Normal Skin Histology - Explained by a Dermatopathologist

Topics discussed:

Epidermis:
Layers of epidermis: 0:10
Melanocytes vs Keratinocytes: 5:16
Langerhans cells: 10:10 & 33:30 & 57:30

Dermis:
Papillary and reticular dermis: 11:50
Three types of white empty spaces on a slide: vessels, glands/ducts/cysts, or artifact: 15:25
Blood vessels & nerves: 18:24 & 48:50 & 58:59
Arrector pili & other dermal smooth muscle: 20:00

Adnexal:
Sebaceous gland: 21:10
Hair follicle 23:14
Eccrine sweat glands and ducts 24:45 & 50:00
Gland/duct vs blood vessel 27:20 & 48:50

Three types of pink bundles: smooth muscle, nerve, dense connective tissue: 27:50

Acral skin (palm sole) with contact dermatitis 29:37
Parakeratosis 30:00
Perivascular lymphocytes 30:40
Eosinophils vs neutrophils 31:20
Spongiosis with desmosome keratinocyte spines 32:10
Spongiotic vesicles with Langerhans cells 33:30
Normal acral skin (palm & sole) with stratum lucidum 34:20
Normal glomus body/apparatus (canal of Sucquet-Hoyer) 35:40
Nerve 36:46 & 51:50
Adipose tissue (white fat cells) in subcutis with Lochkern 37:55
Normal scalp skin with large anagen hair follicles: 39:30
Hair follicle anatomy (bulb/matrix, inner root sheath, outer root sheath, hair shaft, isthmus, infundibulum): 40:55 (labeled images):
Pacinian corpuscle 50:40
Meissner corpuscle 1:02:28

Dense regular connective tissue (Fascia/Tendon/Ligament) vs Smooth Muscle 53:00

Basic Normal Skin Immunohistochemistry:
-cytokeratin in epidermis: 55:33
-S100 in melanocytes and Langerhans cells and adipocytes: 57:30
-Desmin in smooth muscle (arrector pili and blood vessels): 58:59
-CD31 in endothelial cells of blood vessels: 59:33
-SOX-10 in melanocytes: 1:00:40

Digit/Finger/Toe histology (amputation for subungual acral melanoma) 1:04:10 & 1:08:30
-bone 1:05:40
-glomus body 1:05:15
-tendon/ligament 1:06:10
-artery 1:06:58
-fingernail/toenail 1:08:54
-acrosyringium 1:10:45

Solar elastosis (what wrinkles look like microscopically!) 1:11:50

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The basic normal structures of the skin discussed and described by a dermatopathologist. This material is intended for use by medical students, junior pathology or dermatology residents, or for anyone else studying normal human histology. Special thanks to two of my medical students at UAMS for helping make this video possible. Miki Lindsey convinced me that I really needed to sit down and record this video. Akash Patel took time to edit the video and make it ready for YouTube. My sincere thanks to both of them for helping me overcome procrastination.

Correction - I made a mistake in the video. I said that sebaceous gland secretions are turned into smelly substances by bacteria and that this makes body odor. That is incorrect. That is actually true of APOCRINE gland secretions not sebaceous secretions.

Also, in the past I used "keratinocyte" and "squamous cell" interchangeably (this is because in dermatopathology, we see and talk about squamous cell carcinomas all the time, and those tumors are composed of keratinocytes). But technically, in normal skin histology, "squamous cell" refers only to the flattened keratinocytes in the superficial epidermis. Thankfully, a histology PhD colleague pointed this out to me and corrected my lazy nomenclature!

This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.

Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.

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[fernandovet]

I am a professor of pathology in Brazil. I always watch your videos, because it is a mirror where I can try to level myself. You have a didactic talent, showing in a simple and direct way how it works and how our body is attacked. Congratulations.

[mariajoao]

I'm a medical student in Portugal and I could not be more grateful for your effort. It enabled me not just to learn some concepts that will be essential for my studies, but also allowed me to start liking this. It is amazing to learn all this material by listening to your explanations rather than reading a book and finding all this boring, when it is great fun. Thanks, Sir. 😊

[MCX-rzzz]

Dermatology Resident here, OMG I want to thank you so much for recording and uploading these videos. Better than my teachers, for sure :P

[grigonius]

I am a pathology resident and your videos really helped me. Thank you for the great lessons!

[robertmontgomery]

I'm a layman with nerdy hobbies like Microscopy. I have a Lomo Research Microscope circa 1960
that I've used to examine many tissue slides over the years and I loved your video.

I'm 76 years old and I just subscribed to your channel and watch more of your videos
in an effort to continue my education.

Thank you.

[izhakbar]

is there any chance you will make more videos like this? you are a natural gifted teacher. we would definitely appreciate videos in pathology ...
thanks for this one!

[myrtextonwang]

Thank you so much for making these videos. I appreciate it so I am a dermatology resident in Germany and this is so much better than most clinics teach their residents. I love these videos and will hopefully get through all of them step by step. Greetings from Germany <3

[juliemontgomery]

This is absolutely wonderful. I wish there were great videos like this for every organ and their major diseases. Thank you so much!!!

[missknowall]

Went through the whole video once again.
It is so packed with "pearls of wisdom" that every time I see it, I get something new out of it.

So thanks once again Dr Jerad Gardner.

[chrysastamou]

Mr. Gardner, I am really excited that I can finally attend your video! So happy to find that there are closed subtitles, it was very difficult for me to attend the video without subtitles because of my hearing impairment. Thus, I would like to thank you and the volunteer medical student Abigail Cline for the amazing work. Thank you very much!

[lajoswinkler]

Thank you for making this video. It's what a proper histology lesson should look like.

[riccardorondinone]

Thank you very much for your excellent videos. I am a senior dermatologist living in Italy and recently happened to read your book “survival guide to dermatopathology” that is in my opinion the very best introduction to this subject I had ever seen out there. I appreciate your teaching skill. You make a difficult subject easy to understand. Sincerely yours, Riccardo

[burhanemregurdal]

I am a Turkish medical student and i want to thank you for bringing this amazing video. Its really better than other videos, showing us whole content in a video directly from microscopic view is truely educational.

[nana-yaaab]

Thank you for this. I am a first year pathology trainee and I so appreciate you taking the time to go through what normal looks like. I find a lot of people skip what normal looks like and go straight to the pathology of whatever organ they are teaching on, which makes it difficult to recognise normal down the microscope

[ChapmanHistology]

Great job Jerad! You don't see glass slides being used for creating videos nowadays! This is old-school histology teaching and it's great to see.

[RandiF]

Hi Dr. Gardner! I am a sophomore in High School where I was selected to be in the Advanced Science Research Program. Over this course of this upcoming summer I will be conducting my own graduate-level dermatology research which will transpire to the next 3 years of my high school career. Your videos have taught me so much and vastly increased my background knowledge on dermatology which will surely help assist me through my research path. I have such a passion for dermatology and hope you keep making these videos!

[lubnasuaiti]

No words can describe my gratitude! I'm sure those lectures will help not only students but dermatologists all over the world. Thanks a million!

[nicolekraipowich]

I love this video. I hope that in the future you might make a video on the normal hair follicle anatomy, stages, how to differentiate different types of alopecia... I love your book too!Thanks for all you do

[NigerianArchitect]

wish i had the ability to spot a monocyte amidst all that mess, it's a talent

[juliosalamanca]

Thanks Jerad. I really appreciate your work a lot. I am a pathologist in Nicaragua.
I have seen many of your videos and for me they are truly invaluable for colleagues, Pathology residents and Medical students.