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Anatomy and Physiology of the Skin

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Melanoma

Abstract

The human skin is organized into three primary layers: epidermis, dermis, and the subcutaneous fat residing directly beneath them. Most germane to melanoma is the melanocyte, a specialized pigment-producing cell which transfers melanin from cellular cytoplasm to keratinocytes. This pigment is responsible for both skin color and protection from ultraviolet radiation (UVR). Exposure to particular wavelengths of UVR may result in DNA damage through a variety of mechanisms, which, in turn, predisposes to cutaneous malignancies such as melanoma. The development, invasion, and spread of melanoma are largely dependent on the interaction of melanocytes and their surrounding microenvironment. Melanocytes promote their own growth and survival by secreting growth factors. Keratinocytes are the main regulators of melanocytes, while surrounding fibroblasts become associated with melanocytes and promote their proliferation. Integrin proteins in the microenvironment mediate cytoskeleton adhesion to the extracellular matrix, which contributes to melanocyte migration and invasion. Melanoma tumors tend to invade lymphatic vessels and involve regional lymph nodes early in their course. Metastasizing through blood vessels may also be possible, but is less common and leads to an overall worse prognosis. Therefore, there is a great emphasis placed upon the early detection and removal of involved lymph nodes in melanoma management. Melanocytic nevi, nonmalignant nests of melanocytes, are classified as either dysplastic or common. Nevi that appear clinically suspicious for malignancy based on certain criteria are called atypical nevi, while those which bear histopathological resemblance to melanoma are termed dysplastic nevi. Whether dysplastic or common nevi carry greater proportionate risk for malignancy is uncertain.

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Authors and Affiliations

  1. School of Medicine, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Amir Dehdashtian M.D., M.P.H.

  2. Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, NY, USA

    Thomas P. Stringer M.D., M.S.

  3. Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA

    Abby Joan Warren M.D. & Bardia Amirlak M.D., F.A.C.S.

  4. Ronald O. Perelman Department of Dermatology, NYU Langone Medical Center, New York, NY, USA

    Euphemia W. Mu M.D. & Ladan Shahabi M.D., F.A.A.D.

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  1. Amir Dehdashtian M.D., M.P.H.
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  2. Thomas P. Stringer M.D., M.S.
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  3. Abby Joan Warren M.D.
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  5. Bardia Amirlak M.D., F.A.C.S.
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Correspondence to Bardia Amirlak M.D., F.A.C.S. .

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  1. Louisiana State University, New Orleans, Louisiana, USA

    Adam I. Riker

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Dehdashtian, A., Stringer, T.P., Warren, A.J., Mu, E.W., Amirlak, B., Shahabi, L. (2018). Anatomy and Physiology of the Skin. In: Riker, A. (eds) Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-78310-9_2

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