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Cutis – Structure, Function and Skin Diseases

The cutis refers to the skin as a whole organ, comprising all skin layers. It is the largest organ of the human body.

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Things worth knowing about "Cutis"

The cutis refers to the skin as a whole organ, comprising all skin layers. It is the largest organ of the human body.

What is the Cutis?

The cutis is the medical term for the skin considered as a complete organ. It is the largest organ of the human body, covering a surface area of approximately 1.5 to 2 square metres in an adult. The cutis consists of two primary layers: the epidermis (outer skin) and the dermis (inner skin). The deeper lying subcutis (subcutaneous tissue) is sometimes included, although strictly speaking it is not part of the skin in the narrow anatomical sense.

Structure of the Cutis

Epidermis (Outer Skin)

The epidermis is the outermost layer of the cutis. It is composed mainly of keratinocytes, cells that produce the protein keratin and continuously migrate outward, eventually dying and forming the surface layer. The outermost part of the epidermis, the stratum corneum (horny layer), acts as a critical barrier against environmental damage, pathogens, and water loss. The epidermis also contains melanocytes, which produce the pigment melanin responsible for skin colour, as well as immune cells called Langerhans cells.

Dermis (Inner Skin)

The dermis lies beneath the epidermis and consists of a dense network of collagen and elastin fibres, providing the skin with its strength and elasticity. The dermis also contains:

Blood vessels and lymphatic vessels
Nerve endings and sensory receptors
Hair follicles
Sebaceous glands and sweat glands

Subcutis (Subcutaneous Tissue)

The subcutis is the deepest layer, consisting mainly of adipose (fat) tissue. It provides thermal insulation, serves as an energy reserve, and acts as a mechanical cushion protecting underlying muscles, bones, and organs.

Functions of the Cutis

The cutis performs a wide range of vital functions:

Protection: Barrier against mechanical forces, UV radiation, pathogens, and chemical substances
Thermoregulation: Body temperature is regulated through sweating and changes in blood flow
Sensory perception: Detection of touch, pain, pressure, and temperature
Immune defence: Specialised immune cells in the skin help protect against infection
Vitamin D synthesis: UV radiation triggers the production of vitamin D in the skin
Excretion: Small amounts of metabolic waste products are excreted via sweat

Diseases of the Cutis

Dermatology is the medical speciality dedicated to the diagnosis and treatment of skin diseases. Common conditions affecting the cutis include:

Dermatitis / Eczema: Inflammatory skin reaction characterised by redness, itching, and blistering
Psoriasis: A chronic inflammatory condition with accelerated epidermal cell turnover, causing scaling
Acne: A condition affecting the sebaceous glands and hair follicles
Melanoma: A malignant skin tumour originating from melanocytes
Urticaria (Hives): Allergic or non-allergic skin reaction producing raised welts and itching

Clinical Relevance

Changes in the cutis, such as discolouration, swelling, rashes, or wounds, can indicate local skin conditions or be symptoms of systemic diseases such as liver disease, diabetes, or autoimmune disorders. A thorough examination of the cutis is therefore an essential component of clinical diagnosis.

References

Moll, I. (Ed.): Dermatologie. 8th Edition, Thieme Verlag, Stuttgart, 2016.
Kang, S. et al.: Fitzpatrick's Dermatology. 9th Edition, McGraw-Hill Education, 2019.
World Health Organization (WHO): Skin Diseases. Available at: https://www.who.int (accessed 2024).

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