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Thursday, February 10, 2011

Dermatology I - Winter Skin Problems

Your skin is the largest organ of your body weighing an average of 4 kg and covering an area of 2 square meters. It is either glabrous (smooth and without hair) or hairy. Our skin functions as a barrier against physical objects, light and pathogens (germs). It is involved in our temperature regulation, sensation, grasp, insulation and also a calorie reservoir. There are two main layers and several sub-layers. The two main layers are the epidermis and the dermis. There are appendages such as hair and nails and under the dermis lies the sub-cutaneous fat.

In the winter, the combination of low atmospheric moisture, indoor heating and also our age can give way to extreme dryness, itching and skin cracking – especially around the finger nails and heels. Not only are any breaks in our skin painful, but also allow pathogens (germs) in. In the case of someone who is immuno-compromised such as a person with diabetes, this can be a big deal.

So what can we do? First of all, moisturizing daily with a good non-soap cleanser is a must. Also apply a moisturizer after getting out of the shower or bath. Do not put moisturizer or creams between your toes. All moisturizers are not the same - ask your foot specialist, family doctor or dermatologist which one is right for you. Some creams contain ammonium lactate which is good for debriding (removing) rough skin. Others may contain urea which is good for keeping moisture in.

If you have a skin condition which you are concerned about, please see your health care professional right away.

More about skin…

The Epidermis consists of the following 5 layers;         
Stratum Germinativum (bottom layer)
Stratum Spinosum
Stratum Granulosum
Stratum Lucidum( only on palms and soles)
Stratum Corneum (top layer)

And includes the following cell types;
 Keratinocytes (produce keratin)
 Melanocytes (synthesize pigment – skin colour)
 Langerhan’s cells (immunoreaction – protects us from germs)
 Merkel’s cells (mechanoreceptors – allows us to sense pressure)

The basement layer separates the dermis and epidermis layers

The Dermis (also called the Corium) consists of the following 2 layers

Papillary layer – uppermost part
Reticular layer - below the papillary layer

Within these layers are the dermal matrix consisting of collagen, elastin and ground substance
(proteoglycans), appendages, nerves and blood vessels.

Below the dermis lies the subcutaneous fat which insulates us and separates the dermis from
the fascia. 


1.        The Michener Institute, 2008
2.        Dockery, GL & Crawford, ME 1997, Cutaneous Disorders of the Lower Extremity, WB Saunders, Philadelphia