Abstract and Keywords
The skin and its associated specialisations together form the integumentary system, the barrier and sensory structure between the body and our environment. Human skin compared to other mammalian species has undergone significant and specialised evolutionary changes reflected in both development and mature structure. In development, the vernix caseosa protects the skin during prolonged uterine incubation. A lengthy childhood then leaves secondary sex characteristic development for many years, and the cyclic changes of female mammary glands have exposed some key cancer genes. In mature structure, we are comparatively ‘hairless’ and uniquely endowed with copious sweat glands for thermoregulation. The now-exposed skin needs to be protected from UV damage by melanocyte-sourced pigments that are both genetically and environmentally regulated; these cells are today a major cancer cell population. Conversely, we have evolved a UV requirement to generate key vitamin D precursors utilised in many different physiological systems. Evolutionary local modification of the skin, nails, and sensory receptors in the hands has supported fine grip and touch sensitivity. The patterning on the hand surface not only is a unique identification of an individual, but also may be diagnostically associated with some abnormalities. Therapeutically, we can replace damaged skin, have identified stem cells that hold great potential, and now interface with medical devices for monitoring and drug delivery. The future challenges for the skin, as a barrier, are changing environmental conditions, technology assistance and interaction, and how the many other unique functions are dynamically rebalanced in health and disease.
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