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Melanoma pp 15-26 | Cite as

Anatomy and Physiology of the Skin

  • Amir Dehdashtian
  • Thomas P. Stringer
  • Abby Joan Warren
  • Euphemia W. Mu
  • Bardia Amirlak
  • Ladan Shahabi
Chapter

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.

Keywords

Melanoma Microenvironment Invasion Vascular Metastasis Nevus Metastasis Lymphatic Atypical Dysplastic 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Amir Dehdashtian
    • 1
  • Thomas P. Stringer
    • 2
  • Abby Joan Warren
    • 3
  • Euphemia W. Mu
    • 4
  • Bardia Amirlak
    • 3
  • Ladan Shahabi
    • 4
  1. 1.School of Medicine, School of Public HealthTehran University of Medical SciencesTehranIran
  2. 2.Ronald O. Perelman Department of DermatologyNYU School of MedicineNew YorkUSA
  3. 3.Department of Plastic SurgeryUT Southwestern Medical CenterDallasUSA
  4. 4.Ronald O. Perelman Department of DermatologyNYU Langone Medical CenterNew YorkUSA

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