December

07

The SkinThe largest organ of the Human Body

Students
Cristbal Azcar Philippe Dardenne Gabriela Ochoa

Professor
Macarena Palominos

U n i v e r s i d a d d e S a n t i a g o d e C h i l e M e d i c i n e , 2 0 1 2 E n g l i s h

TABLE OF CONTENTS
Introduction Skin
Skin Layers Functions Functions and Parts

Disease: Psoriasis
What is Psoriasis? Who gets Psoriasis? What causes Psoriasis? How is Psoriasis diagnosed? Psoriasis In Chile? What Is The Treatment?

Conclusion

INTRODUCTION
The skin plays a crucial role in all of the human body processes, such as a physical or chemical barrier, acondicionating system (to keep the body at a normal temperature), even it's involved in the nutrition of a person. It's health and care must be especially watched, because one small disorder in our protective barrier will influence not only locally, but could produce systemic problems or even death. Besides the possible effects of the skin in our health, it really affects social aspects of our lives. The skin tone, hair, fragility, greasiness, stains, etc. can make us loose our self-confidence, when we should be proud of having such an unique, useful and versatile organ that provides to the human one of the most wonderful senses: the sense of touch.

THE SKIN
The skin is the largest organ of our body, and is its outer covering (it covers around 2 square meters and weights around 5 kilos), making a component of the integumentary system. The skin has multiple layers of ectodermal tissue and guards the underlying muscles, bones, ligaments and internal organs. Human skin is similar to that of most other mammals, except that it is not protected by pelt or fur. Anyway, it has follicles, but theyre mostly hairless.

Skin is composed of three layers:

1. the epidermis, which provides waterproofing and functions as a barrier to foreign agents. 2. the dermis, which contains important components of the skin, like follicles, glands and nerve endings; and 3. the hypodermis or subcutaneous adipose layer.

The epidermis is composed by various layers too, but the most important are:
Stratum Corneum: Composed of many layers of keratinizated cells, with the palms and soles having the most layers. These cells are filled with water-retaining keratin proteins, and surrounded by lipids. Most of the barrier functions of the epidermis localize to this layer. Stratum spinosum and granulosum: here is formed the lipid barrier that helps in the stratum corneum to protect an waterproof. The stratum basale: is the deepest layer of the epidermis, and it contains the stem cells that replace the cells that fall.

Functions
v Protection: an anatomical barrier from pathogens and damage between the internal and external environment in bodily defense. Sensation: contains a variety of nerve endings and neurons that react to heat and cold,

touch, pressure, vibration, and tissue injury. Heat regulation: the skin contains a blood much more than it requires, and this is for the control of energy loss. Dilated blood vessels increase perfusion and heatloss, while constricted vessels reduce blood flow and conserve heat. Control of evaporation: the skin provides a relatively dry and semi-impermeable barrier to fluid loss. If youre on fire, you lose this function, so you are going to lose a lot of water. Communication: others see our skin and can assess our mood, physical state, etc. Storage and synthesis: acts as a storage center for lipids and water, as well as former of vitamin D with a little help from the UV rays. Excretion: sweat contains a bit concentration of urea; the excretion by sweating is just a secondary function of the body. Absorption: Medicines can be administered through the skin, for example, through an adhesive patch, such as the nicotine patch or iontophoresis (. The skin is an important site of transport in many other organisms, like amphibious and fishes. Water resistance: The skin acts as a water resistant barrier so essential nutrients aren't washed out of the body.

DISEASE: PSORIASIS
First of all What Is Psoriasis?
Psoriasis is a skin disease that causes scaling and inflammation (pain, swelling, heat, and redness). Skin cells grow deep in the skin and slowly rise to the surface. This process is called cell turnover, and it takes about a month. With psoriasis, it can happen in just a few days because the cells rise too fast and pile up on the surface. Most psoriasis causes patches of thick, red skin with silvery scales. These patches can itch or feel sore. They are often found on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet. But they can show up other places such as fingernails, toenails, genitals, and inside the mouth.

Who Gets Psoriasis?

Anyone can get psoriasis, but it occurs more often in adults. In many cases, there is a family history of psoriasis. Certain genes have been linked to the disease. Men and women get psoriasis at about the same rate.

What Causes Psoriasis?

Psoriasis begins in the immune system, mainly with a type of white blood cell called a T cell. T cells help protect the body against infection and disease. With psoriasis, T cells are put into action by mistake. They become so active that they set off other immune responses. This leads to swelling and fast turnover of skin cells. People with psoriasis may notice that sometimes the skin gets better and sometimes it gets worse. Things that can cause the skin to get worse include: Infections Stress Changes in weather that dry the skin Certain medicines.

How Is Psoriasis Diagnosed?

Psoriasis can be hard to diagnose because it can look like other skin diseases. The doctor might need to look at a small skin sample under a microscope.

Psoriasis In Chile?
It's estimated that 500.000 chileans have psoriasis. Like all skin diseases, treatments for psoriasis are quite expensive. Each injection cost 800.000 chilean pesos, and it's not covered by FONASA. In October 2009 was founded the Psoriasis Corporation of Chile. Its main mission it's to make that psoriasis is incorporated in the AUGE.

What Is The Treatment?

There are a number of different treatment options for psoriasis. Typically topical agents are used for mild disease, phototherapy for moderate disease, and systemic agents for severe disease.

Topical agents:
Bath solutions, mineral oil and petroleum jelly may help the affected skin and reduce the dryness which accompanies the build-up of skin on psoriatic plaques. Medicated creams and ointments applied directly to psoriatic plaques can help reduce inflammation, remove built-up scale, reduce skin turn over, and clear affected skin of plaques. The mechanism of action of each is probably different, but they all help to normalize skin cell production and reduce inflammation. Activated vitamin D and its analogues can inhibit skin cell proliferation.

Phototherapy:
Phototherapy in the form of sunlight has long been used effectively for treatment. The exposure time should be controlled to avoid over exposure and burning of the skin. The amount of light used is determined by a person's skin type. Psoralen and ultraviolet A phototherapy (PUVA) combines the oral or topical administration of psoralen with exposure to ultraviolet A (UVA) light. The mechanism of action of PUVA is unknown, but probably involves activation of psoralen by UVA light, which inhibits the abnormally rapid production of the cells in psoriatic skin

Systemic Agents:
Psoriasis that is resistant to topical treatment and phototherapy is treated by medications taken internally by pill or injection. Patients undergoing systemic treatment are required to have regular blood and liver function tests because of the toxicity of the medication. The three main traditional systemic treatments are methotrexate, cyclosporine and retinoids. Methotrexate and cyclosporine are immunosuppressant drugs; retinoids are synthetic forms of vitamin A. Patients taking methotrexate are prone to ulcerations. Methotrexate exposure may contribute to post- surgical events.

Alternative therapy:
Some studies suggest psoriasis symptoms can be relieved by changes in diet and lifestyle. Fasting periods, low energy diets and vegetarian diets have improved psoriasis symptoms in some studies, and diets supplemented with fish oil have also shown beneficial effects.

CONCLUSION
The body of all living multicellular is covered with skin, which forms the outer coat and limited body with the external environment, in humans is considered the largest organ in the body and is an essential and selective. Binds, seamless, with the mucous membranes of the different channels in the various body orifices. Cover is vital and extrinsic, indispensable and mediator between the inside and outside of the human body. It is a supporting connective tissue and support, a sensory organ and a reflection of the health status.