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Normal gross morphology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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There are a variety of variants of normal skin structure e.g. with site on body, race, age, etc. which should be considered during examination:

  • colour: varies with melanocyte density, concentration of pigment, blood flow etc.
  • thickness: thick skin e.g. upper portion of back; different from the histological definition of thick skin based on epidermal thickness
  • density of hairs per unit surface area: certain areas are hairless e.g. palmar surface of hand and plantar surface of foot
  • distribution of hairs: difference between the sexes, dependent on hormonal exposure and response
  • skin creases:
    • joint creases: where skin is more adherent to deeper tissue
    • wrinkle lines: caused by muscle contraction deep to skin and perpendicular to the long axis of the muscle
    • contour lines: lines demarcating the junction of body planes e.g. the nasolabial fold
    • lines of dependency: due to the effect of gravity on loose skin and fatty tissue with age e.g. the folds delimiting facial jowls
    • cleavage lines: Langer's lines following the path of subcutaneous fibrous bundles
  • existing scars: stage of repair, hypertrophic or keloid
  • blood supply: colour, temperature, capillary refill
  • dermal ridges: 'fingerprints'; role in gripping and texture recognition
  • sweat glands: density and activity
  • sebaceous glands: density and activity
  • innervation: sensitivity to a given stimulus and variation across the body e.g. two-point discrimination tests for fine touch

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