skin and nails

Leather and nails: a complex guide for health, beauty and care

I. Anatomy and skin physiology

A. Skin layers:

The skin, the largest organ of the human body, performs critical functions, including protection, temperature regulation, sensory perception and synthesis of vitamin D. It consists of three main layers: epidermis, dermis and hypoderma.

1. Epidermis: The outer layer, the epidermis, is a protective barrier that prevents the penetration of pathogens, ultraviolet (UV) radiation and moisture loss. It consists of several layers of cells called keratinocytes, which gradually ripen and migrate to the surface, becoming flat, keratinized cells forming the cornea layer. Other types of cells present in the epidermis include melanocytes (producing melanin, pigment that protects from UV radiation), Langerganes cells (immune cells) and Merkel cells (sensitive to touch).

   • The horn layer (Stratum corneum): The most outer layer of the epidermis, consisting of flat, dead keratinocytes called corneocytes. These cells are rich in keratin, a protein that provides structural strength and water resistance. The stratum layer constantly exfoliates, replacing with new cells from the lower layers.
   • Layers of the epidermis (from deep to superficial): Basal layer (Stratum Basale), a sewthly layer (Stratum spinosum), granular layer (Stratum granulosum), shiny layer (Stratum lucidum) (is present only in thick skin, for example, on the palms and soles of the legs), the mouth of the stratum (stratum Corneum).
   • Keratinotsite: The dominant type of cells in the epidermis responsible for the synthesis of keratin. The process of keratinization (the formation of keratin) begins in the basal layer and continues as the cells migrate to the surface.
   • Melanocytes: They are located in the basal layer, melanocytes produce melanin, a pigment that absorbs UV radiation and protects the DNA of skin cells from damage. The amount of melanocytes is approximately the same in different people, but the amount of melanin produced varies, determining the color of the skin.
   • Langerganes cells: Immune cells located in the epidermis that detect and capture antigens (foreign substances) and represent them of the immune system, launching the immune response.
   • Merkel cells: Specialized cells located in the basal layer associated with the nerve endings and participating in the feeling of light touch.

2. Dermis: Located under the epidermis, the dermis is a thicker and more complex layer consisting of connective tissue containing collagen, elastin and the main substance. Derma provides strength, elasticity and skin support. It contains blood vessels, nerve endings, hair follicles, sebaceous glands and sweat glands.

   • Connective tissue: The main component of the dermis, consisting of collagen and elastin. Collagen provides tensile strength and structure, and elastin provides elasticity and the ability of the skin to return to its original form after stretching.
   • Blood vessels: Provide the skin with nutrients and oxygen, and also help adjust the body temperature.
   • Nervous endings: Find the touch, pressure, temperature and pain. Different types of nerve endings specialize in the detection of various types of stimuli.
   • Hair follicles: Structures in the dermis from which the hair grows. Each hair follicle is associated with the sebaceous gland and a muscle that lifts the hair.
   • Sebaceous glands: Select skin fat, an oily substance that lubricates the skin and hair, prevents dryness and has antibacterial properties.
   • Sweat glands: Sweat that helps adjust the body temperature by means of evaporative cooling. There are two types of sweat glands: eccrine glands (located throughout the body and release watery sweat) and apocrine glands (located in axillary depressions and groin and release thicker sweat, which can cause the smell of the body).
   • Two layers of dermis: The papillary layer (the upper layer containing the papillae, which go into the epidermis) and the mesh layer (a thicker, deeper layer containing dense irrelevant tissue).

3. Hypoderm (support): The deepest layer of the skin located under the dermis. The hypoderma consists mainly of adipose tissue (fat), which isolates the body, accumulates energy and provides shock absorption. It also contains blood vessels and nerves.

   • Fat tissue (fat): Consists of adipocytes (fat cells) that accumulate triglycerides (fats). Fatty tissue provides insulation, depreciation and storage of energy.
   • Blood vessels and nerves: Pass through the hypoderm to supply the skin and underlying tissues.

B. skin functions:

The skin performs many important functions necessary for health and survival.

1. Protection: The skin acts as a physical barrier that protects the body from external threats, such as pathogens, UV radiation, chemicals and mechanical damage.

   • Physical barrier: The cornea layer of the epidermis provides a physical barrier that prevents the penetration of microorganisms and harmful substances.
   • Ugh-protection: Melanocytes, melanocytes, absorbs UV radiation, protecting the DNA of skin cells from damage.
   • Immune defense: Langerganes cells in the epidermis and other immune cells in the dermis detect and neutralize pathogens, preventing infections.
   • Waterproof barrier: The lipids in the stratum corneum and the skin is secreted by the sebaceous glands form a waterproof barrier that prevents water loss and dehydration.

2. Temperature regulation: The skin plays a decisive role in the regulation of body temperature by means of sweating and regulating blood flow.

   • Sweating: When the body temperature rises, the sweat glands release sweat that evaporates from the surface of the skin, cooling the body.
   • Bloody regulation: The blood vessels in the dermis are narrowed (narrowed) in cold conditions to maintain heat, and expand (expand) in hot conditions to dissipate heat.

3. Sensory perception: The skin contains various nerve endings that allow us to feel touch, pressure, temperature, pain and itching.

   • Mechanoreceptors: Discover touch and pressure. Examples include Meisner Taurus (sensitive to easy touch) and Pacini Taurus (sensitive to deep pressure and vibration).
   • Thermoreceptors: Temperature changes are found. There are separate thermoreceptors for detecting heat and cold.
   • Nociceptors: Discovered pain. These nerve endings are activated by harmful stimuli, such as heat, cold, pressure or chemicals.
   • Itching receptors: Detect itching. It is believed that itching is caused by the release of certain chemicals, such as histamine.

4. Vitamin D: When the skin is exposed to UV radiation, it synthesizes vitamin D, which is necessary for the health of bones, immune function and other processes.

   • UV exposure: UV radiation (in particular, UFV radiation) is necessary for the synthesis of vitamin D in the skin.
   • Transformation: UV radiation transforms 7-decodrocholesterol into the skin into pre-evitamine D3, which is then converted into vitamin D3 (cholecalciferol).
   • Activation: Vitamin D3 is transferred to the liver and kidneys, where it is activated in its active form, calcitriol.

5. Display: The skin can withdraw a small amount of waste, such as salt and urea, through sweat.

   • Sweat: Pot contains water, electrolytes (salt), urea and other waste.
   • Minimum withdrawal: The amount of waste withdrawn through the sweat is relatively small compared to excretion through the kidneys and other organs.

C. skin types:

The type of skin is determined by genetics, the environment and lifestyle. Typically, four main types of skin are distinguished: normal, dry, oily and combined.

1. Normal skin: Balanced skin, not too dry and not too oily. It has small pores, smooth texture and good blood circulation.

   • Features: Small pores, smooth texture, good blood circulation, rare rashes, balanced production of sebum.

2. Dry skin: It produces less sebum than normal skin. It can be tight, peeling and itching. More prone to the formation of wrinkles and thin lines.

   • Features: Small pores, tightness, peeling, itching, dull appearance, increased visibility of wrinkles and thin lines.
   • Factors: Genetics, environmental factors (cold weather, low humidity), aggressive soap and detergents, aging.

3. Burnic leather: It produces more skin fat than normal skin. It can be brilliant, have great pores and be prone to the formation of acne and black dots.

   • Features: Large pores, shine, acne, black dots, white acne.
   • Factors: Genetics, hormonal changes, humidity, the use of certain cosmetics.

4. Combined skin: It has areas of both dry and oily skin. Usually fat in the T-zone (forehead, nose and chin) and dry on the cheeks.

   • Features: Fat T-zone (forehead, nose and chin), dry or normal cheeks, large pores in the T-zone, acne and black dots in the T-zone.

II. Skin diseases

There are many skin diseases, from lungs to severe. Some of the most common skin diseases include:

A. Acne (acne):

Acne is a common skin disease that occurs when hair follicles are clogged with skin fat and dead skin cells. This can lead to acne, black dots, white acne and cysts.

1. Reasons:

   • Excessive production of sebum: Hormonal changes, genetics and some drugs can contribute to the excessive production of sebum.
   • Clogging of the hair follicles: Called skin cells can accumulate in hair follicles, scoring them.
   • Bacteria (Propionibacterium acnes): P. Acnes is a bacterium that usually lives on the skin. When the hair follicles clog, P. acnes can multiply and cause inflammation.
   • Inflammation: Inflammation plays an important role in the development of acne.

2. Types of acne:

   • White acne (closed comedones): Small, white cones that appear under the skin.
   • Black dots (open comedones): Acne with a dark surface that appear on the skin. The dark color is caused by the oxidation of sebum, not mud.
   • Papules: Small, red, inflamed cones.
   • Pustules: Cones filled with pus.
   • Nodes: Large, hard, painful cones that are deep under the skin.
   • Cysts: Large cones filled with pus, which are deep under the skin and can be painful.

3. Treatment:

   • Local funds: Creams, lotions and gels containing benzoilexide, salicylic acid, retinoids or antibiotics.
   • Oral drugs: Antibiotics, contraceptive tablets (for women), isotretinoin (Accutane).
   • Procedures: Chemical peeling, microdermabrase, laser treatment, light therapy.

B. eczema (atopic dermatitis):

Eczema is a chronic inflammatory skin disease that causes itching, dryness, redness and rashes.

1. Reasons:

   • Genetics: Eczema is often inherited.
   • Violation of the barrier function of the skin: People with eczema often have impaired barrier function of the skin, which allows irritants and allergens to easily penetrate the skin.
   • Immune dysfunction: The immune system in people with eczema can react excessively to irritants and allergens, causing inflammation.
   • Environmental factors: Irritants (soap, detergents, wool), allergens (pollen, dust mites, animal dandruff), stress and weather (cold, dry weather) can cause exacerbations of eczema.

2. Symptoms:

   • Quickly: The main symptom of eczema.
   • Dry skin: The skin is often dry, peeling and cracked.
   • Redness: The skin can be red and inflamed.
   • Rashes: Small blisters filled with liquid may appear, which burst and are covered with a crust.
   • Skin thickening (lichenification): Chronic combing can lead to thickening of the skin.

3. Treatment:

   • Moisturizing agents: Regular use of moisturizers helps restore the barrier function of the skin and prevent dryness.
   • Local corticosteroids: Creams and ointments with corticosteroids reduce inflammation and itching.
   • Local immunomodulators (calcinevin inhibitors): Creams and ointments containing tacrolimus or pimecrolymus suppress the immune response and reduce inflammation.
   • Oral drugs: Antihistamines (to reduce itching), corticosteroids (for the treatment of severe exacerbations), immunosuppressants.
   • Phototherapy: The effect of UV radiation can help reduce inflammation.
   • Swimming with a bleach: The diluted solution of the bleach in water can help reduce the amount of bacteria on the skin and prevent infections.

C. Psoriasis:

Psoriasis is a chronic autoimmune skin disease, which causes the rapid reproduction of skin cells. This leads to the formation of thick, red, flaky spots called plaques.

1. Reasons:

   • Autoimmune reaction: The immune system mistakenly attacks healthy skin cells, causing accelerated cell reproduction.
   • Genetics: Psoriasis is often inherited.
   • Environmental factors: Stress, infections, skin injuries and some drugs can cause exacerbations of psoriasis.

2. Symptoms:

   • Plaques: Thick, red, flaky skin spots.
   • Quickly: Plains can cause itching, pain and burning.
   • Dry skin: The skin can be dry and cracked.
   • Changes in nails: Nails can become thick, pitcinated and bleached.
   • Joint pain (psoriatic arthritis): Some people with psoriasis also develop psoriatic arthritis, which causes pain, stiffness and edema of the joints.

3. Types of psoriasis:

   • Plush -shaped psoriasis: The most common type of psoriasis, characterized by plaques.
   • Genital psoriasis: It is characterized by small, hawsty rashes.
   • Inverse psoriasis: It affects skin folds, such as axillary hollows, groin and area under the chest.
   • Pustulent psoriasis: It is characterized by blisters filled with pus.
   • Erytrodermic psoriasis: The severe form of psoriasis, which affects most of the surface of the body.

4. Treatment:

   • Local funds: Corticosteroids, analogues of vitamin D, retinoids, calcineine inhibitors.
   • Phototherapy: UFV radiation, PUVA (PRARALEL PLUS Ufa).
   • Oral drugs: Methotrexate, cyclosporin, acytritis.
   • Biological drugs: Fon-alpha inhibitors (adalimumab, etorenercept, infliximab), interleukin inhibitors (Ustekinumab, second-ookinumab, xekyzumab, goseelkumab).

D. Rozacea:

Rosacea is a chronic skin disease that causes redness, redness of the face, visible blood vessels and acne.

1. Reasons:

   • Unknown: The exact cause of Rosacea is unknown, but it is believed that it is associated with genetics, environmental factors and vascular dysfunction.
   • Environmental factors: The sun, wind, cold weather, hot drinks, spicy foods, alcohol and stress can cause exacerbations of rosacea.
   • Demodex pliers: Demodex ticks are microscopic ticks that usually live on the skin. People with Rosacea can have more Demodex ticks than usual.

2. Symptoms:

   • Redness of the face: Constant redness of the face.
   • Visible blood vessels (telangiectasia): Small, visible blood vessels on the face.
   • Acne: Acne, similar to acne.
   • Thickening of the skin of the nose (Rinophym): Thickening of the skin of the nose, which is less common.
   • Eye irritation (ocular rosacea): Dry, redness and burning in the eyes.

3. Types of rosacea:

   • Erythematotelangiectatic rosacea: It is characterized by redness of the face and visible blood vessels.
   • Papulopologynaya rosacea: It is characterized by redness of the face, acne and pustules.
   • Rinophymatous rosacea: It is characterized by a thickening of the skin of the nose.
   • Occupational rosacea: It affects the eyes, causing dryness, redness and burning.

4. Treatment:

   • Local funds: Metronidazole, azelainic acid, brimonidine.
   • Oral drugs: Antibiotics (tetracycline, doxycycline, minocycline), isotretinoin (Accutane).
   • Laser treatment: Laser therapy can be used to reduce redness and visible blood vessels.

E. Dermatit:

Dermatitis is a general term used to describe skin inflammation. There are several different types of dermatitis, including:

1. Contact dermatitis:

   • Reasons: It occurs when the skin contacts with the irritant (irritating contact dermatitis) or allergen (allergic contact dermatitis).
   • Symptoms: Itching, redness, swelling, blisters and peeling.
   • Treatment: Avoid irritant or allergen, local corticosteroids, moisturizing agents.

2. Seborrheic dermatitis:

   • Reasons: Chronic inflammatory skin disease, which affects areas with a large number of sebaceous glands, such as scalp, face and chest. It is believed that malassezia fungus plays a role in the occurrence of seborrheic dermatitis.
   • Symptoms: Flying, fat spots on the scalp (dandruff), face and chest.
   • Treatment: Therapeutic shampoos (containing ketoconazole, selenium sulfide, zinc pyrithion), local corticosteroids, antifungal creams.

3. Neurodermatitis (simple chronic lichen):

   • Reasons: It occurs due to chronic combing or skin friction.
   • Symptoms: Thick, itchy, crust spots on the skin.
   • Treatment: Stop combing, local corticosteroids moisturizing.

F. skin infections:

Skin infections can be caused by bacteria, viruses or fungi.

1. Bacterial infections:

   • Impetigo: Highly contracted bacterial skin infection, which usually affects children. It is caused by staphylococcus aureus or Streptococcus pyogenes.
   • Cellulite: The bacterial infection of the deep layers of the skin and underlying tissues.
   • Boils and carbuncles: The boils are painful, filled with pus of cones that occur around the hair follicles. Carbuncles are groups of boils connected under the skin.
   • Treatment: Antibiotics (local or oral).

2. Viral infections:

   • Simple herpes (Herpes Simplex Virus): Calls herpes (bubbles around the mouth) and genital herpes.
   • Disgusting lichen (Herpes Zoster): It is caused by the Varicella-Zoster Virus virus and causes a painful rash with blisters.
   • Warts (Human Papillomavirus): They are caused by human papillomans (HPV) and cause education on the skin.
   • Treatment: Antiviral drugs, treatment to relieve symptoms.

3. Fungal infections:

   • Raging Lichen (Tinea): The fungal infection of the skin, hair and nails.
   • Candida (Candida): The fungal infection caused by the fungus Candida albicans. It can affect the skin, mouth (thrush), vagina (vaginal candidiasis) and other parts of the body.
   • Multi -colored lichen (Pityriasis Versicolor): The fungal infection of the skin, which causes small, bleached spots on the skin.
   • Treatment: Antifungal drugs (local or oral).

G. Cancer Leather:

Skin cancer is the most common type of cancer. There are several different types of skin cancer, including:

1. Basal cell carcinoma (BKK): The most common type of skin cancer. Usually develops in areas of skin exposed to the sun, such as the face, head and neck. It grows slowly and rarely metastasizes.

2. Flat cell carcinoma (PKK): The second most common type of skin cancer. It also usually develops in areas of the skin exposed to the sun. It can be metastasized if not treated.

3. Melanoma: The most dangerous type of skin cancer. It can develop from existing moles or appear as a new spot on the skin. It can quickly metastasize and be deadly.

4. Risk factors:

   • Impact of UV radiation: The sun, solariums.
   • Bright leather: People with fair skin are more at risk of developing skin cancer.
   • Family history: Family history of skin cancer increases risk.
   • Immunosuppression: People with a weakened immune system are more at risk of developing skin cancer.
   • Previous skin cancer: People who have already had skin cancer are more at risk of developing new skin cancer.

5. Prevention:

   • Avoid the effects of the sun: Limit the time of stay in the sun, especially in peak hours (from 10:00 to 16:00).
   • Use sunscreen: Apply sunscreen with SPF 30 or higher to all open areas of the skin.
   • Wear protective clothes: Wear a wide -brimmed hat, sunglasses and clothes with long sleeves.
   • Avoid solariums: Solariums distinguish UV radiation, which can damage the skin and increase the risk of skin cancer.
   • Inspect the skin regularly: Regularly inspect your skin on the presence of new or changing moles or spots.

6. Treatment:

   • Surgical removal: Removing skin cancer surgically.
   • Cryosurgery: Freezing skin cancer with liquid nitrogen.
   • Radiation therapy: Using radiation to destroy cancer cells.
   • Chemotherapy: Using drugs to destroy cancer cells.
   • Target therapy: The use of drugs that are aimed at certain molecules involved in the growth of cancer cells.
   • Immunotherapy: The use of drugs to stimulate the immune system to combat cancer.

III. Anatomy and physiology of nails

A. The structure of the nail:

Nails are protective structures located at the tips of the fingers and legs. They consist of keratin, solid protein, which is also the main component of hair and skin.

1. Nail plate: The visible part of the nail. It consists of layers of dead, keratinized cells.

   • Free land: Part of the nail plate that protrudes the tip of the finger.
   • The body of the nail: The main part of the nail plate, which is attached to the nail bed.
   • Nail root: Part of the nail plate, which is under the skin at the base of the nail.

2. Nail bed: The skin under the nail plate. It is rich in blood vessels and nerves.

3. Nail roller: The skin that surrounds the nail plate.

   • Proximal nail roller: The skin roller at the base of the nail.
   • Side nail rollers: Roliks of the skin on the sides of the nail.

4. Cuticle: The thin layer of the skin, which seals the space between the nail roller and the nail plate. It helps to protect the nail bed from infection.

5. Lunked: White, semicircular region at the base of the nail. This is the visible part of the matrix of the nail.

6. Feet matrix: The area under the proximal nail roller, where new nail cells are formed.

B. Rost Nogtey:

Nails grow continuously from the matrix of the nail. New cells of the nail push old cells to the surface, forming a nail plate.

1. Growth speed: The nails in the hands grow faster than the nails on the legs. On average, the nails on the hands grow about 3 mm per month, and the nails on the legs are about 1 mm per month.
2. Factors affecting growth: Age, nutrition, health and injuries can affect the growth rate of nails.

C. Nail functions:

1. Protection: Nails protect the tips of the fingers and legs from damage.
2. Improving sensory sensitivity: Nails help improve the sensory sensitivity of the fingers and legs.
3. Assistance in manipulating: Nails help in manipulating small objects.

IV. Nail diseases

There are many diseases of the nails, from lungs to severe. Some of the most common nail diseases include:

A. Onihomycosis (fungal nail infection):

Onychomycosis is a fungal infection of nails, which causes thickening, bleaching and deformation of nails.

1. Reasons: It is caused by fungi dermatophytes, yeast or mold.

2. Risk factors: Age, diabetes, diseases of peripheral vessels, nail injury, sweating of the legs, wearing cramped shoes.

3. Symptoms:

   • Thickening of the nail: The nail can become thicker than usual.
   • Outcooding of the nail: The nail can become yellow, brown or white.
   • Nail deformation: The nail can become brittle, crumbling or deformed.
   • Failure separation from the nail bed (onycholysis): The nail can separate from the nail bed.

4. Treatment:

   • Local antifungal agents: Nail varnishes containing amorolfin, cyclopyrox or ethenaconazole.
   • Octus antifungal agents: Terbinafine, itraconazole, fluconazole.
   • Removing the nail: In severe cases, surgical removal of the nail may be required.
   • Laser treatment: Laser treatment can be effective for the treatment of onychomycosis.

B. The ingrown nail:

An ingrown nail occurs when the edge of the nail grows into the skin of a nail roller.

1. Reasons: Incorrect cutting of nails, wearing tight shoes, nail injury, heredity.

2. Symptoms: Pain, redness, swelling and inflammation around the nail. In severe cases, an infection may develop.

3. Treatment:

   • Home care: Soaking the legs in warm water, laying