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The skin is divided into epidermis, dermis, and hypodermis, the skin's outermost, middle, and inner layers. The human epidermal layer regularly undergoes renewal, where old, dead cells are replaced by new cells. Epidermal stem cells or EpiSCs divide and differentiate to restore the lost cells. For the renewal process, some EpiSCs continuously self-renew. In contrast, few others differentiate into transit-amplifying cells, which later form prickle or spinous cells, followed by granular...
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The dermis might be considered the "core" of the integumentary system, as distinct from the epidermis and hypodermis. It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that comprise an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts.
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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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The papillary and reticular dermis are the two layers of the dermis. They are made of connective tissue with fibers of collagen extending from one to the other, making the border between the two somewhat indistinct. The dermal papillae extending into the epidermis belong to the papillary layer, whereas the dense collagen fiber bundles below belong to the reticular layer.
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Acne is a multifactorial skin condition primarily affecting adolescents and young adults, with a global prevalence estimated to exceed 75% in this demographic. The condition is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and, in severe cases, cysts, particularly in areas rich in sebaceous glands such as the face, neck, chest, and back. The pathogenesis involves increased sebum production, follicular hyperkeratinization, colonization by...
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The epidermis, the outermost layer of the skin, is composed of several distinct layers. From deep to superficial, the layers of the epidermis are as follows:
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Updated: Apr 7, 2026

Resolving Water, Proteins, and Lipids from In Vivo Confocal Raman Spectra of Stratum Corneum through a Chemometric Approach
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Defining intrinsic vs. extrinsic atopic dermatitis.

Chante Karimkhani1, Jonathan I Silverberg, Robert P Dellavalle

  • 1Columbia University College of Physicians and Surgeons.

Dermatology Online Journal
|July 10, 2015
PubMed
Summary

Atopic dermatitis (AD) is a chronic inflammatory skin condition. The distinction between extrinsic AD (with elevated IgE) and intrinsic AD (without elevated IgE) is controversial but widely used.

Area of Science:

  • Dermatology
  • Immunology
  • Allergology

Background:

  • Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease.
  • AD presents with eczematous lesions, often linked to elevated immunoglobulin E (IgE) and other atopic conditions like asthma and allergies.
  • The classification of AD into extrinsic (with elevated IgE/atopy) and intrinsic (without) forms is common but debated.

Purpose of the Study:

  • To review the distinction between intrinsic and extrinsic atopic dermatitis.
  • To discuss the clinical relevance and controversy surrounding this classification.

Main Methods:

  • Literature review of historical and current research on atopic dermatitis classification.
  • Analysis of the application of the intrinsic/extrinsic dichotomy in AD.

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Main Results:

  • The extrinsic/intrinsic classification, originating from asthma research, is frequently applied to AD.
  • This classification is based on the presence or absence of elevated IgE and associated atopic diseases.
  • Despite its widespread use, the validity and clinical utility of this distinction in AD remain subjects of ongoing debate.

Conclusions:

  • The intrinsic versus extrinsic classification of atopic dermatitis is a widely recognized but controversial concept.
  • Further research is needed to clarify the clinical significance and biological basis of this distinction in AD management.