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Skin Appendages - Hair, Nails and Glands

Skin appendages are specialized structures of the skin, including hair, nails, and glands. They perform essential protective and regulatory functions in the human body.

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Things worth knowing about "Skin appendages"

Skin appendages are specialized structures of the skin, including hair, nails, and glands. They perform essential protective and regulatory functions in the human body.

What are skin appendages?

Skin appendages (also called cutaneous appendages or skin adnexa) are all specialized structures that arise from the skin and are closely associated with it. These include hair, nails, and various glands. They develop during embryonic development from the outermost layer of the skin, the epidermis, and serve a wide range of functions throughout life, including protection, regulation, and sensory perception.

Overview of skin appendages

Hair (Pili)

Hair consists of thread-like keratinized structures that grow from hair follicles located in the dermis. The visible portion is the hair shaft, while the part anchored within the tissue is called the hair root. Hair serves several important functions:

Protection against mechanical stress and UV radiation (e.g., scalp hair)
Thermoregulation through erection of hair shafts (piloerection)
Tactile sensory perception via receptors surrounding hair follicles
Social and communicative roles (e.g., eyelashes, body hair)

Nails (Ungues)

Nails are hard plates of keratin located on the dorsal surface of the fingertips and toes. They protect the sensitive fingertips, aid in fine motor grasping, and can serve as clinical indicators of systemic disease (e.g., clubbing in pulmonary conditions, koilonychia in iron deficiency anemia).

Sebaceous glands (Glandulae sebaceae)

Sebaceous glands are small glands in the dermis that typically open into hair follicles. They produce sebum, a mixture of lipids, waxes, and cell debris. Sebum plays an important role in:

Moisturizing and lubricating skin and hair
Forming the hydrolipid film that prevents excessive water loss
Providing antimicrobial protection through the slightly acidic pH of the skin surface

Overproduction of sebum is a key factor in the development of acne vulgaris.

Sweat glands (Glandulae sudoriferae)

There are two main types of sweat glands:

Eccrine sweat glands: Distributed across the entire body surface, these glands produce a watery sweat primarily used for thermoregulation through evaporative cooling.
Apocrine sweat glands: Found mainly in the axillae, groin, and genital region, these glands produce a thicker secretion that, when metabolized by skin bacteria, results in body odor.

Mammary glands (Glandulae mammariae)

Mammary glands are also classified as skin appendages. They are specialized apocrine glands responsible for producing breast milk for the nourishment of infants. Their activity is regulated by hormones such as prolactin and oxytocin.

Clinical relevance

Diseases affecting the skin appendages are among the most common conditions in dermatology. Important examples include:

Acne vulgaris: Inflammation of sebaceous glands and hair follicles
Alopecia: Hair loss caused by genetic, hormonal, or autoimmune factors
Onychomycosis: Fungal infection of the nails
Hyperhidrosis: Excessive sweating caused by overactive sweat glands
Hidradenitis suppurativa: Chronic inflammatory disease of the apocrine sweat glands

Diagnosis and examination

Assessment of skin appendages is a core part of the dermatological examination. Common diagnostic methods include:

Dermoscopy: Magnified visual examination of hair, nails, and skin lesions
Trichoscopy: Specialized examination of hair and scalp
Biopsy: Tissue sampling for histological analysis
Mycological swab: Detection of fungal infections in nails or hair

References

Moll, I. (Ed.) - Dermatologie, 8th edition, Thieme Verlag, Stuttgart 2016.
Fritsch, P. - Dermatologie und Venerologie, 2nd edition, Springer Medizin Verlag, Heidelberg 2004.
World Health Organization (WHO) - Skin diseases and conditions. Available at: https://www.who.int (accessed 2024).

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