(xì)胞)Melanocytesaremelanin-producingcellslocatedinthebottomlayer(thestratumbasale)oftheskin‘sepidermis,themiddlelayeroftheeye(theuvea),theinnerear,meninges,Melaninisapigment色素

thatisresponsibleprimarilyforthecolorofskin.Nodifferenceinmelanocytenumberbetweenspecies.Thedistributionandtyrosinaseactivity!VitiligoTheHair

SebaceousGlands

皮脂腺SweatGlands

TheNails

TheAccessaryStructuresoftheSkinAlopeciaTotalis(全頭脫毛癥）Alopeciameanslossofhairfromtheheadorbody.baldness,Desmosomes細(xì)胞橋粒

aremolecularcomplexesofcelladhesion黏著蛋白

proteinsandlinkingproteinsthatattachthecellsurfaceadhesionproteinstointracellularkeratin

角蛋白cytoskeletal細(xì)胞支架細(xì)胞

filaments細(xì)絲.Thecelladhesionproteinsofthedesmosome,desmoglein橋粒芯蛋白

anddesmocollin橋粒膠蛋白,aremembersofthecadherin鈣粘蛋白

familyofcelladhesionmolecules.Theyaretransmembraneproteinsthatbridgethespacebetweenadjacentepithelialcellsbywayofhomophilicbindingoftheirextracellulardomainstootherdesmosomalcadherinsontheadjacentcell.Bothhavefiveextracellulardomains,andhavecalcium-bindingmotifs.Age-associatedskinchangesincludethinning,skinlaxity松弛,fragility脆弱,andwrinkles皺紋.Sun-exposedareasdemonstrateadditionalagingchanges,includingdyspigmentation,prematurewrinkling,telangiectasia,andactinicelastosis.UVA400–315nmUVB315–280nmThesun

emitsultravioletradiationintheUVA,UVB,andUVCbands.TheEarth'sozonelayer

blocks97–99%ofthisUVradiationfrompenetratingthroughtheatmosphere.OftheultravioletradiationthatreachestheEarth'ssurface,98.7%isUVAPhotoaging光老化Photoaging:telangiectasia,pigmentationLaserandPhotonskintreatmentSunscreenSPF:ratiooftheminimalerythemadose(MED)ofsunscreen-protectedskinovertheMEDofunprotectedskin.CurrentlyavailableproductsofferexcellentprotectionfromUVBand,toamorevariableextent,fromUVA;therefore,theregularuseofsunscreensshouldofferprotectionagainstsunburnaswellasphotoagingAwater-resistantproductmaintainstheSPFlevelafter40minutesofwaterimmersion,whereasaverywater-resistant(formerlywaterproof)productmaintainstheSPFlevelafter80minutesofwaterimmersion.TheUVexposurewouldbethestrongestbetween10amand4pmandsunavoidancebetweenthisperiodoftimeishighlyencouraged.Ifonecannotavoidexposuretothesun,clothing,hatsandsunglassesthatprotectsonefromsunexposureshould