Structure
CORIUM The foundation layer. It overlies the subcutaneous fat and varies in thickness from 0·5–3.0 mm. Many nerves run through the corium: these have key roles in the sensations of touch, pain and temperature (see NEURON(E)). Blood vessels nourish the skin and are primarily responsible for regulating the body temperature. Hairs are bedded in the corium, piercing the epidermis (see below) to cover the skin in varying amounts in di?erent parts of the body. The sweat glands are also in the corium and their ducts lead to the surface. The ?brous tissue of the corium comprises interlocking white ?brous elastic bundles. The corium contains many folds, especially over joints and on the palms of hands and soles of feet with the epidermis following the contours. These are permanent throughout life and provide unique ?ngerprinting identi?cation. HAIR Each one has a root and shaft, and its varying tone originates from pigment scattered throughout it. Bundles of smooth muscle (arrectores pilorum) are attached to the root and on contraction cause the hair to stand vertical. GLANDS These occur in great numbers in the skin. SEBACEOUS GLANDS secrete a fatty substance and sweat glands a clear watery ?uid (see PERSPIRATION). The former are made up of a bunch of small sacs producing fatty material that reaches the surface via the hair follicle. Around three million sweat or sudoriparous glands occur all over the body surface; sited below the sebaceous glands they are unconnected to the hairs. EPIDERMIS This forms the outer layer of skin and is the cellular layer covering the body surface: it has no blood vessels and its thickness varies from 1 mm on the palms and soles to 0·1 mm on the face. Its outer, impervious, horny layer comprises several thicknesses of ?at cells (pierced only by hairs and sweat-gland openings) that are constantly rubbed o? as small white scales; they are replaced by growing cells from below. The next, clear layer forms a type of membrane below which the granular stratum cells are changing from their origins as keratinocytes in the germinative zone, where ?ne sensory nerves also terminate. The basal layer of the germinative zone contains melanocytes which produce the pigment MELANIN, the cause of skin tanning.
Nail A modi?cation of skin, being analagous to the horny layer, but its cells are harder and more adherent. Under the horny nail is the nail bed, comprising the well-vascularised corium (see above) and the germinative zone. Growth occurs at the nail root at a rate of around 0·5 mm a week – a rate that increases in later years of life.
Skin functions By its ability to control sweating and open or close dermal blood vessels, the skin plays a crucial role in maintaining a constant body temperature. Its toughness protects the body from mechanical injury. The epidermis is a two-way barrier: it prevents the entry of noxious chemicals and microbes, and prevents the loss of body contents, especially water, electrolytes and proteins. It restricts electrical conductivity and to a limited extent protects against ultraviolet radiation.
The Langerhans’ cells in the epidermis are the outposts of the immune system (see IMMUNITY), just as the sensory nerves in the skin are the outposts of the nervous system. Skin has a social function in its ability to signal emotions such as fear or anger. Lastly it has a role in the synthesis of vitamin D.... skin
to heal, or that would leave tethering or unsightly scars. A skin graft is often used in the treatment of burns or sometimes for nonhealing ulcers. A piece of healthy skin is detached from one part of the body and transferred to the affected area. New skin cells grow from the graft and cover the damaged area. In a meshed graft, donor skin is removed and made into a mesh by cutting. The mesh is stretched to fit the recipient site; new skin cells grow to fill the spaces in the mesh. In a pinch graft, multiple small areas of skin are pinched up and removed from the donor site. Placed on the recipient site, they gradually expand to form a new sheet of healthy skin. (See also skin flap.)... skin graft
Researchers are having success in growing human skin in the laboratory for grafting on to people who have been badly burned and have insu?cient intact skin surface to provide an autologous graft (one provided by the recipient of the graft). Other techniques being researched are the use of specially treated shark skin and the production of arti?cial skin.... skin-grafting
A corn is a callus on a toe.
If corns are painful, the thickened skin can be pared away by a chiropodist using a scalpel.... callus, skin
Internal. Goldenseal 1; Myrrh 1; Thuja half; Poke root half. Dose – Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Thrice daily before meals.
Capricin. See entry.
Topical. Thuja lotion: 1 teaspoon Liquid extract Thuja to 1oz (30ml) distilled extract Witch Hazel.
Aloe Vera; fresh juice or gel.
Tea Tree oil; may be diluted many times.
Comfrey cream; Castor oil, Oil of Mullen or Houseleek. Cider vinegar.
Night wash. Warm water to which is added a few drops Tincture Myrrh, Tincture Thuja or Tea Tree oil. Diet and Supplements. Same as for CANDIDA – VAGINAL. ... candida, of skin and nails
Accept. Goat’s milk, yoghurt, eggs – twice weekly. The high potassium and low salt content of bananas help reduce itching. Lecithin. Oily fish. Purslane is a non-fish source of EPA and suitable for the vegetarian approach. Cottage cheese. Pumpkin seeds as a source of zinc. Dandelion coffee. Artichoke: such as Schoenenberger plant juice. Salad dressing: emulsify 1 teaspoon Cider vinegar to each 2 teaspoons safflower seed oil.
Reject: Fried and greasy foods, pastries, chocolates, sweets, ice cream, spicy foods, seasoning, sausage meats, white flour products, white sugar products, alcoholic drinks, meat from the pig (ham, pork, bacon), peppers, horseradish, condiments. Powdered kelp in place of salt, powdered garlic or celery.
Foods known to contain artificial colours and preservatives. All soft drinks, except those made at home from fresh fruits or raw vegetables; coffee, strong tea, oranges. Cola drinks, chocolate, milk, cream, cheese, whey.
Supplement. Beta carotene.
Study. A flare-up can be caused by nuts, jams, fruits, artificially coloured or flavoured foods. (British Journal of Dermatology, 110, 457, (1984)) ... diet - skin disorders
Acne is common in adolescents and is partly related to the action of androgen hormones.
Inflammation of the skin occurs in dermatitis, eczema, and skin allergy.
The skin is also vulnerable to injuries such as burns, cuts, and bites (see bites, animal; insect bites).... skin, disorders of the
Unlike a skin graft, a skin flap retains its blood supply, either by remaining attached to the donor site or through reattachment to blood vessels at the recipient site by microsurgery, so skin flaps adhere well even where there is extensive loss of deep tissue.... skin flap
Others appear under their appropriate alphabetical headings: ACNE; ALBINISM; ALOPECIA; ALOPECIA AREATA; APHTHOUS ULCER; BASAL CELL CARCINOMA; BOILS (FURUNCULOSIS); BOWEN’S DISEASE; CALLOSITIES; CANDIDA; CHEILOSIS; CHEIRAPOMPHOLYX; DANDRUFF; DERMATOFIBROMA; DERMATOMYOSITIS; DERMATOPHYTES; DERMOGRAPHISM; ECTHYMA; ERYSIPELAS; ERYTHEMA; ERYTHRASMA; ERYTHRODERMA; ESCHAR; EXANTHEM; FUNGAL AND YEAST INFECTIONS; HAND, FOOT AND MOUTH DISEASE; HERPES GENITALIS; HERPES SIMPLEX; HERPES ZOSTER; IMPETIGO; INTERTRIGO; KELOID; KERATOSIS; LARVA MIGRANS; LICHEN; LUPUS; MADURA FOOT; MELANOMA; MILIARIA; MOLLUSCUM CONTAGIOSUM; MOLE; MYCOSIS FUNGOIDES; NAEVUS; ORF; PEDICULOSIS; PEMPHIGUS; PHOTOCHEMOTHERAPY; PHOTODERMATOSES; PITYRIASIS; PORPHYRIAS; PRURITUS; PSORIASIS; RINGWORM; ROSACEA; SARCOIDOSIS; SCABIES; SCLERODERMA; URTICARIA; VITILIGO; WARTS; XANTHOMATA.
Skin cancer Primary cancer is common and chronic exposure to ultraviolet light is the most important cause. BASAL CELL CARCINOMA is the most common form; squamous cell carcinoma is less common and presents as a growing, usually painless nodule which may ulcerate. Squamous cancer may spread to regional lymph glands and metastasise, unlike basal cell cancer. Occupational exposure to chemical carcinogens may cause squamous carcinoma – for example, cancer from pitch warts or the scrotal carcinoma of chimney sweeps exposed to coal dust in earlier centuries. Squamous carcinoma of the lip is associated with clay-pipe smoking.
Cancer may arise from the population of melanocytes of the skin (see MELANOCYTE; MELANOMA).
Apart from these three most frequent forms of skin cancer, various forms of cancer can arise from cells of the dermis, of which LYMPHOMA is the most important (see also MYCOSIS FUNGOIDES).
Lastly, secondary deposits from internal cancer, particularly from the breast, may metastasise to the skin.
Dermatitis and eczema These are broadly synonymous, and the terms are frequently interchangeable. Eczema is a pattern of in?ammation with many potential causes. Dermatitis is commonly used to suggest an eczema caused by external factors; it is a common pattern of in?ammation of the skin characterised by redness and swelling, vesiculation (see VESICLE), and scaling with intense itching and often exudation (weeping). Fissuring, thickening (licheni?cation – see LICHEN) and secondary bacterial infection may follow. Dermatitis can affect any part of the body. It may be genetically detemined or due to other ‘internal’ factors, such as venous HYPERTENSION in a leg, or stress. Often it is ‘external’ in origin – due to strong irritants or chemical allergens. (See also ALLERGY; ALLERGEN.) ATOPIC DERMATITIS is genetic in origin and usually begins in infancy. It may persist for years, and ASTHMA, allergic RHINITIS and conjunctivitis (see under EYE, DISORDERS OF) – ‘hay fever’ – may be associated. Atopic children tend to have multiple allergies, especially to inhaled allergens such as house-dust mite, cat and dog dander and pollens. Allergy to foods is less common but potentially more dangerous, especially if to nuts, when it can cause acute URTICARIA or even ANAPHYLAXIS. Atopic subjects are particularly prone to persistent and multiple verrucae (see WARTS) and mollusca (see MOLLUSCUM CONTAGIOSUM) and to severe HERPES SIMPLEX infections. (See also ATOPY.)
EXFOLIATE DERMATITIS (PITYRIASIS RUBRA)
Generalised exfoliation and scaling of the skin, commonly with ERYTHEMA. Drugs may cause it, or the disorder may be linked with other skin diseases such as benign dermatoses and lupus erythematosus (see under LUPUS). SUMMER POMPHOLYX is an acute vesicular eczema of the palms and soles recurring every summer. Inhaled allergens are a frequent cause. VENOUS (STASIS) DERMATITIS begins on a lower calf, often in association with PURPURA, swelling and sometimes ulceration. Chronic venous hypertension in the leg, consequent on valvular incompetence in the deep leg veins owing to previous deep vein thrombosis (see VEINS, DISEASES OF), is the usual cause. NEURODERMATITIS A pattern of well-de?ned plaques of licheni?ed eczema particularly seen on the neck, ulnar forearms or sides of the calves in subjects under emotional stress. IRRITANT CONTACT DERMATITIS Most often seen in an industrial setting (occupational dermatitis), it is due to damage by strong chemicals such as cutting oils, cement, detergents and solvents. In almost all cases the hands are most severely affected. ALLERGIC CONTACT DERMATITIS, in contrast, can affect any part of the body depending on the cause – for example, the face (cosmetics), hands (plants, occupational allergens) or soles (rubber boots). Particularly common allergens include metals (nickel and chromate), rubber addititives, and adhesives (epoxy resins).
Treatment Avoidance of irritants and contact allergens, liberal use of EMOLLIENTS, and topical application of corticosteroid creams and ointments (see CORTICOSTEROIDS) are central.... skin, diseases of
Patch tests are used in the diagnosis of contact allergic dermatitis.
They can also be used to test immunity to certain infectious diseases (such as in the tuberculin test).... skin tests
Keratoses and squamous papillomas are common types of noncancerous tumour; other types include sebaceous cysts, cutaneous horns, keratoacanthomas, and haemangiomas.... skin tumours
Basal Cell Cancer. Strong sunlight on fair skins. Common on face and hands and other exposed areas. Commences as a tiny hard nodule. See – RODENT ULCER.
Squamous Cell Cancer. The role of sunlight in this type of cancer is even more positive. Other causes: photosensitisers such as pitch and PUVA photochemotherapy. Commences as a raised scaly rapidly- growing nodule.
Malignant Melanoma. Rare, but incidence rising. Four different kinds. Incidence is increased in individuals with fair or red hair who tend to burn rather than tan in the sun.
Causes may be numerous: genetic, occupational hazards or exposure to low-level radiation. Heavy freckling in youth doubles the risk. (Western Canada Melanoma study)
A study carried out by the New York’s Memorial-Sloan Kettering Cancer Centre refers to damage to the ultra violet-blocking ozone layer by supersonic jet exhaust and aerosol propellants that can also raise the malignant melanoma rate. A University of Sydney study links fluorescent lighting with the disease. Symptoms. Itching lesion increases in size and with growing discoloration. Colours may present as brown, black, red, blue, white, with a red inflammatory border. May progress to a dry crust, with bleeding.
Study. A study conducted by a team from Melbourne University, Anti-Cancer Council and St Vincent’s Hospital, Australia, describes a summer-long experiment that showed that people who used a sun-screen lotion (in this case SPF-17) cut their chances of developing the first signs of skin cancer.
Study. Patients who receive blood transfusions are more likely to develop malignant lymphomas and non- melanomatous skin cancers. (European Journal of Cancer (Nov 1993))
Eclectic physicians of the 19th century reported success from the use of American Mandrake (podophylum peltatum). Recent experience includes a 76 per cent cure rate achieved in 68 patients with carcinoma of the skin by treatment twice daily for 14 days with an ointment consisting of Podophyllum resin 20 per cent, and Linseed oil 20 per cent, in lanolin, followed by an antibiotic ointment. (Martindale 27; 1977, p. 1341) Podophyllum is an anti-mitotic and inhibits cell-division and should not be applied to normal cells.
Aloe Vera. Fresh cut leaf, or gel, to wipe over exposed surfaces.
Vitamin E oil. Applying the oil to the skin can reduce chances of acquiring skin cancer from the sun. (University of Arizona College of Medicine)
Red Clover. “I have seen a case of skin cancer healed by applying Red Clover blossoms. After straining a strong tea, the liquid was simmered until it was the consistency of tar. After several applications the skin cancer was gone, and has not returned.” (May Bethel, in “Herald of Health”, Dec. 1963)
Clivers. Equal parts juice of Clivers (from juice extractor) and glycerine. Internally and externally.
Thuja. Internal: 3-5 drops Liquid Extract, morning and evening.
Topical. “Take a small quantity powdered Slippery Elm and add Liquid Extract Thuja to make a stiff paste. Apply paste to the lesion. Cover with gauze and protective covering. When dry remove pack and follow with compresses saturated with Thuja.” (Ellingwood’s Therapeutist, Vol 10, No 6, p. 212) Echinacea and Thuja. Equal parts liquid extracts assist healthy granulation and neutralise odour.
Rue Ointment. Simmer whole fresh leaves in Vaseline.
Poke Root. An old physician laid great stress on the use of concentrated juice of green leaves. Leaves are bruised, juice extracted, and concentrated by slow evaporation until the consistency of a paste, for persistent skin cancer. Care should be taken to confine to the distressed area. (Ellingwood’s Therapeutist, Vol 8, No 7, p. 275)
Maria Treben. Horsetail poultice.
Laetrile. Some improvement claimed. 1 gram daily.
Cider vinegar. Anecdotal evidence: external use: small melanoma.
Diet. See: DIET – CANCER. Beta-carotene foods.
Treatment by skin specialist or oncologist. ... cancer – skin
Bergamot, camphor (white), cananga, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), clove bud, galbanum, geranium, grapefruit, immortelle, juniper, lavandin, lavender (spike & true), lemon, lemongrass, lime, linaloe, litsea cubeba, mandarin, mint (peppermint & spearmint), myrtle, niaouli, palmarosa, patchouli, petitgrain, rosemary, rosewood, sage (clary & Spanish), sandalwood, tea tree, thyme, vetiver, violet, yarrow, ylang ylang.
Allergies (M,S,F,B,I):
Melissa, chamomile (German & Roman), immortelle, true lavender, spikenard.
Athlete’s foot (S):
Clove bud, eucalyptus, lavender (true &spike), lemon, lemongrass, myrrh, patchouli, tea tree.
Baldness & hair care (S,H):
West Indian bay, white birch, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), grapefruit, juniper, patchouli, rosemary, sage (clary & Spanish), yarrow, ylang ylang.
Boils, abscesses & blisters (S,C,B):
Bergamot, chamomile (German & Roman), eucalyptus blue gum, galbanum, immortelle, lavandin, lavender (spike & true), lemon, mastic, niaouli, clary sage, tea tree, thyme, turpentine.
Bruises (S,C):
Arnica (cream), borneol, clove bud, fennel, geranium, hyssop, sweet marjoram, lavender, thyme.
Burns (C,N):
Canadian balsam, chamomile (German & Roman), clove bud, eucalyptus blue gum, geranium, immortelle, lavandin, lavender (spike & true), marigold, niaouli, tea tree, yarrow.
Chapped & cracked skin (S,F,B):
Peru balsam, Tofu balsam, benzoin, myrrh, patchouli, sandalwood.
Chilblains (S,N):
Chamomile (German & Roman), lemon, lime, sweet marjoram, black pepper.
Cold sores/herpes (S):
Bergamot, eucalyptus blue gum, lemon, tea tree.
Congested & dull skin (M,S,F,B,I):
Angelica, white birch, sweet fennel, geranium, grapefruit, lavandin, lavender (spike & true), lemon, lime, mandarin, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), palmarosa, rose (cabbage & damask), rosemary, rosewood, ylang ylang.
Cuts/sores (S,C):
Canadian balsam, benzoin, borneol, cabreuva, cade, chamomile (German & Roman), clove bud, elemi, eucalyptus (blue gum, lemon & peppermint), galbanum, geranium, hyssop, immortelle, lavender (spike & true), lavandin, lemon, lime, linaloe, marigold, mastic, myrrh, niaouli, Scotch pine, Spanish sage, Levant styrax, tea tree, thyme, turpentine, vetiver, yarrow.
Dandruff (S,H):
West Indian bay, cade, cedarwood (Atlas, Texas & Virginian), eucalyptus, spike lavender, lemon, patchouli, rosemary, sage (clary & Spanish), tea tree.
Dermatitis (M,S,C,F,B):
White birch, cade, cananga, carrot seed, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), geranium, immortelle, hops, hyssop, juniper, true lavender, linaloe, litsea cubeba, mint (peppermint & spearmint), palmarosa, patchouli, rosemary, sage (clary & Spanish), thyme.
Dry & sensitive skin (M,S,F,B):
Peru balsam, Tolu balsam, cassie, chamomile (German & Roman), frankincense, jasmine, lavandin, lavender (spike & true), rosewood, sandalwood, violet.
Eczema (M,S,F,B):
Melissa, Peru balsam, Tolu balsam, bergamot, white birch, cade, carrot seed, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), geranium, immortelle, hyssop, juniper, lavandin, lavender (spike & true), marigold, myrrh, patchouli, rose (cabbage & damask), rosemary, Spanish sage, thyme, violet, yarrow.
Excessive perspiration (S,B):
Citronella, cypress, lemongrass, litsea cubeba, petitgrain, Scotch pine, Spanish sage.
Greasy or oily skin/scalp (M,S,H,F,B):
West Indian bay, bergamot, cajeput, camphor (white), cananga, carrot seed, citronella, cypress, sweet fennel, geranium, jasmine, juniper, lavender, lemon, lemongrass, !itsea cubeba, mandarin, marigold, mimosa, myrtle, niaouli, palmarosa, patchouli, petitgrain, rosemary, rosewood, sandalwood, clary sage, tea tree, thyme, vetiver, ylang ylang.
Haemorrhoids/piles (S,C,B):
Canadian balsam, Copaiba balsam, coriander, cubebs, cypress, geranium, juniper, myrrh, myrtle, parsley, yarrow.
Insect bites (S,N):
French basil, bergamot, cajeput, cananga, chamomile (German & Roman), cinnamon leaf, eucalyptus blue gum, lavandin, lavender (spike & true), lemon, marigold, melissa, niaouli, tea tree, thyme, ylang ylang.
Insect repellent (S,V):
French basil, bergamot, borneol, camphor (white), Virginian cedarwood, citronella, clove bud, cypress, eucalyptus (blue gum & lemon), geranium, lavender, lemongrass, litsea cubeba, mastic, melissa, patchouli, rosemary, turpentine.
Irritated & inflamed skin (S,C,F,B):
Angelica, benzoin, camphor (white), Atlas cedarwood, chamomile (German & Roman), elemi, immortelle, hyssop, jasmine, lavandin, true lavender, marigold, myrrh, patchouli, rose (cabbage & damask), clary sage, spikenard, tea tree, yarrow.
Lice (S,H):
Cinnamon leaf, eucalyptus blue gum, galbanum, geranium, lavandin, spike lavender, parsley, Scotch pine, rosemary, thyme, turpentine.
Mouth & gum infections/ulcers (S,C):
Bergamot, cinnamon leaf, cypress, sweet fennel, lemon, mastic, myrrh, orange (bitter & sweet), sage (clary & Spanish), thyme.
Psoriasis (M,S,F,B):
Angelica, bergamot, white birch, carrot seed, chamomile (German & Roman), true lavender.
Rashes (M,S,C,F,B):
Peru balsam, Tofu balsam, carrot seed, chamomile (German & Roman), hops, true lavender, marigold, sandalwood, spikenard, tea tree, yarrow.
Ringworm (S,H):
Geranium, spike lavender, mastic, mint (peppermint & spearmint), myrrh, Levant styrax, tea tree, turpentine.
Scabies (S):
Tolu balsam, bergamot, cinnamon leaf, lavandin, lavender (spike & true), lemongrass, mastic, mint (peppermint & spearmint), Scotch pine, rosemary, Levant styrax, thyme, turpentine.
Scars & stretch marks (M,S):
Cabreuva, elemi, frankincense, galbanum, true lavender, mandarin, neroli, palmarosa, patchouli, rosewood, sandalwood, spikenard, violet, arrow.
Slack tissue (M,S,B):
Geranium, grapefruit, juniper, lemongrass, lime, mandarin, sweet marjoram, orange blossom, black pepper, petitgrain, rosemary, yarrow.
Spots (S,N):
Bergamot, cade, cajeput, camphor (white), eucalyptus (lemon), immortelle, lavandin, lavender (spike & true), lemon, lime, litsea cubeba, mandarin, niaouli, tea tree.
Ticks (S,N):
Sweet marjoram.
Toothache & teething pain (S,C,N):
Chamomile (German & Roman), clove bud, mastic, mint (peppermint & spearmint), myrrh.
Varicose veins (S,C):
Cypress, lemon, lime, neroli, yarrow.
Verrucae (S,N):
Tagetes, tea tree.
Warts & corns (S,N):
Cinnamon leaf, lemon, lime, tagetes, tea tree.
Wounds (S,C,B):
Canadian balsam, Peru balsam, Tolu balsam, bergamot, cabreuva, chamomile (German & Roman), clove bud, cypress, elemi, eucalyptus (blue gum & lemon), frankincense, galbanum, geranium, immortelle, hyssop, juniper, lavandin, lavender (spike & true), linaloe, marigold, mastic, myrrh, niaouli, patchouli, rosewood, Levant styrax, tea tree, turpentine, vetiver, yarrow.
Wrinkles & mature skin (M,S,F,B):
Carrot seed, elemi, sweet fennel, frankincense, galbanum, geranium, jasmine, labdanum, true lavender, mandarin, mimosa, myrrh, neroli, palmarosa, patchouli, rose (cabbage & damask), rosewood, clary sage, sandalwood, spikenard, ylang ylang.... skin care