{{ANAT2341Project2014header}}
=Integumentary=
==Introduction==
This page concerns the development of the integumentary system in the fetal stage of development, particularly its organs i.e. the skin, glands, hair, teeth, and nails. It explores the mechanism of development as well as the timeline of development. This page also outlines some recent findings on the development of the integumentary system, as well as historic findings. Finally, this page also explores some of the congenital abnormalities of the integumentary system, its mechanism or pathogenesis, clinical manifestations, and how they are treated or managed.

==Development Overview==
===Skin===

The skin consists of 2 layers: the outer layer (epidermis) and a deeper connective tissue layer (dermis).
*The epidermis is derived from the ectoderm. Initially it exists as only a single layer of ectodermal cells at 7-8 days of gestation. However, by about 13-14 weeks after gestation, a 3- layered structure of fetal epidermis exists- consisting of the stratum basale, 1 or 2 intermediate layers and the periderm. The peridermal cells eventually become desquamated and form part of the vernix cervix.
** The 5 definitive layers of the adult skin are evident in the human fetus after 22-24 weeks of gestation. Indirect influences form the dermis help differentiate the epidermis into: stratum basale, stratum spinosium, stratum granulosum, stratum lucidum and stratum corneum.
*The somatic mesoderm is the embryonic origin of the dermis. The mesoderm of the dermatones of the body, also contribute to the development of the dermis. Specifically though, in the head and neck region of the body, the dermis is derived from neural crest cells.
** The dermis is initially composed of just mesenchymal cells- loosely aggregated mesodermal cells. These mesenchymal cells later develop into fibroblasts- which function to secrete collagen and lay-down elastic fibers into the extracellular matrix.

3 other specialised cells of the epidermis also exists- these include melanoblasts, Langherhan cells and Merkel cells.
*Melanoblasts- are derived from neural crest cells that have migrated into the stratum basale. Mid-pregnancy, melanosomes are observed, differentiating the melanoblasts into melanocytes
*Langheran cells- are derived from bone marrow (originally form mesoderm) and migrate into the epidermis. They have the function of antigen presentation.
*Merkel cells- still have an uncertain origin. They have a function related to mechanoreception.

{| style="width:60%; height:125px" border="1" align="center"
|-
! Week !! Description !! Phase Diagram
|-
| Week 6-8|| In an electron micrograph study of the epidermis, the periderm and and basal layer of the developing skin was observed. || [[Image:Human_embryo_skin_8-9_week_EGA.jpg|100x100px|Weeks 6-8]]
|-
| Week 7-9 || In an electron micrograph study of the epidermis at weeks 7-9 of development, the stratified three-layer structure of the epidermis was observed. Kertain filaments have been encircled. || [[Image:Human_embryo_skin_9-11_week_EGA.jpg|100x100px| Weeks 7-9]]
|-
| Week 14 || By week 14, the basal layer, the intermediate layer/s and the periderm 3-layered structure can be observed in the fetus. By week 14, K17 can also be found in the basal and intermediate layers of the epidermis (In adult skin, K17 was not observed) || [[Image:Fetal_integumentary_histology_14w.jpg|100x100px| Week 14]]
|-
| Week 16 || In a study, by week 16, developing blood vessels were observed. CD31 and a sub-type of smooth-muscle actin stained positive in these observed developing blood vessels. || [[Image:Inaugumentary_week16.jpg|100x100px| Week 16]]
|-
| Week 18 || Example || [[Image:542px-Fetal_integumentary_histology_18.jpg|100x100px| Week 18]]
|-
| Week 19 || In a study, by week 19, as opposed to week 14, K17 was found present in the basal, intermediate and periderm layers. K17 also stained positive in the developing hair follicles. || [[Image:Inaugumentary-_Week_19.jpg|100x100px| Week 19]]
|-
| Week 20 || By week 20, hair follicles can be already be seen in the epidermis. The total number of intermediate layers has also increased || [[Image:Fetal_integumentary_histology_20.jpg|100x100px|Week 20]]
|-
| Week 22 || In an electron micrograph study at week 22 of development, kertanised epidermis was analysed. It was observed that glycogen was abundantly present throughout all epidermal layers. The included arrows, highlight the keratin filament bundles, which are now organised and peripherally placed. || [[Image:Human_embryo_skin_24_week_EGA.jpg|100x100px| Week 22]]
|-
| Adult|| In adult skin- a greater diversity of cells can be seen as more cells differentiate. Basal, spinous, granular and cornified cells are all example of such. In another study, chondroitin sulphate was observed in the basement membrane zone of the adult epidermis. In the same study, chondroitin sulphate was only observed towards the upper-part of the dermis. Also, elastin was present in the adult specimens, but not in the earlier fetal samples. || [[Image:Fetal_integumentary_histology_Adult.jpg|100x100px| Adult]] [[Image:542px-Fetal_integumentary_histology_Adult.jpg|100x100px| Adult]]
|}

===Hair===
Hair originates from the ectoderm. At about 12 weeks, it is believed that specific signals from the dermis are released- signaling for the induction hair follicle formation <ref name= PMID1566372><pubmed>1566372</pubmed></ref><ref name= PMID20590427><pubmed>20590427</pubmed></ref>

{| style="width:75%" border="1" align="center" style="text-align:center"
|-
! Stage !! Description
|-
| Undifferentiated Epithelium || Through reciprocal interactions and ‘first dermal signaling’, cells from the stratum basale grow into the underlying dermis. The signaling pathway, however, has not been fully identified<ref name= PMID11841536><pubmed>11841536</pubmed></ref>
|-
| Placode || The ‘first dermal signals’ influence epithelial cells to develop a placode- a thickening of the columnar cells. It is theorised that varying intrinsic dermal signals lead to the expression of various placodes and consequently, the differences in the expression of hair thickness/size throughout the body<ref name= PMID10529418><pubmed>10529418</pubmed></ref>. The specific combination of promoter and repressor activators for hair development, is also theorised to characterise for the regional differences in eventual hair expression<ref name= PMID10431226><pubmed>10431226</pubmed></ref>
|-
| Germ || WNT Signalling is believed to have a role in the induction of the dermal condesate<ref name= PMID11841536><pubmed>11841536</pubmed></ref>. Platelet-derived growth factor-A molecules from the placode, also contributes to the induction of the dermal condensate. The development of the dermal condensate helps further induce the downward growth of the placode.
Through secreted proteins such as Sonic Hedgehog, the placode continues to proliferate and enclose the dermal condensate. This eventually forms a deep, club-shaped hair bud, with an invaginated dermal papillae <ref name= PMID11841536><pubmed>11841536</pubmed></ref>. These dermal papillae are rapidly infiltrated by blood vessels and nerve endings.
|-
| Peg || Sonic Hedgehog and the induction of a ‘secondary dermal signal’ (characterisation unknown) leads to a significant down-growth and proliferation of the follilular epithelium<ref name= PMID9768360><pubmed>9768360</pubmed></ref>.
In this stage, it is also believed that the polarity of the hair follicle (the angle at which hair-follicles grow in relation to skin) and the architecture of the hair follicle itself (straight hair, wavy hair, etc) is regulated in part by Sonic Hedgehog and TGF-a signaling respectively<ref name= PMID11841536><pubmed>11841536</pubmed></ref>.
|-
| Bulbous Peg || This stage is characterised by the appearance of the hair follicle bulb. Further and significant differentiation of the inner root sheeth and the hair shaft also characterises this stage<ref name= PMID11841536><pubmed>11841536</pubmed></ref>.
The epithelial cells within the hair bulb, begin to differentiate into the germinal matrix – which grow, proliferate and keratinise to form the hair shaft and internal root sheet<ref name= PMID11841536><pubmed>11841536</pubmed></ref>. Other epithelial cells outside of the hair bud, form the external hair sheeth. Mesodermal cells of the dermis that surround the invaginating hair follicle form the dermal root sheeth and the arrecrtor pili muscles for hairs.
Proteins such as Notch1 are believed to help regulate the phenotype of keratinocytes as they differentiate<ref name= PMID10804183><pubmed>10804183</pubmed></ref>.
|}

{| style="width:100%" border="1" align="center" style="text-align:center"
|-
| [[Image:---|frame|right|middle|180x150px|Undifferentiated Epithelium|]]||[[Image:Fetal Hair Follicle Development - Week 8-12.JPG|frame|right|middle|180x150px|Week 8-12|]]||[[Image:Fetal Hair Follicle Development - Week 12-14.JPG|frame|right|middle|180x150px|Week 12-14|]]|| [[Image:Fetal Hair Follicle Development - Week 13-16.JPG|frame|right|middle|180x150px|Week 13-16|]] || [[Image:---|frame|right|middle|180x150px|Week 19-21|]]|| [[Image:---|frame|right|middle|180x150px|Week 23-28|]]
|}

===Nail===
{| style="width:100%" border="1" align="center" style="text-align:center"
|-
| [[Image:Feta Nail Development - Week 9-10.jpg|frame|right|middle|135x115px|Week 9-10|]]|| [[Image:Fetal Nail Development - Week 11-12.jpg|frame|right|middle|135x115px|Week 11-12 |]] || [[Image:Fetal Nail Development - Week 13-14 .jpg|frame|right|middle|135x115px|Week 13-14|]]|| [[Image:Mature Nail .jpg|frame|right|middle|135x115px|Mature Nail|]]
|}

Together, fingernails and toenails are modifications of the epidermis, embryologically derived in humans from the same origin of ectodermal skin cells <ref>Pansky, B. (1982). Review of Medical Embryology. Embryome Sciences, Inc 1301 Harbor Bay Parkway, Alameda, CA, 94502</ref>.

* Nails commence development at the tips of the digits around the stage of 10 weeks, with the initiation of fingernail growth preceding that of toenails by approximately 4 weeks <ref>Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Nail Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Nail_Development</ref>. The earliest recognisable stages of nail development by week 10 are thickenings of epidermis, known as the primary nail fields, repositioning from the initial ventral surface to the eventual dorsum of each digit <ref>Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2011). The developing human: clinically oriented embryology (9th ed.). Philadelphia: Saunders. </ref>.
* The nail fields are bounded by folds of epidermis: the shallower lateral nailfolds, which adjoin into the much deeper proximal nailfold <ref>Pansky, B. (1982. Review of Medical Embryology. Embryome Sciences, Inc 1301 Harbor Bay Parkway, Alameda, CA, 94502</ref>.
* The true nail is developed via the keratinization of cells within the proximal nailfold that proliferate over nail field, developing into the nail plate.
*Initially the developing nail is covered by a thin layer of epidermis, the eponychium (corneal layer of epidermis) that at later fetal stages declines to expose the free nail, however endures as the cuticle. Beneath the free end of the nail, epidermal cells aggregate to form the mass known as the hyponychium <ref>Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2011). The developing human: clinically oriented embryology (9th ed.). Philadelphia: Saunders. </ref>.
* By 32 and 36 weeks of development, the fingernails and toenails respectively reach the tips of the digits and toes <ref>Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Nail Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Nail_Development</ref>.

{| style="width:30%" border="1" align="center" style="text-align:center"
|-
! Week !! Event
|-
| Week 9 || The primitive nail beings to from
|-
| Week 10|| The primary nail field is establish
|-
| Week 11 || Distal ridges of nail bed keratinise.
|-
| Week 13 || Early nail matrix.
|-
| Week 20 || Nail plate begins to grow over the nail bed.
|-
| Week 24 || Free nail plate is visible to the naked eye.
|}

===Glands===
{| style="width:75%" border="1" align="center" style="text-align:center"
|-
! Gland Type !! Description !! Image
|-
| Sebaceous Glands || *Sebaceous glands develop from the epithelial wall of the hair follicle.
*secretes vernix caseosa

Vernix caseosa is a material secreted by sebaceous glands in the foetus in the last trimester of development <ref name="PMID15830002"><pubmed>15830002</pubmed></ref> and is characterised by it’s cheese-like appearance around the neonate at birth. The functions of vernix caseosa include:
*thermal regulation <ref name="PMID15830002"><pubmed>15830002</pubmed></ref>
*barrier to water loss (to keep fetal skin hydrated)<ref name="PMID21504444"><pubmed>21504444</pubmed></ref><ref name="PMID15830002"><pubmed>15830002</pubmed></ref>
*prevents the epidermis from water contact while epidermal cornification and formation of the stratum corneum occurs<ref name="PMID21504444"><pubmed>21504444</pubmed></ref>
*antioxidant<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*anti-infective<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*moisturises the skin<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*assists in wound-healing<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
|| [[Image:Newborn - vernix caseosa.jpg|frame|right|middle|250x187px|Vernix caseosa on a neonate.<ref>Image source: JazlynRoseVernixByPhilKonstantin.jpg‎ http://en.wikipedia.org/wiki/File:JazlynRoseVernixByPhilKonstantin.jpg</ref>]]
|-
| Mammary Glands || *Mammary glands develop from the mammary ridge- a downgrowth of the epidermis (ectoderm) into the underlying dermis (mesoderm). This occurs at about week 6 of development. Prior to puberty, the mammary glands are anatomically indistinguishable. || Image
|-
| Sweat Glands || *Eccrine and apocrine sweat glands develop from the downgrowths of the epidermis into the underlying dermis. It has been seen and detected in studies from week 21. || [[Image:Integumentary_histology_02.jpg|frame| 250x250px|Histology of eccrine sweat gland]]
|}

::: Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Gland Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Gland_Development

===Teeth===

The ectoderm and the associated underlying layer of neural crest cells, are the origin for teeth development. As the oral epithelium grows and proliferates, it has a downward movement into the underlying neural crest layer. This leads to the formation of the dental lamina. These dental lamina, then, gives rise to tooth buds. These tooth buds, later form and develop into enamel organs. With further development, these enamel organs give rise to ameloblasts- which produce enamel. The dental papilla, on the other hand is formed by the neural crest cells which underlie the enamel organs <ref name= PMID19266065><pubmed>19266065</pubmed></ref>. These dental papillae than give rise to the dental pulp and odontoblasts- which produce predentin and dentin, in the adult body.

[[Image:Tooth development stage.jpg|frame|left|middle|425x300px|The stages of embryonic teeth development]]

{| class="wikitable"
|-
! Stage!! Week !! Description
|-
| (A) Lamina|| Week 6 || The oral ectoderm, closely interacts with the neural crest ectomesenchyme. In the Lamina stage, teeth may grow only within the epithelium.
|-
| (B) Placode|| Week 7 || The dental lamina and and the dental placodes arise, due to specific signals from adjacent epithelial cells
|-
| (C) Bud || Week 8 || Tooth buds are formed, as the epithelium cells interact with the messenchyme. This occurs at the sides of the dental placodes. Also, as opposed to the earlier Lamina stage, in the Bud stage, teeth may now only grow within the ectomesenchyme
|-
| (D) Cap|| Week 11 || After folding, the bud takes upon the shape of an inverted cap
|-
| (E) Bell|| Week 14 || The bud refolds once again, this time taking upon the shape of a bell
|}

===Video===
<html5media height="300" width="400">https://www.youtube.com/watch?v=nRH8M-arC58</html5media>

==Some Recent Findings==
{|
|-bgcolor="F5FFFA"
|
* '''Expression of caspase-14 and keratin-19 in the human epidermis and appendages during fetal skin development:''' <ref name=PMID23377137><pubmed>23377137</pubmed></ref> In recognition of the vital roles of CASP-14 and CK-19 in human skin development and maturation, the purpose of this study was to primordially investigate the expression of these two molecular factors throughout the stages of human fetal skin development from gestation to the postnatal period in order to evaluate their singular and collective functions in epidermal and associated appendage maturation and processes of differentiation and re-modelling of human fetal skin. The results of the immunohistochemical study showed the expression of CASP-14 to be a biochemical marker of human epithelial differentiation during gestation, whilst CK-19 was a marker for epidermal stem cells nests of the stratum basale of the fetal epidermis and appendages. CASP-14 was concentrated within the more differentiated fetal epidermal layers, progressively declining from the basal layer toward term whilst CK-19 showed reduced expression with progressive epidermal development of the fetal stages and was a biochemical marker for epidermal stem cells nests of the stratum basale showing marginal conservation in basal cell nests at term and postnatally. Expression of CASP-14 within the epidermal appendages of the hair follicles and sebaceous glands were concentrated within the greater differentiated inner root sheath whilst CK-19 was greatly concentrated within the outer root sheath. Inconsistent patterns of expression of both molecules CASP-14 and CK-19 were demonstrated within eccrine sweat glands.
|}

{|
|-bgcolor="F5FFFA"
|
* '''Cxcr4 is transiently expressed in both epithelial and mesenchymal compartments of nascent hair follicles but is not required for follicle formation:''' <ref name= PMID25066162><pubmed>25066162</pubmed></ref> Cellular signalling between mesencyhmal and epithelial layers of the developing skin initiate an assortment of morphogenetic events throughout embryogenesis, involving the formation of the skin and in particular, the development of hair follicles (HF). The aims of this study was to identify the specific signalling pathways associated with HF morphogenesis during the primary stages of mouse hair follicle development through the investigation of the precise expression patterns and role of the Cxcr4 receptor in two specialised cell types- mesenchymal dermal condensate (DC) cells and epithelial placode cells. Staining patterns of the Cxcr4 receptor in the budding HF revealed a high concentration within epithelial placode cells and later DC cells in developing HF’s, signifying a shift of expression between epithelial and mesenchymal layers during HF morphogenesis. The functionality of the Cxcr4 receptor was tested through Cxcr4 receptor ablation in both the mesenchymal and epithelial layers of the developing embryonic skin of conditional knockout mice (cKO) and was verified through immunofluorescence staining techniques. Normal HF development was still induced despite the absence of Cxcr4 expression in the skin of the cKO mice and numbers were comparable to those found in the wild-type (WT) control group in embryonic and postnatal skin groups demonstrating that the chemokine signalling through the Cxcr4 receptor is inessential for normal early HF development (Figure 1).
|}

{| style="width:40%; height:170px" align="center"
|-
| [[Image: Eosin_staining_of_mouse_embryonic_skin.png|frame|250x250px|Figure 1: Hematoxylin/ eosin staining of embryonic skin sections and macroscopic view of external hair shafts of mouse. Cxcr4 receptor ablation in condensates and placodes show no effect on mouse HF morphogenesis. Hair follicle and shaft develop normally and in comparable numbers in both Tbx18cre (a) and Krt14-cre (b) Cxcr4fl/fl cKO mice.]] || [[Image:- compound mouse mutants demonstrate partially rescued upper and lower molars.png|frame|right|middle|300px|Figure 2: Msx1-/--;Tbx2+/-mouse mutants showed rescue from bud to cap phase transition in embryonic dental development. Both upper and lower molars showed an enlargement in the tooth buds (H, K, L), with few upper molars progressing to cap stage (G). The arrowheads indicate enamel knots (E,G,I).]]

|}

{|
|-bgcolor="F5FFFA"
|
* '''The ventral proximal nail fold: stem cell niche of the nail and equivalent to the follicular bulge--a study on developing human skin:''' <ref name= PMID22804461><pubmed>22804461</pubmed></ref> In comparison to the characterization of the stem cell niche within the folliculosebaceous-apocrine unit, the local microenvironment of stem cells within the human nail organ is yet to be characterized. The aims of the current study was through immunohistochemical analysis to describe the expression pattern of six follicular stem cell markers; cytokeratin 15 (CK15, two clones), cytokeratin 19 (CK-19), PHLDA1, CD200 and nestin within the developing human nail and compare it with the embryonic and fetal human hair follicle. In addition, locations of vast proliferative activity within the nail were assessed using labeling with Ki-67. The stem cell markers CK15 (both clones), CK19, PHLDA1, CD200 and nestin showed no staining within the nail and hair matrix samples, however were present within the central proximal nail fold and follicular bulge. The biochemical marker for proliferation, Ki-67 showed the highest concentration of proliferative cells within the hair germ, lower regions of the hair peg and in the hair matrix. In the developing human nail the expression of Ki-67 was most prominent within the nail bed epithelium and the later nail matrix. In contrast the lowest numbers of kI-67 positive staining cells were located in regions of stem cell niches of the follicular bulge and proximal ventral nail fold as stem cells divide infrequently. Throughout the course of embryonic development these stem cell markers exhibit a highly specific expression pattern both within the nail and the hair follicle. The results seem to suggest that during embryonic envelopment the proximal ventral nail fold is the niche for nail stem cells.
|}

{|
|-bgcolor="F5FFFA"
|
* '''Msx1 and Tbx2 antagonistically regulate Bmp4 expression during the bud to cap stage transition in tooth development:''' <ref name= PMID23720046><pubmed>23720046</pubmed></ref> The expression of Bmp4 is essential for the bud to cap phase transition in embryonic dental development and is accordingly firmly regulated, with earlier stages of expression localised within the dental epithelial placode developing in to a later forms of expression in the dental mesenchyme. Numerous transcription factors including Pax 9, Osr2, Barx 1, Msx1, have been identified to prompt and maintain Bmp4 expression in these critical stages of tooth development. In particular Msx1 is one such transcription factor induced through epithelial Bmp4 expression and in turn is essential for the induction and regulation of dental mesencyhmal Bmp4 expression. The results of this investigation have demonstrated the expression of an additional transcription factor, Tbx2, induced through epithelial Bmp4, within the dental mesenchyme at bud stage of dental development. To determine a functional connection between the Msx1 and Tbx2 transcription factors, a cross was made between Tbx2 and Msx1 mutant mice. The data demonstrates that bud phase tooth arrest in Msx1-/- mice is moderately restored in Msx1-/-. Tbx2+/- compound mutants. The maintenance of Tbx2 expression in the Msx-/- arrested tooth buds exhibits that the expression of Tbx2 is not dependant on that of Msx1. This restoration in the developmental process is associated with the establishment of the enamel knot (EK) and the reinstatement of mesencyhmal Bmp4 expression (Figure 2). Knockout of Tbx2 resulted in an increase mesencyhmal Bmp4 expression. This data demonstrates that subsequent to the induction of epithelial Bmp4, both transcription factors Msx1 and Tbx2 in turn antagonistically regulate odontogenic activity that results in EK formation as well as mesenchymal Bmp4 expression at the vital bud to cap phase transition in embryonic dental development resulting in appropriate morphogenesis and patterning.

|}

{| class="wikitable mw-collapsible mw-collapsed"
! More Recent Papers
|-
|
<pubmed>23826487</pubmed>
<pubmed>22342389</pubmed>
<pubmed>24911066</pubmed>
<pubmed>25143675</pubmed>
<pubmed>23271751</pubmed>
<pubmed>25249463</pubmed>
<pubmed>23097355</pubmed>
|}

==Historic Findings==

Knowledge of the Integumentary expands in conjunction with technological developments that allow observation of microscopic structures. Historically animal models have been used to map the stages in the development of the fetal integumentary system.

===Skin===

* '''1900''' - Bardeen used the pig animal model to study the histogenesis of the dermomyotomes and nervous appratus. Bardeen and other scientists established that the human skin results from the union of the epithelial material derived from the ectoderm (epidermis) and the connective tissue origination from the mesoderm (dermis).

http://journals.lww.com/plasreconsurg/Citation/1949/07000/CLINICAL_ASPECTS_OF_EMBRYOLOGICAL_SKIN.8.aspx
Bardeen, C. R. (1900). The development of the musculature of the body wall in the pig, including its histogenesis and its relations to the myotomes and to the skeletal and nervous apparatus. Johns Hopkins Hosp. Rep, 9, 367-399.

===Glands===

Sebaceous glands / Sweat glands / Mammary

In the 1968 Robins and Breathnatch investigated the development on the sebacious and apocrine swelling in the skin, which where closely associated with development of the hair follicle. They observed differentiation of desmosomes and development of cytoplasmic contents of the cell.

===Hair===

The major anatomic details of hair development in the human foetus have been established by studies with light microscopy. Electron microscopy was not commonly used to until recently and so little was known about the ultrastructure of the skin. Over the past few years, reports have been published on the epidermal melanocytes and periderm.

* '''1958''' - Pinkus established the following stages of fetal hair follicle development: pre-germ, hair-germ, hair-peg,andbulbous-peg stages. Pinkus also determined that the developed hair fibres grow through the epidermis and appears at the level of the skin at around 19-21 weeks of development. The lanugo (foetal) hair is extremely fine with no medulla and a tip free of pigment.

* '''1968''' - Breathnach and Smith determined the fine structure of the cells of follicle and dermal papilla in the first two weeks of fetal development. The Peripheral Nerves, the sweat duct and nail development were also explored and the interrelationship of cells at particular foetal stages was deduced. These studies, and other laboratory animals, have provided information on the differentiation of cells and tissue of some functional importance and underline the role of cells and tissues.<ref name= PMID5656140><pubmed>5656140</pubmed></ref>

Robertson, J. R. (Ed.). (2002). Forensic examination of hair. CRC Press.

* '''1959''' - Chase and Eaton's investigated fetal hair follicle development. With key observations in understanding the cycling nature of hair follicle growth, following development. Development begins with the downwards growth of the follicle structure from the level of the dermis. The follicle is a processes during the quiecent phase thought he adipose layer during gowth and differntiation. They also established that upward movement of hair inovlves the addition of next cells from the matrix of the follicle and an enlargement of each cell. Furthermore their research also showed that the epidermal and dermal layers were dynamic and interacting with each other. The most significant developments in the understanding of hair follicle development came from studies investigating the differentiation pattern of cells as the follicle develops. <ref name= PMID5656140><pubmed>5656140</pubmed></ref>

<pubmed>5656140</pubmed>
<pubmed>4097391</pubmed>

Determined that the hair fibre finally breaks through the epidermis and appres about the skin at around 19-21 weeks of development. The lanugo (foetal) hair is extremely fine with no medulla and a tip free of pigment.

===Nail===

Microscopy and staining techniques have been essential tools in study of nail development, anatomy and physiology. Thus, as such technology advances scientists have been able to uncover the morphological details of the nail and understand the changes that occur during nail development. A review of the history allows us to recognize the major contributor to this field. History of research on nail development also reveals the interesting debate on the origins of keratinized cells which migrate to form the nail palate in weeks 20-24 of fetal development.

[[Image:Nail Plate Development - Pinkus .jpg|frame|right|middle|180x150px|Nail Plate Development - Pinkus|]]

* German scientists Unna and Pinkus were both highly reputable dermatologists who conducted a great deal of research on the development of the skin and associated structures. They were (<ref name= PMID12581143><pubmed>12581143</pubmed></ref> <ref>Roberts, H. L., & Walker, N. (1929). PAUL GERSON UNNA. British Journal of Dermatology, 41(4), 157-160.</ref>)
* '''1883''' - Unna published a chapter on the anatomy and development of the human nail in the German textbook "Ziemsssen's Handbuch der Speciell Pathologie und Therapie" - Ziemsssen 's manual of special pathology and therapy.
* '''1927''' - Pinkus conducted his earliest investigations into fetal nail development. His findings were published in the "Handbuch Der Haut und Geschlechtskrankeiten” - Manual of Skin and Venerail Disease.
* Based on their findings both scientists proposed that the nail matrix structure gives rise to the entire nail plate during normal fetal development. <ref name= PMID5556500><pubmed>5556500</pubmed></ref>

[[Image:Nail Plate Development -Lewis .jpg|frame|right|middle|170x145px|Nail Plate Development -Lewis|]]

* '''1954''' - Barton and Lewis conducted a through investigation on the microscopic features of the fetal and mature nail and surrounding soft tissue. Lewis challenged the current thought and proposed a "tri-partite" origin of the nail plate from three tissue origins (1) the proximal nail fold (2) the matrix and (3) bed. <ref name= PMID5556500><pubmed>5556500</pubmed></ref>
* Prior to the 1900’s it was difficulty in obtaining normal fetal specimens. Furthermore, the histological staining techniques used to prepare slides of nail tissue often damage the specimen and little detail could be seen during the microscopic examinations. Barton and Lewis conducted this investigation in hopes that a better understanding of the normal developmental anatomy and physiology would assist physicians in diagnosing and treating abnormalities. <ref name= PMID13206419><pubmed>13206419</pubmed></ref>

* '''1959''' - Samman carried out an investigation on the blood supply of the human toe nail. It was thought that a deeper understanding of morphology of the vasular supply might allows us to infer the mechanism of nail plate genesis. Samman studied the morphology and distribution of blood vessels with in the nail found capillary loops through out the nail fold and concluded that this supports the theory of multiple sites giving rise to the nail plate. <ref name= PMID14441224><pubmed>14441224</pubmed></ref>

* '''1963''' - Zaias conducted a number of studies on the embryology of the human nail. This investigation contributed to our understanding of different stages in foetal nail development. Zaias studied an number of foetal specimens at different stages in development. As a result, Zaias was able to propose a rough timeline highlighting morphological hallmarks in normal nail development. <ref name= PMID14003041><pubmed>14003041</pubmed></ref>

The current understanding of fetal nail development is a summation contributions of many researches in the international scientific community. Today research continues, technology allows exploration beyond macroscopic and microscopic morphological changes in the fetal nail. Now the aim is to understand the molecular signalling with in the epidermal cells which drives this process.

===Teeth===
<ref name= PMID5267156><pubmed>5267156</pubmed></ref> -- <pubmed>5267156</pubmed>

==Abnormalities==

===Aplasia Cutis Congenita===
[[Image:Cutis aplasia.jpg|frame|right|middle|250x187px|Aplasia cutis congenita at the scalp]]
Aplasia cutis congenita (ACC) is a rare skin abnormality, characterised by the absence of all layers of the skin. It is most common to occur on the scalp (70%), specially the vertex. In severe cases, the defect can go as deep as the bone or the dura. Other sites of ACC include the skin of the limb regions. “ACC occurs in approximately 1 in 10000 live births, with a female-to-male ratio of 7:5.” The specific aetiologic agent for ACC is still unknown. It has been suggested to be genetic and/or environmental. The damage to the vertex is suggested to be the result of the biomechanical stretch at this area when the fetal brain is growing.<ref name= PMID22549580><pubmed>22549580</pubmed></ref>

Presently, ACC is managed via conservative treatments or surgical treatments. Conservative treatments refer to basic wound treatments and preventing infection with the use dressings and antibiotics. Surgical treatments, specifically scalp reconstruction procedures, aim to reconstruct the damage to the skin through skin grafts, local scalp flaps, and pericardial scalp flaps. Large defects are often treated using surgical treatments.<ref name= PMID23147310><pubmed>23147310</pubmed></ref>

===Dystrophic Epidermolysis Bullosa===
[[Image:Dystrophic Epidermolysis Bullosa lesions.jpg|frame|right|sub|270x230px|Severe skin lesions due to Dystrophic epidermolysis bullosa.<ref name="PMID23739692"><pubmed>23739692</pubmed></ref>]]
Dystrophic Epidermolysis Bullosa (DEB), a type of epidermolysis bullosa, is a genetic disease of the skin, usually present at birth or at an early age. Currently, around 400,000 - 500,000 people are affected with the disease<ref name= PMID252845240><pubmed>25284524</pubmed></ref>. It is characterised by the fragility of the skin<ref name= PMID252845240><pubmed>25284524</pubmed></ref>, where it blisters upon minimal trauma and scars<ref name= PMID19945622><pubmed>19945622</pubmed></ref>, usually at the extremities<ref name= PMID252845240><pubmed>25284524</pubmed></ref>. It is caused by a mutation in collagen VII gene (COL7A1)<ref name= PMID19945622><pubmed>19945622</pubmed></ref><ref name= PMID24860657><pubmed>24860657</pubmed></ref>, which is responsible for the the formation of anchoring fibrils<ref name= PMID19945622><pubmed>19945622</pubmed></ref>. Anchoring fibrils are responsible for dermal-epidermal adherence<ref name= PMID19945622><pubmed>19945622</pubmed></ref>, that is why it’s loss of function results to blistering of the skin. In some cases, even teeth and nails are affected. Teeth of patients with DEB have enamel defects and when combined with poor oral hygiene, it may lead to decay. Nails of DEB patients are often dystrophic and will eventually be lost.<ref name= PMID252845240><pubmed>25284524</pubmed></ref>

There are currently no known cures for DEB; however there are techniques to manage the clinical manifestations of the disease, which include:
*wound care<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*preventing factors that may cause blistering<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*using aqueous disinfectants - highly effective<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*dental care<ref name= PMID252845240><pubmed>25284524</pubmed></ref>:
:-use of topical fluoride
:-careful prophylaxis
:-use of topical antibiotics to prevent secondary infections<ref name= PMID24860657><pubmed>24860657</pubme></ref>

One study is currently exploring the potential of protein therapy as a treatment for DEB. Their results show that intradermal injection of recombinant human collagen 7 in mice with DEB led to “restoration of C7 and anchoring fibrils.”<ref name= PMID19018253><pubmed>19018253</pubmed></ref> Other techniques that aim to restore C7 include:
*bone marrow transplant- improved blistering in mice specimen and increase survival rates<ref name= PMID24860657><pubmed>24860657</pubmed></ref>
*hematopoietic cell transplant (HCT)- increased deposition of C7 in injured skin<ref name= PMID24860657><pubmed>24860657</pubmed></ref>

===Congenital Alopecia Areata===
[[Image:Alopecia Areata.jpg|frame|right|middle|270x220px|Patches of hair loss: a sign of alopecia areata.<ref name="PMID23960401"><pubmed>23960401</pubmed></ref>]]
Alopecia areata (AA) is an abnormality of the hair affecting anagen hair follicles, characterised by well-demarcated patches of hair loss. It is non-scarring and can occur on the scalp and/or the body. 90% of AA cases occur on the scalp. 5%-10% of patients with AA lose all hair on their scalp; this is called alopecia totalis. While others lose all of their body hair, this is called alopecia universalis. <ref name= PMID17269961><pubmed>17269961</pubmed></ref> Its pathogenesis is considered to be both genetic and autoimmune. There is an abnormality with the genes related to the immune system and to the hair follicles. And histopathology shows signs of lymphatic infiltration of the hair follicles and the loss of these scalp lymphocytes allow hair follicles to recover.<ref name= PMID16338213><pubmed>16338213</pubmed></ref> High frequencies of catagen and telogen hair follicles are also present in areas affected by AA.<ref name= PMID17269961><pubmed>17269961</pubmed></ref>

There is currently no cure for AA. There are several treatments to combat AA but none of these have led to remission of the disease, the most effective being corticosteroids and topical immunotherapy.<ref name= PMID17269961><pubmed>17269961</pubmed></ref> A new method of treating alopecia areata is currently being studied. Transepidermal drug delivery (TED) is a new treatment that functions by creating micro-channels in the epidermis. By doing so, drug delivery to the skin is improved. This treatment was highly effective and had lower rates of side effects, e.g. pain, compared to previous treatments.<ref name= PMID25260052><pubmed>25260052</pubmed></ref>

===Harlequin Ichthyosis===
[[Image:Harlequin Ichthyosis.jpg|frame|right|middle|250x200px|A baby with harlequin ichthyosis.<ref name="PMID24520234"><pubmed>24520234</pubmed></ref>]]
Congenital ichthyosis is an autosomal recessive disease of the skin, characterised by visible and excessive scaling of the skin and hyperkeratosis, i.e. thickening of stratum corneum layer of the epidermis and in some cases, hypohidrosis, i.e. the lack of ability to sweat. <ref name= PMID19824737><pubmed>19824737</pubmed></ref> Harlequin ichthyosis (HI) occurs only in 1 in 1,000,000 babies. It is life-threatening in the first few weeks and/or months of the neonate.<ref name= PMID19824737><pubmed>19824737</pubmed></ref> The thick skin can restrict movement of the baby and sometimes constrict extremities and lead to necrosis then autoamputation.<ref name= PMID23419760><pubmed>23419760</pubmed></ref> Babies with HI are also characterised by bilateral ectropion (everted eyelids), eclabium (everted lips), and underdeveloped nose.<ref name= PMID23419760><pubmed>23419760</pubmed></ref> In 50% of HI cases, respiratory failure is often the cause of death.<ref name= PMID24124810><pubmed>24124810</pubmed></ref> This disease is caused by a nonsense mutation in the ATP-binding-cassette A12 (ABCA12) gene, which is responsible for encoding a lipid transporter essential for the regulation of lamellar bodies. <ref name= PMID19824737><pubmed>19824737</pubmed></ref><ref name= PMID23419760><pubmed>23419760</pubmed></ref><ref name= PMID24124810><pubmed>24124810</pubmed></ref>

There is currently no known cure for this disease. Management techniques include:
*Monitoring in neonatal intensive care units.
:-Temperature within the incubator is controlled to avoid fluctuation in body temperature and to stop sweating. <ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Mechanical removal of excess scales from the skin <ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Bathing to remove excess scales from the skin<ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Topical therapy - to reduce hyperkeratosis. <ref name= PMID19824737><pubmed>19824737</pubmed></ref><ref name= PMID24124810><pubmed>24124810</pubmed></ref>
*Use of oral retinoids - known to have high rates of survival.<ref name= PMID24124810><pubmed>24124810</pubmed></ref>

===Hypohidrotic Ectodermal Dysplasia===
[[Image:Oligodontia.jpg|frame|right|middle|250x187px|Oligodontia: a clinical manifestation of HED.<ref name="PMID21165248 "><pubmed>21165248 </pubmed></ref>]]
Hypohidrotic ectodermal dysplasia (HED) is the most of all ectodermal dysplasias, caused by an abnormality in the development of ectodermal tissues, which inlude skin, hair, teeth, sweat glands, and nails.<ref name= PMID20682465><pubmed>20682465</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref> Patients with ectodermal dysplasia often have sparse hair and oligodontia, which is a condition where teeth are missing and are poorly developed.<ref name= PMID20682465><pubmed>20682465</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref> Sweating is a very important function in the body in terms of thermoregulation. HED is mainly characterised by hypohidrosis due to the lack of sweat glands in the skin, which could lead to hyperpyrexia and sometimes death. In neonates, the mortality rate of HED reaches up to 30%, with the first year of life having the highest risk. <ref name= PMID20682465><pubmed>20682465</pubmed></ref> HED is caused by a genetic abnormality of the ectodysplasin A gene (EDA) and passed on by X-linked inheritance. The mutations of this gene results in the poor sweating ability or none at all in a person. The effects of this abnormality is usually more severe in males than in females. <ref name= PMID21357618><pubmed>21357618</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref>

There is currently no pharmacological therapies for HED but there are methods applied to prevent the disease from aggravating. Neonates with HED are placed in incubators and monitored to prevent them from overheating. Management of this disease gets easier as the patient ages. Adults with HED can control their thermoregulation by staying in cool environments or drinking cold drinks to lower the body temperature. Currently, there are studies that aim to find a cure for this abnormality, e.g. gene replacement therapy in animal models.<ref name= PMID24678015><pubmed>24678015</pubmed></ref>

==References==
<references/>

File:Fetal Hair Follicle Development - Week 13-16.JPG

2014-10-23T05:06:27Z

Z3418340: Z3418340 uploaded a new version of "File:Fetal Hair Follicle Development - Week 13-16.JPG"

Fetal Hair Follicle Development - Week 13-16

The collection of dermal cells and meloncytes at the base of hair peg, now give it rounded bulb like appearance.
Thus, this stage of hair follicle development is known as the "bulb" stage

Reference
Pansky, B. (1982). Review of medical embryology. New York: Macmillan.

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z3418340

File:Fetal Hair Follicle Development - Week 13-16.JPG

2014-10-23T05:01:56Z

Z3418340: Fetal Hair Follicle Development - Week 13-16 The collection of dermal cells and meloncytes at the base of hair peg, now give it rounded bulb like appearance. Thus, this stage of hair follicle development is known as the "bulb" stage Reference Pansk...

2014 Group Project 5

2014-10-23T04:57:27Z

Z3418340: /* Hair */

{{ANAT2341Project2014header}}
=Integumentary=
==Introduction==
This page concerns the development of the integumentary system in the fetal stage of development, particularly its organs i.e. the skin, glands, hair, teeth, and nails. It explores the mechanism of development as well as the timeline of development. This page also outlines some recent findings on the development of the integumentary system, as well as historic findings. Finally, this page also explores some of the congenital abnormalities of the integumentary system, its mechanism or pathogenesis, clinical manifestations, and how they are treated or managed.

==Development Overview==
===Skin===

The skin consists of 2 layers: the outer layer (epidermis) and a deeper connective tissue layer (dermis).
*The epidermis is derived from the ectoderm. Initially it exists as only a single layer of ectodermal cells at 7-8 days of gestation. However, by about 13-14 weeks after gestation, a 3- layered structure of fetal epidermis exists- consisting of the stratum basale, 1 or 2 intermediate layers and the periderm. The peridermal cells eventually become desquamated and form part of the vernix cervix.
** The 5 definitive layers of the adult skin are evident in the human fetus after 22-24 weeks of gestation. Indirect influences form the dermis help differentiate the epidermis into: stratum basale, stratum spinosium, stratum granulosum, stratum lucidum and stratum corneum.
*The somatic mesoderm is the embryonic origin of the dermis. The mesoderm of the dermatones of the body, also contribute to the development of the dermis. Specifically though, in the head and neck region of the body, the dermis is derived from neural crest cells.
** The dermis is initially composed of just mesenchymal cells- loosely aggregated mesodermal cells. These mesenchymal cells later develop into fibroblasts- which function to secrete collagen and lay-down elastic fibers into the extracellular matrix.

3 other specialised cells of the epidermis also exists- these include melanoblasts, Langherhan cells and Merkel cells.
*Melanoblasts- are derived from neural crest cells that have migrated into the stratum basale. Mid-pregnancy, melanosomes are observed, differentiating the melanoblasts into melanocytes
*Langheran cells- are derived from bone marrow (originally form mesoderm) and migrate into the epidermis. They have the function of antigen presentation.
*Merkel cells- still have an uncertain origin. They have a function related to mechanoreception.

{| style="width:60%; height:125px" border="1" align="center"
|-
! Week !! Description !! Phase Diagram
|-
| Week 6-8|| In an electron micrograph study of the epidermis, the periderm and and basal layer of the developing skin was observed. || [[Image:Human_embryo_skin_8-9_week_EGA.jpg|100x100px|Weeks 6-8]]
|-
| Week 7-9 || In an electron micrograph study of the epidermis at weeks 7-9 of development, the stratified three-layer structure of the epidermis was observed. Kertain filaments have been encircled. || [[Image:Human_embryo_skin_9-11_week_EGA.jpg|100x100px| Weeks 7-9]]
|-
| Week 14 || By week 14, the basal layer, the intermediate layer/s and the periderm 3-layered structure can be observed in the fetus. By week 14, K17 can also be found in the basal and intermediate layers of the epidermis (In adult skin, K17 was not observed) || [[Image:Fetal_integumentary_histology_14w.jpg|100x100px| Week 14]]
|-
| Week 16 || In a study, by week 16, developing blood vessels were observed. CD31 and a sub-type of smooth-muscle actin stained positive in these observed developing blood vessels. || [[Image:Inaugumentary_week16.jpg|100x100px| Week 16]]
|-
| Week 18 || Example || [[Image:542px-Fetal_integumentary_histology_18.jpg|100x100px| Week 18]]
|-
| Week 19 || In a study, by week 19, as opposed to week 14, K17 was found present in the basal, intermediate and periderm layers. K17 also stained positive in the developing hair follicles. || [[Image:Inaugumentary-_Week_19.jpg|100x100px| Week 19]]
|-
| Week 20 || By week 20, hair follicles can be already be seen in the epidermis. The total number of intermediate layers has also increased || [[Image:Fetal_integumentary_histology_20.jpg|100x100px|Week 20]]
|-
| Week 22 || In an electron micrograph study at week 22 of development, kertanised epidermis was analysed. It was observed that glycogen was abundantly present throughout all epidermal layers. The included arrows, highlight the keratin filament bundles, which are now organised and peripherally placed. || [[Image:Human_embryo_skin_24_week_EGA.jpg|100x100px| Week 22]]
|-
| Adult|| In adult skin- a greater diversity of cells can be seen as more cells differentiate. Basal, spinous, granular and cornified cells are all example of such. In another study, chondroitin sulphate was observed in the basement membrane zone of the adult epidermis. In the same study, chondroitin sulphate was only observed towards the upper-part of the dermis. Also, elastin was present in the adult specimens, but not in the earlier fetal samples. || [[Image:Fetal_integumentary_histology_Adult.jpg|100x100px| Adult]] [[Image:542px-Fetal_integumentary_histology_Adult.jpg|100x100px| Adult]]
|}

===Hair===
Hair originates from the ectoderm. At about 12 weeks, it is believed that specific signals from the dermis are released- signaling for the induction hair follicle formation <ref name= PMID1566372><pubmed>1566372</pubmed></ref><ref name= PMID20590427><pubmed>20590427</pubmed></ref>

{| style="width:75%" border="1" align="center" style="text-align:center"
|-
! Stage !! Description
|-
| Undifferentiated Epithelium || Through reciprocal interactions and ‘first dermal signaling’, cells from the stratum basale grow into the underlying dermis. The signaling pathway, however, has not been fully identified<ref name= PMID11841536><pubmed>11841536</pubmed></ref>
|-
| Placode || The ‘first dermal signals’ influence epithelial cells to develop a placode- a thickening of the columnar cells. It is theorised that varying intrinsic dermal signals lead to the expression of various placodes and consequently, the differences in the expression of hair thickness/size throughout the body<ref name= PMID10529418><pubmed>10529418</pubmed></ref>. The specific combination of promoter and repressor activators for hair development, is also theorised to characterise for the regional differences in eventual hair expression<ref name= PMID10431226><pubmed>10431226</pubmed></ref>
|-
| Germ || WNT Signalling is believed to have a role in the induction of the dermal condesate<ref name= PMID11841536><pubmed>11841536</pubmed></ref>. Platelet-derived growth factor-A molecules from the placode, also contributes to the induction of the dermal condensate. The development of the dermal condensate helps further induce the downward growth of the placode.
Through secreted proteins such as Sonic Hedgehog, the placode continues to proliferate and enclose the dermal condensate. This eventually forms a deep, club-shaped hair bud, with an invaginated dermal papillae <ref name= PMID11841536><pubmed>11841536</pubmed></ref>. These dermal papillae are rapidly infiltrated by blood vessels and nerve endings.
|-
| Peg || Sonic Hedgehog and the induction of a ‘secondary dermal signal’ (characterisation unknown) leads to a significant down-growth and proliferation of the follilular epithelium<ref name= PMID9768360><pubmed>9768360</pubmed></ref>.
In this stage, it is also believed that the polarity of the hair follicle (the angle at which hair-follicles grow in relation to skin) and the architecture of the hair follicle itself (straight hair, wavy hair, etc) is regulated in part by Sonic Hedgehog and TGF-a signaling respectively<ref name= PMID11841536><pubmed>11841536</pubmed></ref>.
|-
| Bulbous Peg || This stage is characterised by the appearance of the hair follicle bulb. Further and significant differentiation of the inner root sheeth and the hair shaft also characterises this stage<ref name= PMID11841536><pubmed>11841536</pubmed></ref>.
The epithelial cells within the hair bulb, begin to differentiate into the germinal matrix – which grow, proliferate and keratinise to form the hair shaft and internal root sheet<ref name= PMID11841536><pubmed>11841536</pubmed></ref>. Other epithelial cells outside of the hair bud, form the external hair sheeth. Mesodermal cells of the dermis that surround the invaginating hair follicle form the dermal root sheeth and the arrecrtor pili muscles for hairs.
Proteins such as Notch1 are believed to help regulate the phenotype of keratinocytes as they differentiate<ref name= PMID10804183><pubmed>10804183</pubmed></ref>.
|}

{| style="width:100%" border="1" align="center" style="text-align:center"
|-
| [[Image:---|frame|right|middle|180x150px|Undifferentiated Epithelium|]]||[[Image:Fetal Hair Follicle Development - Week 8-12.JPG|frame|right|middle|180x150px|Week 8-12|]]||[[Image:Fetal Hair Follicle Development - Week 12-14.JPG|frame|right|middle|180x150px|Week 12-14|]]|| [[Image:---|frame|right|middle|180x150px|Week 13-16|]] || [[Image:---|frame|right|middle|180x150px|Week 19-21|]]|| [[Image:---|frame|right|middle|180x150px|Week 23-28|]]
|}

===Nail===
{| style="width:100%" border="1" align="center" style="text-align:center"
|-
| [[Image:Feta Nail Development - Week 9-10.jpg|frame|right|middle|135x115px|Week 9-10|]]|| [[Image:Fetal Nail Development - Week 11-12.jpg|frame|right|middle|135x115px|Week 11-12 |]] || [[Image:Fetal Nail Development - Week 13-14 .jpg|frame|right|middle|135x115px|Week 13-14|]]|| [[Image:Mature Nail .jpg|frame|right|middle|135x115px|Mature Nail|]]
|}

Together, fingernails and toenails are modifications of the epidermis, embryologically derived in humans from the same origin of ectodermal skin cells <ref>Pansky, B. (1982). Review of Medical Embryology. Embryome Sciences, Inc 1301 Harbor Bay Parkway, Alameda, CA, 94502</ref>.

* Nails commence development at the tips of the digits around the stage of 10 weeks, with the initiation of fingernail growth preceding that of toenails by approximately 4 weeks <ref>Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Nail Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Nail_Development</ref>. The earliest recognisable stages of nail development by week 10 are thickenings of epidermis, known as the primary nail fields, repositioning from the initial ventral surface to the eventual dorsum of each digit <ref>Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2011). The developing human: clinically oriented embryology (9th ed.). Philadelphia: Saunders. </ref>.
* The nail fields are bounded by folds of epidermis: the shallower lateral nailfolds, which adjoin into the much deeper proximal nailfold <ref>Pansky, B. (1982. Review of Medical Embryology. Embryome Sciences, Inc 1301 Harbor Bay Parkway, Alameda, CA, 94502</ref>.
* The true nail is developed via the keratinization of cells within the proximal nailfold that proliferate over nail field, developing into the nail plate.
*Initially the developing nail is covered by a thin layer of epidermis, the eponychium (corneal layer of epidermis) that at later fetal stages declines to expose the free nail, however endures as the cuticle. Beneath the free end of the nail, epidermal cells aggregate to form the mass known as the hyponychium <ref>Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2011). The developing human: clinically oriented embryology (9th ed.). Philadelphia: Saunders. </ref>.
* By 32 and 36 weeks of development, the fingernails and toenails respectively reach the tips of the digits and toes <ref>Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Nail Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Nail_Development</ref>.

{| style="width:30%" border="1" align="center" style="text-align:center"
|-
! Week !! Event
|-
| Week 9 || The primitive nail beings to from
|-
| Week 10|| The primary nail field is establish
|-
| Week 11 || Distal ridges of nail bed keratinise.
|-
| Week 13 || Early nail matrix.
|-
| Week 20 || Nail plate begins to grow over the nail bed.
|-
| Week 24 || Free nail plate is visible to the naked eye.
|}

===Glands===
{| style="width:75%" border="1" align="center" style="text-align:center"
|-
! Gland Type !! Description !! Image
|-
| Sebaceous Glands || *Sebaceous glands develop from the epithelial wall of the hair follicle.
*secretes vernix caseosa

Vernix caseosa is a material secreted by sebaceous glands in the foetus in the last trimester of development <ref name="PMID15830002"><pubmed>15830002</pubmed></ref> and is characterised by it’s cheese-like appearance around the neonate at birth. The functions of vernix caseosa include:
*thermal regulation <ref name="PMID15830002"><pubmed>15830002</pubmed></ref>
*barrier to water loss (to keep fetal skin hydrated)<ref name="PMID21504444"><pubmed>21504444</pubmed></ref><ref name="PMID15830002"><pubmed>15830002</pubmed></ref>
*prevents the epidermis from water contact while epidermal cornification and formation of the stratum corneum occurs<ref name="PMID21504444"><pubmed>21504444</pubmed></ref>
*antioxidant<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*anti-infective<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*moisturises the skin<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*assists in wound-healing<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
|| [[Image:Newborn - vernix caseosa.jpg|frame|right|middle|250x187px|Vernix caseosa on a neonate.<ref>Image source: JazlynRoseVernixByPhilKonstantin.jpg‎ http://en.wikipedia.org/wiki/File:JazlynRoseVernixByPhilKonstantin.jpg</ref>]]
|-
| Mammary Glands || *Mammary glands develop from the mammary ridge- a downgrowth of the epidermis (ectoderm) into the underlying dermis (mesoderm). This occurs at about week 6 of development. Prior to puberty, the mammary glands are anatomically indistinguishable. || Image
|-
| Sweat Glands || *Eccrine and apocrine sweat glands develop from the downgrowths of the epidermis into the underlying dermis. It has been seen and detected in studies from week 21. || [[Image:Integumentary_histology_02.jpg|frame| 250x250px|Histology of eccrine sweat gland]]
|}

::: Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Gland Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Gland_Development

===Teeth===

The ectoderm and the associated underlying layer of neural crest cells, are the origin for teeth development. As the oral epithelium grows and proliferates, it has a downward movement into the underlying neural crest layer. This leads to the formation of the dental lamina. These dental lamina, then, gives rise to tooth buds. These tooth buds, later form and develop into enamel organs. With further development, these enamel organs give rise to ameloblasts- which produce enamel. The dental papilla, on the other hand is formed by the neural crest cells which underlie the enamel organs <ref name= PMID19266065><pubmed>19266065</pubmed></ref>. These dental papillae than give rise to the dental pulp and odontoblasts- which produce predentin and dentin, in the adult body.

[[Image:Tooth development stage.jpg|frame|left|middle|425x300px|The stages of embryonic teeth development]]

{| class="wikitable"
|-
! Stage!! Week !! Description
|-
| (A) Lamina|| Week 6 || The oral ectoderm, closely interacts with the neural crest ectomesenchyme. In the Lamina stage, teeth may grow only within the epithelium.
|-
| (B) Placode|| Week 7 || The dental lamina and and the dental placodes arise, due to specific signals from adjacent epithelial cells
|-
| (C) Bud || Week 8 || Tooth buds are formed, as the epithelium cells interact with the messenchyme. This occurs at the sides of the dental placodes. Also, as opposed to the earlier Lamina stage, in the Bud stage, teeth may now only grow within the ectomesenchyme
|-
| (D) Cap|| Week 11 || After folding, the bud takes upon the shape of an inverted cap
|-
| (E) Bell|| Week 14 || The bud refolds once again, this time taking upon the shape of a bell
|}

===Video===
<html5media height="300" width="400">https://www.youtube.com/watch?v=nRH8M-arC58</html5media>

==Some Recent Findings==
{|
|-bgcolor="F5FFFA"
|
* '''Expression of caspase-14 and keratin-19 in the human epidermis and appendages during fetal skin development:''' <ref name=PMID23377137><pubmed>23377137</pubmed></ref> In recognition of the vital roles of CASP-14 and CK-19 in human skin development and maturation, the purpose of this study was to primordially investigate the expression of these two molecular factors throughout the stages of human fetal skin development from gestation to the postnatal period in order to evaluate their singular and collective functions in epidermal and associated appendage maturation and processes of differentiation and re-modelling of human fetal skin. The results of the immunohistochemical study showed the expression of CASP-14 to be a biochemical marker of human epithelial differentiation during gestation, whilst CK-19 was a marker for epidermal stem cells nests of the stratum basale of the fetal epidermis and appendages. CASP-14 was concentrated within the more differentiated fetal epidermal layers, progressively declining from the basal layer toward term whilst CK-19 showed reduced expression with progressive epidermal development of the fetal stages and was a biochemical marker for epidermal stem cells nests of the stratum basale showing marginal conservation in basal cell nests at term and postnatally. Expression of CASP-14 within the epidermal appendages of the hair follicles and sebaceous glands were concentrated within the greater differentiated inner root sheath whilst CK-19 was greatly concentrated within the outer root sheath. Inconsistent patterns of expression of both molecules CASP-14 and CK-19 were demonstrated within eccrine sweat glands.
|}

{|
|-bgcolor="F5FFFA"
|
* '''Cxcr4 is transiently expressed in both epithelial and mesenchymal compartments of nascent hair follicles but is not required for follicle formation:''' <ref name= PMID25066162><pubmed>25066162</pubmed></ref> Cellular signalling between mesencyhmal and epithelial layers of the developing skin initiate an assortment of morphogenetic events throughout embryogenesis, involving the formation of the skin and in particular, the development of hair follicles (HF). The aims of this study was to identify the specific signalling pathways associated with HF morphogenesis during the primary stages of mouse hair follicle development through the investigation of the precise expression patterns and role of the Cxcr4 receptor in two specialised cell types- mesenchymal dermal condensate (DC) cells and epithelial placode cells. Staining patterns of the Cxcr4 receptor in the budding HF revealed a high concentration within epithelial placode cells and later DC cells in developing HF’s, signifying a shift of expression between epithelial and mesenchymal layers during HF morphogenesis. The functionality of the Cxcr4 receptor was tested through Cxcr4 receptor ablation in both the mesenchymal and epithelial layers of the developing embryonic skin of conditional knockout mice (cKO) and was verified through immunofluorescence staining techniques. Normal HF development was still induced despite the absence of Cxcr4 expression in the skin of the cKO mice and numbers were comparable to those found in the wild-type (WT) control group in embryonic and postnatal skin groups demonstrating that the chemokine signalling through the Cxcr4 receptor is inessential for normal early HF development (Figure 1).
|}

{| style="width:40%; height:170px" align="center"
|-
| [[Image: Eosin_staining_of_mouse_embryonic_skin.png|frame|250x250px|Figure 1: Hematoxylin/ eosin staining of embryonic skin sections and macroscopic view of external hair shafts of mouse. Cxcr4 receptor ablation in condensates and placodes show no effect on mouse HF morphogenesis. Hair follicle and shaft develop normally and in comparable numbers in both Tbx18cre (a) and Krt14-cre (b) Cxcr4fl/fl cKO mice.]] || [[Image:- compound mouse mutants demonstrate partially rescued upper and lower molars.png|frame|right|middle|300px|Figure 2: Msx1-/--;Tbx2+/-mouse mutants showed rescue from bud to cap phase transition in embryonic dental development. Both upper and lower molars showed an enlargement in the tooth buds (H, K, L), with few upper molars progressing to cap stage (G). The arrowheads indicate enamel knots (E,G,I).]]

|}

{|
|-bgcolor="F5FFFA"
|
* '''The ventral proximal nail fold: stem cell niche of the nail and equivalent to the follicular bulge--a study on developing human skin:''' <ref name= PMID22804461><pubmed>22804461</pubmed></ref> In comparison to the characterization of the stem cell niche within the folliculosebaceous-apocrine unit, the local microenvironment of stem cells within the human nail organ is yet to be characterized. The aims of the current study was through immunohistochemical analysis to describe the expression pattern of six follicular stem cell markers; cytokeratin 15 (CK15, two clones), cytokeratin 19 (CK-19), PHLDA1, CD200 and nestin within the developing human nail and compare it with the embryonic and fetal human hair follicle. In addition, locations of vast proliferative activity within the nail were assessed using labeling with Ki-67. The stem cell markers CK15 (both clones), CK19, PHLDA1, CD200 and nestin showed no staining within the nail and hair matrix samples, however were present within the central proximal nail fold and follicular bulge. The biochemical marker for proliferation, Ki-67 showed the highest concentration of proliferative cells within the hair germ, lower regions of the hair peg and in the hair matrix. In the developing human nail the expression of Ki-67 was most prominent within the nail bed epithelium and the later nail matrix. In contrast the lowest numbers of kI-67 positive staining cells were located in regions of stem cell niches of the follicular bulge and proximal ventral nail fold as stem cells divide infrequently. Throughout the course of embryonic development these stem cell markers exhibit a highly specific expression pattern both within the nail and the hair follicle. The results seem to suggest that during embryonic envelopment the proximal ventral nail fold is the niche for nail stem cells.
|}

{|
|-bgcolor="F5FFFA"
|
* '''Msx1 and Tbx2 antagonistically regulate Bmp4 expression during the bud to cap stage transition in tooth development:''' <ref name= PMID23720046><pubmed>23720046</pubmed></ref> The expression of Bmp4 is essential for the bud to cap phase transition in embryonic dental development and is accordingly firmly regulated, with earlier stages of expression localised within the dental epithelial placode developing in to a later forms of expression in the dental mesenchyme. Numerous transcription factors including Pax 9, Osr2, Barx 1, Msx1, have been identified to prompt and maintain Bmp4 expression in these critical stages of tooth development. In particular Msx1 is one such transcription factor induced through epithelial Bmp4 expression and in turn is essential for the induction and regulation of dental mesencyhmal Bmp4 expression. The results of this investigation have demonstrated the expression of an additional transcription factor, Tbx2, induced through epithelial Bmp4, within the dental mesenchyme at bud stage of dental development. To determine a functional connection between the Msx1 and Tbx2 transcription factors, a cross was made between Tbx2 and Msx1 mutant mice. The data demonstrates that bud phase tooth arrest in Msx1-/- mice is moderately restored in Msx1-/-. Tbx2+/- compound mutants. The maintenance of Tbx2 expression in the Msx-/- arrested tooth buds exhibits that the expression of Tbx2 is not dependant on that of Msx1. This restoration in the developmental process is associated with the establishment of the enamel knot (EK) and the reinstatement of mesencyhmal Bmp4 expression (Figure 2). Knockout of Tbx2 resulted in an increase mesencyhmal Bmp4 expression. This data demonstrates that subsequent to the induction of epithelial Bmp4, both transcription factors Msx1 and Tbx2 in turn antagonistically regulate odontogenic activity that results in EK formation as well as mesenchymal Bmp4 expression at the vital bud to cap phase transition in embryonic dental development resulting in appropriate morphogenesis and patterning.

|}

{| class="wikitable mw-collapsible mw-collapsed"
! More Recent Papers
|-
|
<pubmed>23826487</pubmed>
<pubmed>22342389</pubmed>
<pubmed>24911066</pubmed>
<pubmed>25143675</pubmed>
<pubmed>23271751</pubmed>
<pubmed>25249463</pubmed>
<pubmed>23097355</pubmed>
|}

==Historic Findings==

Knowledge of the Integumentary expands in conjunction with technological developments that allow observation of microscopic structures. Historically animal models have been used to map the stages in the development of the fetal integumentary system.

===Skin===

* '''1900''' - Bardeen used the pig animal model to study the histogenesis of the dermomyotomes and nervous appratus. Bardeen and other scientists established that the human skin results from the union of the epithelial material derived from the ectoderm (epidermis) and the connective tissue origination from the mesoderm (dermis).

http://journals.lww.com/plasreconsurg/Citation/1949/07000/CLINICAL_ASPECTS_OF_EMBRYOLOGICAL_SKIN.8.aspx
Bardeen, C. R. (1900). The development of the musculature of the body wall in the pig, including its histogenesis and its relations to the myotomes and to the skeletal and nervous apparatus. Johns Hopkins Hosp. Rep, 9, 367-399.

===Glands===

Sebaceous glands / Sweat glands / Mammary

In the 1968 Robins and Breathnatch investigated the development on the sebacious and apocrine swelling in the skin, which where closely associated with development of the hair follicle. They observed differentiation of desmosomes and development of cytoplasmic contents of the cell.

===Hair===

The major anatomic details of hair development in the human foetus have been established by studies with light microscopy. Electron microscopy was not commonly used to until recently and so little was known about the ultrastructure of the skin. Over the past few years, reports have been published on the epidermal melanocytes and periderm.

* '''1958''' - Pinkus established the following stages of fetal hair follicle development: pre-germ, hair-germ, hair-peg,andbulbous-peg stages. Pinkus also determined that the developed hair fibres grow through the epidermis and appears at the level of the skin at around 19-21 weeks of development. The lanugo (foetal) hair is extremely fine with no medulla and a tip free of pigment.

* '''1968''' - Breathnach and Smith determined the fine structure of the cells of follicle and dermal papilla in the first two weeks of fetal development. The Peripheral Nerves, the sweat duct and nail development were also explored and the interrelationship of cells at particular foetal stages was deduced. These studies, and other laboratory animals, have provided information on the differentiation of cells and tissue of some functional importance and underline the role of cells and tissues.<ref name= PMID5656140><pubmed>5656140</pubmed></ref>

Robertson, J. R. (Ed.). (2002). Forensic examination of hair. CRC Press.

* '''1959''' - Chase and Eaton's investigated fetal hair follicle development. With key observations in understanding the cycling nature of hair follicle growth, following development. Development begins with the downwards growth of the follicle structure from the level of the dermis. The follicle is a processes during the quiecent phase thought he adipose layer during gowth and differntiation. They also established that upward movement of hair inovlves the addition of next cells from the matrix of the follicle and an enlargement of each cell. Furthermore their research also showed that the epidermal and dermal layers were dynamic and interacting with each other. The most significant developments in the understanding of hair follicle development came from studies investigating the differentiation pattern of cells as the follicle develops. <ref name= PMID5656140><pubmed>5656140</pubmed></ref>

<pubmed>5656140</pubmed>
<pubmed>4097391</pubmed>

Determined that the hair fibre finally breaks through the epidermis and appres about the skin at around 19-21 weeks of development. The lanugo (foetal) hair is extremely fine with no medulla and a tip free of pigment.

===Nail===

Microscopy and staining techniques have been essential tools in study of nail development, anatomy and physiology. Thus, as such technology advances scientists have been able to uncover the morphological details of the nail and understand the changes that occur during nail development. A review of the history allows us to recognize the major contributor to this field. History of research on nail development also reveals the interesting debate on the origins of keratinized cells which migrate to form the nail palate in weeks 20-24 of fetal development.

[[Image:Nail Plate Development - Pinkus .jpg|frame|right|middle|180x150px|Nail Plate Development - Pinkus|]]

* German scientists Unna and Pinkus were both highly reputable dermatologists who conducted a great deal of research on the development of the skin and associated structures. They were (<ref name= PMID12581143><pubmed>12581143</pubmed></ref> <ref>Roberts, H. L., & Walker, N. (1929). PAUL GERSON UNNA. British Journal of Dermatology, 41(4), 157-160.</ref>)
* '''1883''' - Unna published a chapter on the anatomy and development of the human nail in the German textbook "Ziemsssen's Handbuch der Speciell Pathologie und Therapie" - Ziemsssen 's manual of special pathology and therapy.
* '''1927''' - Pinkus conducted his earliest investigations into fetal nail development. His findings were published in the "Handbuch Der Haut und Geschlechtskrankeiten” - Manual of Skin and Venerail Disease.
* Based on their findings both scientists proposed that the nail matrix structure gives rise to the entire nail plate during normal fetal development. <ref name= PMID5556500><pubmed>5556500</pubmed></ref>

[[Image:Nail Plate Development -Lewis .jpg|frame|right|middle|170x145px|Nail Plate Development -Lewis|]]

* '''1954''' - Barton and Lewis conducted a through investigation on the microscopic features of the fetal and mature nail and surrounding soft tissue. Lewis challenged the current thought and proposed a "tri-partite" origin of the nail plate from three tissue origins (1) the proximal nail fold (2) the matrix and (3) bed. <ref name= PMID5556500><pubmed>5556500</pubmed></ref>
* Prior to the 1900’s it was difficulty in obtaining normal fetal specimens. Furthermore, the histological staining techniques used to prepare slides of nail tissue often damage the specimen and little detail could be seen during the microscopic examinations. Barton and Lewis conducted this investigation in hopes that a better understanding of the normal developmental anatomy and physiology would assist physicians in diagnosing and treating abnormalities. <ref name= PMID13206419><pubmed>13206419</pubmed></ref>

* '''1959''' - Samman carried out an investigation on the blood supply of the human toe nail. It was thought that a deeper understanding of morphology of the vasular supply might allows us to infer the mechanism of nail plate genesis. Samman studied the morphology and distribution of blood vessels with in the nail found capillary loops through out the nail fold and concluded that this supports the theory of multiple sites giving rise to the nail plate. <ref name= PMID14441224><pubmed>14441224</pubmed></ref>

* '''1963''' - Zaias conducted a number of studies on the embryology of the human nail. This investigation contributed to our understanding of different stages in foetal nail development. Zaias studied an number of foetal specimens at different stages in development. As a result, Zaias was able to propose a rough timeline highlighting morphological hallmarks in normal nail development. <ref name= PMID14003041><pubmed>14003041</pubmed></ref>

The current understanding of fetal nail development is a summation contributions of many researches in the international scientific community. Today research continues, technology allows exploration beyond macroscopic and microscopic morphological changes in the fetal nail. Now the aim is to understand the molecular signalling with in the epidermal cells which drives this process.

===Teeth===
<ref name= PMID5267156><pubmed>5267156</pubmed></ref> -- <pubmed>5267156</pubmed>

==Abnormalities==

===Aplasia Cutis Congenita===
[[Image:Cutis aplasia.jpg|frame|right|middle|250x187px|Aplasia cutis congenita at the scalp]]
Aplasia cutis congenita (ACC) is a rare skin abnormality, characterised by the absence of all layers of the skin. It is most common to occur on the scalp (70%), specially the vertex. In severe cases, the defect can go as deep as the bone or the dura. Other sites of ACC include the skin of the limb regions. “ACC occurs in approximately 1 in 10000 live births, with a female-to-male ratio of 7:5.” The specific aetiologic agent for ACC is still unknown. It has been suggested to be genetic and/or environmental. The damage to the vertex is suggested to be the result of the biomechanical stretch at this area when the fetal brain is growing.<ref name= PMID22549580><pubmed>22549580</pubmed></ref>

Presently, ACC is managed via conservative treatments or surgical treatments. Conservative treatments refer to basic wound treatments and preventing infection with the use dressings and antibiotics. Surgical treatments, specifically scalp reconstruction procedures, aim to reconstruct the damage to the skin through skin grafts, local scalp flaps, and pericardial scalp flaps. Large defects are often treated using surgical treatments.<ref name= PMID23147310><pubmed>23147310</pubmed></ref>

===Dystrophic Epidermolysis Bullosa===
[[Image:Dystrophic Epidermolysis Bullosa lesions.jpg|frame|right|sub|270x230px|Severe skin lesions due to Dystrophic epidermolysis bullosa.<ref name="PMID23739692"><pubmed>23739692</pubmed></ref>]]
Dystrophic Epidermolysis Bullosa (DEB), a type of epidermolysis bullosa, is a genetic disease of the skin, usually present at birth or at an early age. Currently, around 400,000 - 500,000 people are affected with the disease<ref name= PMID252845240><pubmed>25284524</pubmed></ref>. It is characterised by the fragility of the skin<ref name= PMID252845240><pubmed>25284524</pubmed></ref>, where it blisters upon minimal trauma and scars<ref name= PMID19945622><pubmed>19945622</pubmed></ref>, usually at the extremities<ref name= PMID252845240><pubmed>25284524</pubmed></ref>. It is caused by a mutation in collagen VII gene (COL7A1)<ref name= PMID19945622><pubmed>19945622</pubmed></ref><ref name= PMID24860657><pubmed>24860657</pubmed></ref>, which is responsible for the the formation of anchoring fibrils<ref name= PMID19945622><pubmed>19945622</pubmed></ref>. Anchoring fibrils are responsible for dermal-epidermal adherence<ref name= PMID19945622><pubmed>19945622</pubmed></ref>, that is why it’s loss of function results to blistering of the skin. In some cases, even teeth and nails are affected. Teeth of patients with DEB have enamel defects and when combined with poor oral hygiene, it may lead to decay. Nails of DEB patients are often dystrophic and will eventually be lost.<ref name= PMID252845240><pubmed>25284524</pubmed></ref>

There are currently no known cures for DEB; however there are techniques to manage the clinical manifestations of the disease, which include:
*wound care<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*preventing factors that may cause blistering<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*using aqueous disinfectants - highly effective<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*dental care<ref name= PMID252845240><pubmed>25284524</pubmed></ref>:
:-use of topical fluoride
:-careful prophylaxis
:-use of topical antibiotics to prevent secondary infections<ref name= PMID24860657><pubmed>24860657</pubme></ref>

One study is currently exploring the potential of protein therapy as a treatment for DEB. Their results show that intradermal injection of recombinant human collagen 7 in mice with DEB led to “restoration of C7 and anchoring fibrils.”<ref name= PMID19018253><pubmed>19018253</pubmed></ref> Other techniques that aim to restore C7 include:
*bone marrow transplant- improved blistering in mice specimen and increase survival rates<ref name= PMID24860657><pubmed>24860657</pubmed></ref>
*hematopoietic cell transplant (HCT)- increased deposition of C7 in injured skin<ref name= PMID24860657><pubmed>24860657</pubmed></ref>

===Congenital Alopecia Areata===
[[Image:Alopecia Areata.jpg|frame|right|middle|270x220px|Patches of hair loss: a sign of alopecia areata.<ref name="PMID23960401"><pubmed>23960401</pubmed></ref>]]
Alopecia areata (AA) is an abnormality of the hair affecting anagen hair follicles, characterised by well-demarcated patches of hair loss. It is non-scarring and can occur on the scalp and/or the body. 90% of AA cases occur on the scalp. 5%-10% of patients with AA lose all hair on their scalp; this is called alopecia totalis. While others lose all of their body hair, this is called alopecia universalis. <ref name= PMID17269961><pubmed>17269961</pubmed></ref> Its pathogenesis is considered to be both genetic and autoimmune. There is an abnormality with the genes related to the immune system and to the hair follicles. And histopathology shows signs of lymphatic infiltration of the hair follicles and the loss of these scalp lymphocytes allow hair follicles to recover.<ref name= PMID16338213><pubmed>16338213</pubmed></ref> High frequencies of catagen and telogen hair follicles are also present in areas affected by AA.<ref name= PMID17269961><pubmed>17269961</pubmed></ref>

There is currently no cure for AA. There are several treatments to combat AA but none of these have led to remission of the disease, the most effective being corticosteroids and topical immunotherapy.<ref name= PMID17269961><pubmed>17269961</pubmed></ref> A new method of treating alopecia areata is currently being studied. Transepidermal drug delivery (TED) is a new treatment that functions by creating micro-channels in the epidermis. By doing so, drug delivery to the skin is improved. This treatment was highly effective and had lower rates of side effects, e.g. pain, compared to previous treatments.<ref name= PMID25260052><pubmed>25260052</pubmed></ref>

===Harlequin Ichthyosis===
[[Image:Harlequin Ichthyosis.jpg|frame|right|middle|250x200px|A baby with harlequin ichthyosis.<ref name="PMID24520234"><pubmed>24520234</pubmed></ref>]]
Congenital ichthyosis is an autosomal recessive disease of the skin, characterised by visible and excessive scaling of the skin and hyperkeratosis, i.e. thickening of stratum corneum layer of the epidermis and in some cases, hypohidrosis, i.e. the lack of ability to sweat. <ref name= PMID19824737><pubmed>19824737</pubmed></ref> Harlequin ichthyosis (HI) occurs only in 1 in 1,000,000 babies. It is life-threatening in the first few weeks and/or months of the neonate.<ref name= PMID19824737><pubmed>19824737</pubmed></ref> The thick skin can restrict movement of the baby and sometimes constrict extremities and lead to necrosis then autoamputation.<ref name= PMID23419760><pubmed>23419760</pubmed></ref> Babies with HI are also characterised by bilateral ectropion (everted eyelids), eclabium (everted lips), and underdeveloped nose.<ref name= PMID23419760><pubmed>23419760</pubmed></ref> In 50% of HI cases, respiratory failure is often the cause of death.<ref name= PMID24124810><pubmed>24124810</pubmed></ref> This disease is caused by a nonsense mutation in the ATP-binding-cassette A12 (ABCA12) gene, which is responsible for encoding a lipid transporter essential for the regulation of lamellar bodies. <ref name= PMID19824737><pubmed>19824737</pubmed></ref><ref name= PMID23419760><pubmed>23419760</pubmed></ref><ref name= PMID24124810><pubmed>24124810</pubmed></ref>

There is currently no known cure for this disease. Management techniques include:
*Monitoring in neonatal intensive care units.
:-Temperature within the incubator is controlled to avoid fluctuation in body temperature and to stop sweating. <ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Mechanical removal of excess scales from the skin <ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Bathing to remove excess scales from the skin<ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Topical therapy - to reduce hyperkeratosis. <ref name= PMID19824737><pubmed>19824737</pubmed></ref><ref name= PMID24124810><pubmed>24124810</pubmed></ref>
*Use of oral retinoids - known to have high rates of survival.<ref name= PMID24124810><pubmed>24124810</pubmed></ref>

===Hypohidrotic Ectodermal Dysplasia===
[[Image:Oligodontia.jpg|frame|right|middle|250x187px|Oligodontia: a clinical manifestation of HED.<ref name="PMID21165248 "><pubmed>21165248 </pubmed></ref>]]
Hypohidrotic ectodermal dysplasia (HED) is the most of all ectodermal dysplasias, caused by an abnormality in the development of ectodermal tissues, which inlude skin, hair, teeth, sweat glands, and nails.<ref name= PMID20682465><pubmed>20682465</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref> Patients with ectodermal dysplasia often have sparse hair and oligodontia, which is a condition where teeth are missing and are poorly developed.<ref name= PMID20682465><pubmed>20682465</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref> Sweating is a very important function in the body in terms of thermoregulation. HED is mainly characterised by hypohidrosis due to the lack of sweat glands in the skin, which could lead to hyperpyrexia and sometimes death. In neonates, the mortality rate of HED reaches up to 30%, with the first year of life having the highest risk. <ref name= PMID20682465><pubmed>20682465</pubmed></ref> HED is caused by a genetic abnormality of the ectodysplasin A gene (EDA) and passed on by X-linked inheritance. The mutations of this gene results in the poor sweating ability or none at all in a person. The effects of this abnormality is usually more severe in males than in females. <ref name= PMID21357618><pubmed>21357618</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref>

There is currently no pharmacological therapies for HED but there are methods applied to prevent the disease from aggravating. Neonates with HED are placed in incubators and monitored to prevent them from overheating. Management of this disease gets easier as the patient ages. Adults with HED can control their thermoregulation by staying in cool environments or drinking cold drinks to lower the body temperature. Currently, there are studies that aim to find a cure for this abnormality, e.g. gene replacement therapy in animal models.<ref name= PMID24678015><pubmed>24678015</pubmed></ref>

==References==
<references/>

File:Fetal Hair Follicle Development - Week 8-12.JPG

2014-10-23T04:56:54Z

Z3418340:

Fetal Hair Follicle Development - Week 8- 12

* This stages of hair follicle development is known as the "placode"
* Signalling from the epidermal cells attracts fibroblasts in the dermis to the site of germination.

Reference -
Pansky, B. (1982). Review of medical embryology. New York: Macmillan.

Copyright
Beginning six months after publication, I z3418340 grant the public the non-exclusive right to copy, distribute, or display the Work under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported license, as described at http://creativecommons.org/licenses/by-nc-sa/3.0/ and http://creativecommons.org/licenses/by-nc-sa/3.0/legalcode

{{Template:Student Image}}

z3418340

File:Fetal Hair Follicle Development - Week 8-12.JPG

2014-10-23T04:55:59Z

Z3418340: Fetal Hair Follicle Development - Week 8- 12 This stages of hair follicle development is known as the "placode" Signalling from the epidermal cells attracts fibroblasts in the dermis to the site of germination. Reference Pansky, B. (1982). Review...

Fetal Hair Follicle Development - Week 8- 12

This stages of hair follicle development is known as the "placode"
Signalling from the epidermal cells attracts fibroblasts in the dermis to the site of germination.

Reference
Pansky, B. (1982). Review of medical embryology. New York: Macmillan.

Copyright
Beginning six months after publication, I z3418340 grant the public the non-exclusive right to copy, distribute, or display the Work under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported license, as described at http://creativecommons.org/licenses/by-nc-sa/3.0/ and http://creativecommons.org/licenses/by-nc-sa/3.0/legalcode

{{Template:Student Image}}

z3418340

Talk:2014 Group Project 5

2014-10-23T04:51:32Z

Z3418340: /* Week 12 */

{{ANAT2341Project2014discussionheader}}
==Peer Reviews==

Group 5, you have a brilliant introduction, introducing the reader to what your page is about. Your introduction contains information for each of the parts involved in the integumentary system such as skin, glands, hair nails and teeth. There is a clear structure to your project with clear headings and sub-headings. This makes the reader find information about a particular part in your project more easily.

There is an extensive list of references, which demonstrates, a great effort towards researching your projects system. Some of the references however, need to be put into in the correct format. There are different reference lists under the different sections of your group project and as I understand why, I'm sure these are just small things that will be fixed before the final submission.

I have to commend you on your table, it is more than sufficient. It not only clear describes a clear transition from week to week changes in development of the integumentary system. The table however, needs to be reformatted to fit the window of the page and likewise, the pictures inside the table as there are too small to be seen without opening up the image. There are other images also on the page were too small such as "The stages of embryonic teeth development". These are just minor changes that need to be made before your groups final submission.

At the start of your project, all descriptions were matched with an image. This provided an appropriate balance between written text and visual representations. However, in the historic findings section, this balance was not seen as there are no images for this section.

Under your section of some recent findings, there are blocks of information in purple; I'm not sure as to the reasoning behind this, as the other parts in your project do not have the same background.

I particularly liked how in the introductory paragraph you mentioned what topics you will be covering; including abnormalities associated with the Integumentary system and delivered this information under the abnormalities section, where treatments and managements of these abnormalities were put forward!

Overall, good work guys! 

----
The introduction covers all the topics of the project, however it does so briefly. Merging the development overview with the introduction will hide the fact that the introduction paragraph is short as this whole section will become one large detailed introduction about the integumentary system. The development overview is detailed and separated in terms of the structures found in the system. This is great, however less dot points should be used as it looks more like notes than presentable information. The creation of this timeline table is amazing and addition of the images according to the weeks is a well generated idea. Not all the images are described, so please do so for the final copy as it is essential that images of histological slides are describes as they can be confusion and difficult to understand. The information about hair and its adjacent image is the scaffold that should be followed throughout the whole section, as it has been written concisely and easily understandable. The hair development stages image is adequately describes and references with the copyright statement. Well done.

I appreciate the uniqueness in the layout of the recent findings, however I find it slightly overwhelming and out of place. Possibly adding a collapse and expand option to each article is beneficial. The summaries of the findings are in-depth and it is obvious that the author of this summary understands the topic.

A great start in historic findings with information present for a wide range of structures in this system. With that said, each section requires more research, however you are on the right path in finding articles greater than 50 years old. Only one image is attempted to be added, it is hard to find copyright granted images or historical drawings, but redrawing those original images is vital in providing solid historical information. In terms of the referencing, if you are unable to find a PMID for a certain article then manually add the reference and the URL link as you have but adhere to correct formatting.

Each abnormality is consistent with detailed information, statistics and a described image. The writing style is consistent and the image uploads with captions are correctly completed. Great work. The information is frequently cited emphasising efficient research ability. On that note, the references are correctly numbered and superscripts used instead of repeating the reference.

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The introduction clearly states the content in the website, which is good as this can prepare the readers for understanding. However, it would be better if some information about integumentary system, such as functions, is included in this section.

The development of integument system includes a lot of information. They are presented in good structure by the use of table for skin and nail. It is a great way to put some images in the table for easy understanding of the description in the development of teeth.

The recent findings area is well-researched. I would suggest try to put the content into small paragraph or in several points as the amount of text is a bit too much. Some images should be included as well.

Abnormalities section is great with the help of the images. It would be good if some more abnormalities are included. There is a lot of details under historic findings, try to illustrate them with the help of images.

In-text references should be included in the sections under development, recent findings and historic findings.

The project is well prepared. It would be better if some more images are included and the function of integument system is stated in the introduction.
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This group has made an outstanding effort in their efforts. I particularly liked the fact that they summarized the actual purpose of the page and what it would contain within the introduction itself, something the other groups have not really done.

They have structured and organized the page extremely well and it is consistent and flows between each of the headings. I would suggest to tabulate the three types of cells in skin and have a column describing their origin and then their function to make it easier to read. The table for development of dermal layers and the table for teeth development should also ideally have a title and table numbers.

In general the content is very well written and informative, supported with relevant images and diagrams that illustrate the actual development process. The recent findings heading is also well written however there are a few formatting issues with the text box sizes that need to be fixed up. I think it would be a good idea to list the sources of historic findings and then elaborate on what contribution they may have made to our current understanding.

The referencing just seems to be inconsistent in this section. Additionally it would be a good idea to move all the references for the other sections to the end of the page under the actual references heading rather than having them scattered over the wiki page. The abnormalities section is highly commendable and written extremely well. Great job on the excellent and informative wiki page you have produced.
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The introduction is a great summary of what the project page will discuss making sure to highlight every aspect. However, the introduction should also mention more about the integumentary system listing all the organs involved, their function, anatomical position and the difference between the embryonic and fetal stages of integumentary development. The content presented on the page is fantastic. All information under the subheadings looks complete and has key information related to the topic. I like how the timeline is divided into each organ making it easy to understand and navigate. The use of the table to format the information is a brilliant idea and has been presented beautifully with images in each textbox. Also the content under current research is relating to the topic and shows extensive research. The use of the purple background is appealing to the viewer highlighting its significance. I do however believe that the information under ‘historic findings’ should be formatted into a table to make it easier to navigate. The content under ‘abnormalities’ has the right amount of information and clearly relates to the key topic of the project.

In terms of images, I believe a satisfactory amount of images have been used which clearly describes the content. However, some images are missing the all the copyright information needed as well as the description, references and student template such as those in the ‘development overview’ table. This should be added right away to ensure these images do not get deleted. The use of captions on these pictures is important to highlight what the image is referring to and this is present in the page. Although, images could be added under current research as this section looks like it could use more images. Great job on the images under abnormalities, they accurately relate to the content mentioned.

There are some incite references missing such as in the development overview. I’m not sure if the references listed below are supposed to the references for it, however all references should be placed under one ‘references’ subheading. The same references have been combined into one number showing that the group knows how to make the references set out. Also a glossary list should be added to help viewers understand the content more instead of just being confused at some sections. Overall, this is a great project and if the group makes edits based on the peer-reviews received, this could enhance their project.

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Much more information on introduction is needed maybe. Also in text citations is needed.
EXCELLENT job on the overview development section. The table and the images are great especially. Great use to information and the corresponding images. One suggestion though, put in text citations.
Try to avoid repetitions as in the overview “this page” is repeated and in the table “a study” is repeated. Try being specific to which study you are referring to.
Well balance of text and images in the development overview section. In text citations are needed and all the references would look better in the end of the page in a bulk.
For your first research findings maybe obtain an image/s to aid the information.
Historic findings section is just a bulk of text. No images can be seen so if possible I suggest you add images to this section. Although it is VERY WELL researched.
VERY WELL DONE with the abnormalities section as each abnormality is well explained and has an image to accompany it.
Try not to use a lot of pictures and references from the Embryology website.
Over all this page is good but a lot of in text citation needs to be done and the references need to be in the end of the page in a bulk.

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Group Project 5 – Integumentary Development

This page looks very neat and well organised, with an introduction that explains exactly what is going to appear and be discussed on the page. The Development Overview section is very well done, with the appropriate use of subheadings and content. The use of dot points is very effective, making the page look neater. Perhaps it would be good to draw a histological diagram of the skin layers, and uploading it to the skin development section. Specialised cells or important names throughout the page could be highlighted in bold or underlined as well, to highlight important terms and make it easier to learn and remember from. The title ‘Some Recent Findings’ accurately portrays what we as students can only do, which is identify SOME of the recent findings. This section could have more than 2 recent findings however and could be further subdivided by subheadings into the different components of the integumentary system – perhaps have 2-3 research articles for each component of the system. Historic findings are well researched but some more information would be good. The ‘Abnormalities’ section is so far the best looking section as it seems it is almost completed. Perhaps a few more abnormalities would be even better.

The table of the timeline in the ‘Development Overview’ section is superbly done and the use of histological images is fantastic as it provides the anatomical information visually. When I clicked on an image however, there was no proper referencing of the image and the copyright information and student image information was not present. The images are described very well.
One image has a problem and is present in red writing, so might need to remove this as something is wrong with the file and it could not be uploaded. There are no student-drawn images and I think if this group did this, it would really benefit their project and emphasise their understanding.

The ‘Some Recent Findings’ section has a purple background, which makes the page look more aesthetically pleasing and less monochrome. I like the ‘More recent papers’ box that can be expanded to reveal any more research papers related to the integumentary fetal development, in case anyone wants to have a further read- very clever.

Journal articles are correctly referenced but website references need to be improved upon- to find how to do this go to the ‘How to reference’ page. References are all over the place and need to be compiled under each heading or one main heading titled ‘References’ at the bottom of the page.

Overall, this page is looking fantastic at this point in time so keep up the great work!
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Introduction should be more to do with the content rather than the intention of the page. Introduce the reader to the system and then go into development in the next sections.

Fantastic job on the overview with the table being a highlight of this project

All of the images are very well integrated and presented. good work on the text and also the referencing in abnormalities section.

More references need to be included within text. Low amount thus far. References also need to be reformatted to be listed in one spot. You can always look at other groups page and copy their layout. The abnormalities section on your page has the right idea. Have a chat in group about it.

The main issues with this project are mainly formatting, very well done otherwise
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Introduction is short though luckily few words can go a long way, with all sections of the wiki page being properly addressed. Development overview content is good; the use of table integrated with pictures allows viewers to visually grasp the progression in skin and teeth development. The changing between dot-points and paragraph format should be standardized or use paragraphs with dot-point only for list based information. References need to be properly integrated into the page, instead of at the bottom of each section.

In the recent findings section 2 out of the 4 studies presented have any content. To improve cutting some of excess information for the 2 studies already addressed and creating summaries for the other 2 will create better scope of recent findings. The formatting of recent findings is unusual, proper placement of the “Hematoxylin/eosin” image”, removal of dot-point and removal of purple highlighting, will make the section easier for viewers to understand. Historical findings okay, more detail could be added to “skin”, “glands”, “nails”. Use of capital letters like “DEVELOPMENT” show be replaced with subheadings, the image “File:Screen Shot 2014-10-08 at 10.38.04 am.png” has not appeared properly, should be easy to fix.

Straight up the abnormalities section is amazing, no improvement needed. All 4 diseases have in-depth relevant information, sufficient referencing and images to allow viewers to visualise clinical manifestation. To improve use of dot-points or paragraphs should be standard throughout the project, referencing in beginning sections needs to compiled at ending of each Main heading or bottom of page, recent findings need 1-2 more studies, and recent findings need significant reformatting.

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Overall I was very impressed with this project page. I loved your use of pictures and diagrams as it provided a great understanding of what was happening- and also, a lot of the images were quite interesting- which is a great thing for a project! I also enjoyed the use of bullet points- it was very to the point and it retained my attention throughout the piece. I did find, however, that the introduction was a bit short. Whilst it did cover most of what was required, I don’t think it hurts to be a bit more exhaustive in what you’re saying, because the introduction sets the mindset of the reader for the rest of the project- and if they have a clear understanding from the start, it makes it much easier when you are explaining more complex things such as the abnormalities later on.

Overall, I thought that the developmental timeline was extremely well done, and a highlight of your project. The rest of the developmental overview was quite well done, however I think in areas it was a bit sloppy, and it would be of great benefit to clear this up so as to improve the clarity of your work. Further, I enjoyed the succinctness of your paragraphs, it made it easy to read and wasn’t too much to take in at once. I think that currently, your use of colour is a bit random in the recent findings. I think that this could really boost your project if you applied it to more areas of the page. As far as the content goes, I think that the recent findings is just too wordy and I began to lose my concentration a bit. I think maybe by forming more succinct dot points- you will be able to convey your message more clearly.

I think the historic findings could do with a bit more beefing up, but what you have so far is well done. The abnormalities is also very well done, and I think that your use of images really grab the readers attention.

I think that overall this project is shaping up to be a great one. I think you need to be careful and consistent with your referencing though as I noticed some sections lacked in-text citations.

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This page seems to be done extremely well. It looks very visually appealing as multiple images are used, information is presented in tables, bullet points and very few slabs of text. The introduction is short and to the point. You could possibly add to this area a tiny bit of info concerning the embryonic development of this system, where it first started, then mention how you will expand on the fetal development. Otherwise it just seems way too short.

Explanation of the organs in this system is well done and concise. In the glands section, I would suggest not using dot points for the function of the vernix caseosa as it looks as though the dot points continue from those of the glands, therefore can be confusing when first looked at. Other than that, I would suggest that you make sure your referencing is correct and is used within the text.

The recent findings area is nicely done, but I still can’t help but feel the amount of text is just too much, even though the section is made better looking by making it purple (keep the colour, it looks awesome). The slab of text is just too much, so you should try and simplify it a bit. Historic findings are few but there is at least one for every organ which is good (more would be better). The abnormalities covered are done well, going into detail and providing a good image to describe what it looks like. I would suggest having at least 5 abnormalities, one for each organ discussed.

Overall, this page is very well done, with lots of images and colour used. The main thing I would suggest would be to make sure correct referencing is used. There were some paragraphs were no references were used at all. Also, all references should be at the bottom of the page, not within individual sections.

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This page has great overall structure and presentation. The introduction gives good insight of the overall contents of the page, however it is very brief and should be expanded upon.

The table included in the developmental overview serving, as a timeline is excellent, really well done. It’s easy to follow and looks very neat. I like how there is an image for each of the weeks mentioned, just don’t forget to add in-text citations for its contents. The glands sub-section is very brief and would benefit if there were more contents added. Great job on the images though. The nail section is the same, more contents needs to be added and image would look really good.

The developmental overview and historic findings sections also seems to lack in-text citations. There is also has an image with a broken link. The subsection hair seems to be well researched, however I would also suggest either bolding or underlining the words you want to emphasize such as “structure” for a neater look.

The recent findings section looks superb I love the purple background colour. Its very well researched and the link to more research papers are very helpful for readers. I would suggest you put the image at the bottom of the mentioned content though, just to avoid the big gap on the page, or even if you can manage to wrap the text around the image, it would look much better in terms of presentation.

Although disturbing, the abnormalities section I could not fault. Very well done. It is evident that it has been research well and the images allow for great visualization of the diseases mentioned.

Overall, excellent page just needs a very formatting edits and some expanded contents mentioned above. Good luck!

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Integumentary
The introduction seems really over formal and non friendly. Maybe try rewording some parts to make it more reader-friendly and welcoming.
The developmental time line is absolutely BEAUTIFUL! It shows the week of development, a brief explanation of each, and a picture to visually explain what is happening! I think it’s the best developmental timeline of all the wiki pages! Awesome job :)
The references should be put together at the end of the wiki page before final submission.
Hair and nail sections are very well done, teeth section are in dot points; this should be converted into paragraphs to match the wiki page format.
The section on recent findings seem to be copy pasted? Or not yet converted into the students’ own words. The formatting is very different to the whole of the wiki page as well which should be changed. On the section on historic findings, you should try to find a picture to supplement the information you have.
The abnormalities section is very well done, pictures visually supplementing each of the abnormalities. The picture of the infant with harlequin ichthyosis especially helps the reader understand the degree of extremity of the abnormality.
Overall, very informative and well done!

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This is a really well done project. You have made sure that that you have ticked all the boxes as well that Mark has asked for. The abnormalities section is really good. You have done well with most of your images as when you click on them there is a good description and they are well referenced. The development overview table is exceptional and makes the project easy to understand. For the week 22 maybe include the study in which you got your information from.

Apart from the abnormalities section it appears as though the referencing is a bit all over the place. Need to follow the abnormalities section and put references into the specific parts of the information you are using it for. Because otherwise it becomes difficult to know exactly where you got your information from. The historic findings are really good and well done however there is probably a space for more information to be included as I feel as though some of the findings are a bit hard to follow at times. It may have just been my computer I couldn’t see the picture of ‘fetal hair development’.

I think it would give a nice touch to the project if you were to add some student images because it would give the page a more ‘student’ and also make it easier to understand. Don’t mind the purple background on the ‘some recent findings’ part but it just looks a bit out of the blue. It’s certainly unique and attracts the eye but it puts a lot of emphasis on this section which I’m not entirely sure you want.

Overall though a really good project with excellent information. There needs to be a bit more focus on referencing technique, some minor edits which I have mentioned and maybe introduce some student pictures to make the project more student-like. Great work though and good luck in finishing it off.

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The introduction of this page was good as it provided a great overview and insight into what the project would later go on to discuss. Perhaps a little information on defining the integumentary system itself would be valuable though, to let the reader know the constituents.

The sub-sectioning of the page’s content into ‘introduction, ‘development overview’, ‘recent findings’, ‘historic findings’ and ‘abnormalities’ was clever, as the development section then went on to describe each component such as skin, nails etc. This effectively segmented the information into smaller chunks that could easily be navigated to. I especially liked the use of the table in the ‘skin’ section, showing the week of development, description and image corresponding alongside it, as it provided a holistic approach to that section. However, there were no in-text citations in the ‘skin’, ‘hair’, ‘nail’ or ‘teeth’ sections, hence the source of the information is unclear. To do this correctly, Dr Hill’s Wiki help page should be consulted.

The use of various images with labelled captions was a strength of this project, as the pictures were effective in balancing the text components to make the page more visually appealing. Most of the sections under ‘development overview’ have a decent amount of content, however the ‘nails’ part is a bit lacking and also needs to be correctly cited. The use of the table of images alongside the description of developmental stage in the ‘teeth’ section was very good to include, however the image is captioned ‘The stages of embryonic teeth development’. This may be irrelevant as the project’s focus is on fetal development. Further research into this area may uncover more relevant information.

Although the section on ‘recent findings’ contains a lot of information, the use of chunky paragraphs detracts from the readability of the page and the purple boxes could be summarised into dot points to help the reader understand the content more quickly. The section on historic findings seems concise and relevant, however the image included says it has been removed/deleted, so this requires editing. Lastly, the ‘abnormalities’ section was very well-structured and written, as each example had a captioned image accompanying it to help the reader visualise. This section was also well-done in terms of in-text citations, with an extensive reference list provided at the end. Perhaps consider adding some student-drawn images and possibly a relevant video, but otherwise it is very good as it is. Overall, the project has a good layout and a decent amount of content; with some editing and formatting it can be improved further.

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Overall this is an impressive and well researched wiki page incorporating lots of pictures and tables to keep the reader engaged and interested. However there are a few areas that have the potential to be tweaked. Firstly there are references scattered throughout the page. A more attractive way of presenting the references is as a long list at the end of the page. The introduction is clear, concise and short. All the organ development section is well presented and has the right amount of information. It is well structured in the sense that the student introduces the organ, it’s embryonic origin, the fetal growth stage and then goes into slightly more depth in a bullet point form. Along with complementary pictures, this is a very effective way of presenting their topic. This page could be improved by adding student-drawn schematic diagrams to summarise the layers of the skin in particular since histological images can be confusing and unclear to a non-expert embryology student.

The skin development section appears to dwell on the content that was covered in lectures. Considering there appears to be only three references associated with the entire integumentary organ development section, the depth of the information is limited. By doing some more research you might be able to find interesting additional information that can be added. The recent findings section is interesting and the images are great. However the dense block of information and slightly odd formatting make it hard to follow. Perhaps using diagrams to explain the differing gene expression and breaking down the information into bullet points would make it more readable.

The historic findings and abnormalities section is particularly well done. The images complement the minimal yet important points made. I was left wanting to read more into it so that suggests there’s room for further development and a deeper explanation of skin abnormalities.

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*Great overview given in the introduction. Maybe look to replacing the words "this page" to something else to avoid repetition
*I'm really liking how everything has been simplified into dot points and tables where relevant. Don't forget to include relevant references all throughout though, to justify all that you've included in each section
*I can't express how much I love your first table. Great work!
*Proofread so that you don't repeat the same things in your table though. You mention "in a study" numerous times but there's no indication to which studies they are
*I'm sure Mark would be thinking this same thing, but look to getting different references outside of this Embryology website, maybe from textbooks or otherwise for preliminary information on development
*The "recent findings" section looks nicely formatted but just a bit wordy. Maybe think of dividing the text up with bullet points or images
*Really liking your "historic findings" section! Great research
*Maybe think of re-creating some of the simpler pictures by drawing them yourselves. That way you're not using too many pictures from this Embryology website, Mark warned our group about this point
*Great choices for the "abnormalities" section. Traumatising at first, but very well-researched and presented

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The presentation of this page is very well with multiple images being used and text organised into tables and dot points. The introduction is short however includes necessary information regarding what is being included in the project. I recommend adding background information on anatomy of the skin (explaining on different layers) and other structures as well as a brief summary on the embryonic development of the system so that fetal development can be further expanded throughout the project.

The development overview section is done very well and is divided into different sections each explaining the development of a different structure. The use of table, images and bullet points has made the page look very interesting. The table of the timeline in the ‘Development Overview’ is done very well and the use of histological images is excellent as it helps in visualising the anatomy at each stage. There is however no proper referencing, copyright information or student template for any of the images. The table under “teeth” is also a very good summary of events during fetal period. I recommend including self-drawn diagram as well, since this is the only feature missing from your project. You can include a drawing of the different layers of skin (possibly in the introduction section). I also suggest putting all the references under one reference list at the end of the page instead of having references at the end of each section.

The “some research finding” section is presented well with a different background colour to other sections (it is similar to recent findings in mark’s wiki pages). This makes the page look very visually appealing! You have elaborated on two out of four research papers which is very good. However I recommend describing the other two papers as well and even including more papers (It would be perfect if you could provide research papers for different structures). I like how the “more research papers” can be expanded for anyone interested.

Historic findings section is very well researched considering it is difficult to find information for this section. The ‘Abnormalities’ section is also perfect and complete with all four diseases having sufficient information and appropriate references. The images are also relevant and illustrate the clinical manifestations well. Overall this page is very well-organised and only minor issues mentioned above need to be fixed.

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The introduction to this page offers a brief insight into the information presented in this wiki and is a good way to start your page. In the ‘Developmental Overview, the use of dot points to break up the text is a great way of presenting the information in conjunction with the table. The table is a really good piece of work and the images make it really interesting addition to the page.

The ‘Recent Findings’ section contains a good selection of articles but I think it could benefit from a brief description of each paper to reveal the relevance of the studies. The ‘Historic Findings’ section is well written but could also be improved by including some historic images to make it more interesting.

Overall this page is really well written with plenty of detailed text. The strong point of this page is the ‘Abnormalities’ section - it has great information and really good images to support it. It could be made even better if some more abnormalities were included. This page also benefits from its neat presentation and plenty of references.

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The project page contains a decent amount of information in the introduction section as it introduces what sections of the integumentary system will be covered below, but does not give a brief description of the system. For example, listing of the organs involved as well as function and their changes in position as development progresses in the embryonic period. The content general has been written well as it is clear and concise and readers that are not in the field of embryology are able to understand ideas presented. The use of tables and well-structured images further complements this and hence shows that there is a good project page structure adopted.

====Strengths====

• Good images are used to further show ideas and improve understanding.

• Bullet points used to great effect in summarising information and making it easier to read.

• Tables are used to great effect as the timeline is easy to read and right to the point

• Recent findings are an ‘eye opener’ for information as it summarises the article quite well as well the images displaying the results.

• In-text citations are used quite well as they are distributed.

====Weaknesses====

• Consistency needs to be ensured regarding references as some references are written after paragraphs. Hence, they should be put in the reference list at the end of the project page.

• Most images have an image name but some lack an image description.

• Structural error such as some bullet points needs to be fixed up.

• Historic finding research article should be mentioned as they are highly relevant to the current knowledge possessed today.

• References from the embryology website should be used scarcely.

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This is one of the best pages so far.
Introduction clear, concise, however maybe have a little more about the integumentary system in the introduction. Also maybe consider an image or video here, if you can not find a photo perhaps think of getting one of the group members to draw.
For the development overview, your table is fantastic as it is informative, concise and also has relevant images to help visually learn and understand. Dot points for format is a great idea, making it less overwhelming for readers. The subheading for glands and hair is small however detailed, clear and effective in being informative. Also the image brightens up your page and is inviting. I could say the same for the section on teeth.
Nail seems to be small section maybe consider an image here, and more content- maybe some more research.

Recent findings, very colourful at first glance. Again inviting , once you read very detailed and obvious research has been done. Images are referenced and have a detailed caption leading tot the knowledge behind the image.

Abnormalities has great references throughout the content that has been uploaded. However this is the only section that has done this and if the rest of the group would take note of this referencing format they would better this page. Great images related to the abnormality and content in information.

Overall great page, just need to work on more images in some sections and also referencing within the content of the sections. A fantastic job!

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You have covered the main topics. I very much like how you have simply listed the relevant topics. It is very useful how you have put in the introduction what the page is mainly focusing on and that it is focusing on fetal development. This is very useful for readers that may come across your website in the future in giving context. Your page has a particularly good use of tables. The first table with the weeks, description and phase diagrams is very good. It really helps in understanding. And I can say that it is good method of explaining the fetal skin development to peers. It is also innovative and gives the reader a comprehensive understanding of the topic. It shows that the group understands the topic as they can express it so simply and effectively. Again the combination of images and descriptive tables for the teeth section is very useful. There is an image in the historic findings section where it has not worked. As you guys must it can be fixed by referring to the referencing manual on the website (https://embryology.med.unsw.edu.au/embryology/index.php/Help:Reference_Tutorial ). The recent findings sections use of coloured boxes is a good visual change. It is helpful for reading and attracting towards this section.

It is also evident that your group has done a lot of research and I your group has gone past the normal teaching level knowledge. Possibly more information could be added to Historic Findings section. There are a few minor things like spelling of Mammillary as ‘Mamailliary’ in the Historic Findings section. There are a lot of references and in text citations which is good. However there are separate reference lists for each section. This could be modified by putting them all together into a main reference list. This can easily be done before the dead line.
Overall this page is awesome!

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Good use of table and images to map out the stages of skin development. Try and wrap the text around the diagrams to incorporate them more into the text. Good descriptions of abnormalities associated with integumentary development. You could put all of the references at the end to make the main text flow better. The descriptions about development are detailed and easy to understand which is good.
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Group 5

The page is well organised, key points relating to topic is clearly described in the “development overview section”. Not only do they put in dot point keeping it short and to the point there is also table and diagrams appropriately used to enhance understanding of development of skin in fetal stage. It shows they have understood the topic. Particular liked the teeth table as it showed good understanding of the phase in its development and it was clear and to the point. Hair section could be written in dot point just to have consistency with rest of information and the diagram in gland section could be placed on the opposite side, it disorganise the information when placed in the middle. Overall good overview nail section could include picture.

Recent findings although incomplete there is good research provided on skin and hair follicle. There should be 1 or 2 more research findings included for either for nail or gland however with what it written on the page it is relevant and in-depth. Could put it in dot points so that readers don’t lose interest in reading the whole thing and also so it’s easier to understand. Diagram is labelled and relates to the second recent finding information showing sufficient level of research. Although mentioned mouse model there is no other models mentioned for any of the Integumentary development, should make a subheading for it and try including 2-3 models.

In historic findings the hair section is well written shows good understanding and appropriate subheadings have been used (structure, Development). Its in chronological order and key points have been addressed, other structures doesn’t sure enough research being done its basic and incomplete for example Skin. In this section some labelled diagram would make it more engaging to read.

Abnormalities is well written it is clear and they are all defined with real life pictures associated with the abnormalities making it easier to visualise. Thorough research is evident in this section and it is of appropriate length. Overall the project page is well organised and quite engaging having table format, historic pictures as well as real life picture and even adding colour to the page. Could maybe include video onto the page. Reference is in the correct format and it’s good that there is list at the end of the page, maybe for consistency just have reference at the end instead of both (throughout the page and at the end). Recent findings could be simplified further while more information could be added for recent model and for historic findings for some structures.

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This page is laid out really well in its organization of each heading and then corresponding subheadings. A well-developed introduction, clearly establishes what will be covered. The development overview is written really well and images are incorporated adequately. The use of a table with images is really good effort, might consider using it on our group page. Try to be more consistent with the formatting in each subsequent component of the overviews, e.g the ‘nails’ are dot points but then the ‘teeth’ section is a paragraph. This is just a minor observation that could be changed later.
The in text citations seem to be only in some parts of the page, this could be due to the reference not being a pubmed site. Here are some tips that may be helpful with referencing; for the pubmed sites it’s the following format <ref name=PMIDnumber><pubmed>pubmedIDnumber</pubmed></ref> and then for all others its <ref> “insertsource” </ref>. Then after those are inserted, add an additional referencing heading and under it write <references/>.

The ‘recent findings’ section is written well, with in depth detail, might want to consider using a few dot points to avoid lengthy paragraphs. Once this section is completely filled with info, it will prove to be really great as it seems a lot of research has been carried out here. There seem to be more referencing issues and the lack of in text citations, try to fix these with the use of the formatting mentioned above. A well written section on ‘historic findings’, again the use of formatting would complete this part. The abnormalities section is done exceptionally well as the cause, risk and management has all been covered. The in text citations are used well as well as the structure of the paragraphs. Some confronting images but well done for finding them for each abnormality, consider adding a few more abnormalities and this will be a really great section.

Finally the work that has been conducted so far is really well done, there are minor adjustments in regards to formatting, referencing and the in text citations. Once these are completed it will look really great. Also some of the sections seems to have info missing, however once this is all filled out it will be sufficient. Good work so far everyone , keep it up and good luck completing the rest of it ☺.

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A clear and concise introduction to the group project allows us to know what to expect to see throughout the group project. It clearly outlines what will be covered.

The development overview section is really well laid out, with information split up by breaks to allow for easier reading and for readers to recognize the different stages of development. The tabulated data, timeline and diagrams are extremely well put out! The information in the table description is adequate and explains what needs to be explained about the diagram (week 18 just says example?)

Recent findings section is nice a purple :) Informative and well broken down, however some more uses of paragraphing would help with the overall structure of this section. great use of diagrams with the recent findings. Last 2 Recent finding articles have yet to be explained right?

Historical findings have been covered with lots of good information, use some use of text formatting '''(bolding words)''' to help with the different sub-subheadings in this section :) Some in-text citations would be helpful in understanding where the information came from.

Abnormalities have been extensively covered with some interesting information and nice use of diagrams as well as the descriptive text which accompany them. Adding a few more abnormalities and diagrams would help with the project :)

Overall great work on your group project! Looking very good so far! Fix up some citation errors and place all your references at the bottom of the page and you should be all set to go

==Week 5==
Hey guys!! I found some research material that we can use to construct our time line!

Historic information is hard to find! I might go look at some text books in the library
--[[User:Z3418340|Z3418340]] ([[User talk:Z3418340|talk]]) 12:50, 27 August 2014 (EST)
How is everyone else going?

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 12:52, 27 August 2014 (EST) Hey!! That's great! I also found some material for abnormalities. There seem to be a lot about septal defects. I'm gonna try to look up for more defects.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 22:53, 30 August 2014 (EST)Woo!! Nice to see more links in the page! Rehmina and I also thought that it would be easier for marking if one of the two people in current research do timeline instead because that would make marking easier and less confusing. But that's not final, it's only a suggestion. Also, Dr. Hill gave us some tips on what to focus/include in our research such as:
*Remodelling during the fetal period
*Changes during ossification - haematopoietic elocution from liver to bone marrow
*Early development of WBCs — hot topic right now!!

Hey everyone, yeah that sounds good with me.. :) so rather each person focuses on 1 of the 4 topics right? --[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 12:35, 31 August 2014 (EST)

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 18:36, 1 September 2014 (EST)Yep, exactly! I'm really glad that's alright with you but we can still talk about more in the lab.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 12:14, 2 September 2014 (EST)Hey everyone! I just asked Dr. Hill about using review articles. He said it's alright to use review articles as long as you say that the information came from a review article when citing. We can also use images from review articles and there is no need to say that it came from a review article.

==Week 6==
--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 20:19, 3 September 2014 (EST)Hey guys, I had a good talk with Mark today after the lab. Since we're doing the Cardiovascular system, it incorporates the (i) development of the heart, (ii) development of the blood vessels and (iii) the formation of red blood cells/white blood cells. But Mark said that as a group, we would be able to create and produce this web-site in a manner that we thought was appropriate. We could focus on one of the specific areas or more broadly on each area, if we chose to. But, MOST IMPORTANTLY, our project should be cohesive. What we talk about should be introduced well at the start and should be cohesive through out all of the subsections that we're working on. He really stressed the importance of us having a single, unified vision of our end product and that it should be succinct throughout it all. Im proposing that we actually decide what to focus on very soon.

: --[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 20:19, 3 September 2014 (EST) I'd particularly like to just focus on the development of the heart? Maybe incorporate the formation of blood cells if the research in the other areas is interesting and notable?

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 20:24, 3 September 2014 (EST)In regards to the use of the textbook, we are allowed to use the information from it if we cite it properly, but he really want us to be using articles (and even Review articles) to discuss our information.

I agree, the heart should remain our focus, but of course other aspects such as blood vessel formation/ blood cells would naturally fall into it as well- maybe just a brief mention wherever appropriate? --[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 21:22, 3 September 2014 (EST)

==Week 7==
--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 21:05, 8 September 2014 (EST) Hmm. I agree. Let's try and focus on the heart for now and see how we go? And if time permits, maybe we will be able to include the development of blood vessels and blood cells. Sorry I didn't reply so soon, kinda busy week for me haha!
: --[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 00:24, 10 September 2014 (EST)Ok that sounds really good and reasonable! I'd be happy to follow that plan. And yeah, same! Very busy week for me as well! But yeah, I think lets just focus and refine our research to just the development of the heart at the moment

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 00:40, 10 September 2014 (EST)Hey guys, Im having difficulty knowing whether the use of an article is fine or not?! If it says "Full-free-text" does that mean we're allowed to incoporate it? Because a lot of the copyright information, is very brief. Thanks heaps, if you guys know an answer haha
: --[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 00:55, 10 September 2014 (EST)Ok, never mind.. I find out the answer haha. If it says "Open-Access" or "Full-free-text" it is only free to read online and may/may not be allowed for re-use. You'; have to read carefully or apply for permission lol. I guess i'll just be sticking to mainly the Public Library of Science (PLoS), Biomed central (BMC) and Springer Open... which we are pretty much able to use, with the right referencing and acknowledgement. I read this on the 'Copy rights' page on this wiki. http://php.med.unsw.edu.au/embryology/index.php?title=Help:Copyright_Tutorial. Can someone verify or correct me if i'm wrong haha?

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 11:56, 10 September 2014 (EST) I thought copyright only applied on images and not on content. It would be really difficult to write a report when the most papers have copyright. We can ask Dr. Hill in the lab just to confirm.

==Week 8==
--[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 12:56, 17 September 2014 (EST) Hey guys, so Carl and I had a talk with Dr. Hill and he has agreed to allow us to change topics from Cardio to Integumentary. To finalise the change all members have to personally email him saying we all agree to the topic change. Carl and I have started thinking about our approach to the topic and we think we should have a main focus on skin and smaller sub-topics on hair, nails, glands and teeth. Each members role just remains the same and any problems we will all still help eachother :)

==Week 9==
--[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 12:46, 22 September 2014 (EST)Hey guys, I've added some headings for our new page just to get a start, we've got alot to catch up on, I guess we still have to talk about it as a group for the overall layout, we should all start adding some content soon.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 12:41, 23 September 2014 (EST) Thank you for fixing it! Yeah, we have a lot to do but that's okay. Midsem break is next week and hopefully we can get most of the bulk done before week 10.

==Midsem Break==
--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 23:24, 29 September 2014 (EST) Just wanted to let you guys know that Dr. Hill gave us some tips on what to look at a few weeks back. He mentioned "vernix caseosa and fetal hair." Here's a wikipedia link to vernix caseosa (http://en.wikipedia.org/wiki/Vernix_caseosa) just to give you guys an idea on what it is. I'm aiming to finish before the end of the week so that I could help anyone with their parts. Anyway, I hope everyone's having a good break!

==Week 11==
--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 15:02, 15 October 2014 (EST) So the review is done and we're getting lots of good feedback! Yay to us! Here's the list of things we need to get done before handing in the project:
*student drawn images have to be referenced and add student copyright
*more info on skin, glands, nails
*table for glands
*timeline of ALL organ development (drawing)
*reorganise development section (from most content - least content)
*find more articles on historic findings (before 1950s)
*add 1 more abnormality
*get references organised/unified
*fix links in development and recent findings
*fix introduction - list the outcomes of what the page wants to achieve e.g. “understand the development of the integumentary organs…, etc.”
*add a video https://embryology.med.unsw.edu.au/embryology/index.php/Help:Movies
*make usage of dot point and/or paragraphs consistent (recent findings)
*Add external links

We do have quite a bit to get done but that's okay! I'm pretty much done with my section, I just need to add one more. Lastly, since Dr. Hill extended the deadline to Friday next week (5:00pm), we'll aim to finish the content by Sunday 12:00pm. Then we can spend the rest of the week make it pretty/neat.

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 17:04, 18 October 2014 (EST)Hey Carl, could I get your help in finding information for gland and nail development? Could help beeef up that section? Haha only if possible please! Thanks heaps!

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 17:04, 18 October 2014 (EST)And yeah just a reminder guys, that Rehmina needed help with dot-point 6 above! Just remember to try find good historic articles and just post them here. We'll try to get a good collapsable table like in the recent findings section!

--[[User:Z3418340|Z3418340]] ([[User talk:Z3418340|talk]]) 19:20, 19 October 2014 (EST) Thanks Cart, if you feel that your section is almost done, I would really appreciate a few suggestions on how to improve my section.
Barbra, Im going to change the name of your section from "Some Recent Findings" --> "Current Research" I hope thats okay, if you have any other suggestions then thats cool too.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 19:33, 19 October 2014 (EST)Sure thing, I'll see if I can find some information on both development and historic findings now. And to Rehmina, yeah sure, happy to give you suggestions. :) I've also found a few articles for the presentation. I'll post them on the Facebook page since I don't know how to post the PDFs here.

==Week 12==
--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 18:18, 22 October 2014 (EST)
*Add outcomes to introduction (similar style to Mark in lectures)- Carl
*Everyone fix overall intext referencing- everyone do it for themselves
*Create general timeline- Carl
*Rehmina to tell Jerome about Hair follicle stages
*Barbara to complete and fix references in her section and nail development
*Carl to add a collapsable table to other abnormalities
*Jerome to add a table to Gland development
*Jerome change nail-development code
*Rehmina and Jerome to upload images

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 19:09, 22 October 2014 (EST) Great! I'll get those done as soon as I can. Jerome, I found this article about hair development. I haven't read it yet but I figured it might help you with the hair section. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2561923/

- --[[User:Z3418340|Z3418340]] ([[User talk:Z3418340|talk]]) 15:51, 23 October 2014 (EST)Hey, on the basis of the feedback, Im removing this image that we got from the UNSW Embryology page. I'm in the process of uploading the images now, Thanks for the checklist Carl!
[[Image:Hair_development_stages.jpg|frame|center|middle|300x250px|The stages of hair development]]

Talk:2014 Group Project 5

2014-10-23T04:49:35Z

Z3418340:

{{ANAT2341Project2014discussionheader}}
==Peer Reviews==

Group 5, you have a brilliant introduction, introducing the reader to what your page is about. Your introduction contains information for each of the parts involved in the integumentary system such as skin, glands, hair nails and teeth. There is a clear structure to your project with clear headings and sub-headings. This makes the reader find information about a particular part in your project more easily.

There is an extensive list of references, which demonstrates, a great effort towards researching your projects system. Some of the references however, need to be put into in the correct format. There are different reference lists under the different sections of your group project and as I understand why, I'm sure these are just small things that will be fixed before the final submission.

I have to commend you on your table, it is more than sufficient. It not only clear describes a clear transition from week to week changes in development of the integumentary system. The table however, needs to be reformatted to fit the window of the page and likewise, the pictures inside the table as there are too small to be seen without opening up the image. There are other images also on the page were too small such as "The stages of embryonic teeth development". These are just minor changes that need to be made before your groups final submission.

At the start of your project, all descriptions were matched with an image. This provided an appropriate balance between written text and visual representations. However, in the historic findings section, this balance was not seen as there are no images for this section.

Under your section of some recent findings, there are blocks of information in purple; I'm not sure as to the reasoning behind this, as the other parts in your project do not have the same background.

I particularly liked how in the introductory paragraph you mentioned what topics you will be covering; including abnormalities associated with the Integumentary system and delivered this information under the abnormalities section, where treatments and managements of these abnormalities were put forward!

Overall, good work guys! 

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The introduction covers all the topics of the project, however it does so briefly. Merging the development overview with the introduction will hide the fact that the introduction paragraph is short as this whole section will become one large detailed introduction about the integumentary system. The development overview is detailed and separated in terms of the structures found in the system. This is great, however less dot points should be used as it looks more like notes than presentable information. The creation of this timeline table is amazing and addition of the images according to the weeks is a well generated idea. Not all the images are described, so please do so for the final copy as it is essential that images of histological slides are describes as they can be confusion and difficult to understand. The information about hair and its adjacent image is the scaffold that should be followed throughout the whole section, as it has been written concisely and easily understandable. The hair development stages image is adequately describes and references with the copyright statement. Well done.

I appreciate the uniqueness in the layout of the recent findings, however I find it slightly overwhelming and out of place. Possibly adding a collapse and expand option to each article is beneficial. The summaries of the findings are in-depth and it is obvious that the author of this summary understands the topic.

A great start in historic findings with information present for a wide range of structures in this system. With that said, each section requires more research, however you are on the right path in finding articles greater than 50 years old. Only one image is attempted to be added, it is hard to find copyright granted images or historical drawings, but redrawing those original images is vital in providing solid historical information. In terms of the referencing, if you are unable to find a PMID for a certain article then manually add the reference and the URL link as you have but adhere to correct formatting.

Each abnormality is consistent with detailed information, statistics and a described image. The writing style is consistent and the image uploads with captions are correctly completed. Great work. The information is frequently cited emphasising efficient research ability. On that note, the references are correctly numbered and superscripts used instead of repeating the reference.

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The introduction clearly states the content in the website, which is good as this can prepare the readers for understanding. However, it would be better if some information about integumentary system, such as functions, is included in this section.

The development of integument system includes a lot of information. They are presented in good structure by the use of table for skin and nail. It is a great way to put some images in the table for easy understanding of the description in the development of teeth.

The recent findings area is well-researched. I would suggest try to put the content into small paragraph or in several points as the amount of text is a bit too much. Some images should be included as well.

Abnormalities section is great with the help of the images. It would be good if some more abnormalities are included. There is a lot of details under historic findings, try to illustrate them with the help of images.

In-text references should be included in the sections under development, recent findings and historic findings.

The project is well prepared. It would be better if some more images are included and the function of integument system is stated in the introduction.
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This group has made an outstanding effort in their efforts. I particularly liked the fact that they summarized the actual purpose of the page and what it would contain within the introduction itself, something the other groups have not really done.

They have structured and organized the page extremely well and it is consistent and flows between each of the headings. I would suggest to tabulate the three types of cells in skin and have a column describing their origin and then their function to make it easier to read. The table for development of dermal layers and the table for teeth development should also ideally have a title and table numbers.

In general the content is very well written and informative, supported with relevant images and diagrams that illustrate the actual development process. The recent findings heading is also well written however there are a few formatting issues with the text box sizes that need to be fixed up. I think it would be a good idea to list the sources of historic findings and then elaborate on what contribution they may have made to our current understanding.

The referencing just seems to be inconsistent in this section. Additionally it would be a good idea to move all the references for the other sections to the end of the page under the actual references heading rather than having them scattered over the wiki page. The abnormalities section is highly commendable and written extremely well. Great job on the excellent and informative wiki page you have produced.
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The introduction is a great summary of what the project page will discuss making sure to highlight every aspect. However, the introduction should also mention more about the integumentary system listing all the organs involved, their function, anatomical position and the difference between the embryonic and fetal stages of integumentary development. The content presented on the page is fantastic. All information under the subheadings looks complete and has key information related to the topic. I like how the timeline is divided into each organ making it easy to understand and navigate. The use of the table to format the information is a brilliant idea and has been presented beautifully with images in each textbox. Also the content under current research is relating to the topic and shows extensive research. The use of the purple background is appealing to the viewer highlighting its significance. I do however believe that the information under ‘historic findings’ should be formatted into a table to make it easier to navigate. The content under ‘abnormalities’ has the right amount of information and clearly relates to the key topic of the project.

In terms of images, I believe a satisfactory amount of images have been used which clearly describes the content. However, some images are missing the all the copyright information needed as well as the description, references and student template such as those in the ‘development overview’ table. This should be added right away to ensure these images do not get deleted. The use of captions on these pictures is important to highlight what the image is referring to and this is present in the page. Although, images could be added under current research as this section looks like it could use more images. Great job on the images under abnormalities, they accurately relate to the content mentioned.

There are some incite references missing such as in the development overview. I’m not sure if the references listed below are supposed to the references for it, however all references should be placed under one ‘references’ subheading. The same references have been combined into one number showing that the group knows how to make the references set out. Also a glossary list should be added to help viewers understand the content more instead of just being confused at some sections. Overall, this is a great project and if the group makes edits based on the peer-reviews received, this could enhance their project.

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Much more information on introduction is needed maybe. Also in text citations is needed.
EXCELLENT job on the overview development section. The table and the images are great especially. Great use to information and the corresponding images. One suggestion though, put in text citations.
Try to avoid repetitions as in the overview “this page” is repeated and in the table “a study” is repeated. Try being specific to which study you are referring to.
Well balance of text and images in the development overview section. In text citations are needed and all the references would look better in the end of the page in a bulk.
For your first research findings maybe obtain an image/s to aid the information.
Historic findings section is just a bulk of text. No images can be seen so if possible I suggest you add images to this section. Although it is VERY WELL researched.
VERY WELL DONE with the abnormalities section as each abnormality is well explained and has an image to accompany it.
Try not to use a lot of pictures and references from the Embryology website.
Over all this page is good but a lot of in text citation needs to be done and the references need to be in the end of the page in a bulk.

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Group Project 5 – Integumentary Development

This page looks very neat and well organised, with an introduction that explains exactly what is going to appear and be discussed on the page. The Development Overview section is very well done, with the appropriate use of subheadings and content. The use of dot points is very effective, making the page look neater. Perhaps it would be good to draw a histological diagram of the skin layers, and uploading it to the skin development section. Specialised cells or important names throughout the page could be highlighted in bold or underlined as well, to highlight important terms and make it easier to learn and remember from. The title ‘Some Recent Findings’ accurately portrays what we as students can only do, which is identify SOME of the recent findings. This section could have more than 2 recent findings however and could be further subdivided by subheadings into the different components of the integumentary system – perhaps have 2-3 research articles for each component of the system. Historic findings are well researched but some more information would be good. The ‘Abnormalities’ section is so far the best looking section as it seems it is almost completed. Perhaps a few more abnormalities would be even better.

The table of the timeline in the ‘Development Overview’ section is superbly done and the use of histological images is fantastic as it provides the anatomical information visually. When I clicked on an image however, there was no proper referencing of the image and the copyright information and student image information was not present. The images are described very well.
One image has a problem and is present in red writing, so might need to remove this as something is wrong with the file and it could not be uploaded. There are no student-drawn images and I think if this group did this, it would really benefit their project and emphasise their understanding.

The ‘Some Recent Findings’ section has a purple background, which makes the page look more aesthetically pleasing and less monochrome. I like the ‘More recent papers’ box that can be expanded to reveal any more research papers related to the integumentary fetal development, in case anyone wants to have a further read- very clever.

Journal articles are correctly referenced but website references need to be improved upon- to find how to do this go to the ‘How to reference’ page. References are all over the place and need to be compiled under each heading or one main heading titled ‘References’ at the bottom of the page.

Overall, this page is looking fantastic at this point in time so keep up the great work!
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Introduction should be more to do with the content rather than the intention of the page. Introduce the reader to the system and then go into development in the next sections.

Fantastic job on the overview with the table being a highlight of this project

All of the images are very well integrated and presented. good work on the text and also the referencing in abnormalities section.

More references need to be included within text. Low amount thus far. References also need to be reformatted to be listed in one spot. You can always look at other groups page and copy their layout. The abnormalities section on your page has the right idea. Have a chat in group about it.

The main issues with this project are mainly formatting, very well done otherwise
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Introduction is short though luckily few words can go a long way, with all sections of the wiki page being properly addressed. Development overview content is good; the use of table integrated with pictures allows viewers to visually grasp the progression in skin and teeth development. The changing between dot-points and paragraph format should be standardized or use paragraphs with dot-point only for list based information. References need to be properly integrated into the page, instead of at the bottom of each section.

In the recent findings section 2 out of the 4 studies presented have any content. To improve cutting some of excess information for the 2 studies already addressed and creating summaries for the other 2 will create better scope of recent findings. The formatting of recent findings is unusual, proper placement of the “Hematoxylin/eosin” image”, removal of dot-point and removal of purple highlighting, will make the section easier for viewers to understand. Historical findings okay, more detail could be added to “skin”, “glands”, “nails”. Use of capital letters like “DEVELOPMENT” show be replaced with subheadings, the image “File:Screen Shot 2014-10-08 at 10.38.04 am.png” has not appeared properly, should be easy to fix.

Straight up the abnormalities section is amazing, no improvement needed. All 4 diseases have in-depth relevant information, sufficient referencing and images to allow viewers to visualise clinical manifestation. To improve use of dot-points or paragraphs should be standard throughout the project, referencing in beginning sections needs to compiled at ending of each Main heading or bottom of page, recent findings need 1-2 more studies, and recent findings need significant reformatting.

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Overall I was very impressed with this project page. I loved your use of pictures and diagrams as it provided a great understanding of what was happening- and also, a lot of the images were quite interesting- which is a great thing for a project! I also enjoyed the use of bullet points- it was very to the point and it retained my attention throughout the piece. I did find, however, that the introduction was a bit short. Whilst it did cover most of what was required, I don’t think it hurts to be a bit more exhaustive in what you’re saying, because the introduction sets the mindset of the reader for the rest of the project- and if they have a clear understanding from the start, it makes it much easier when you are explaining more complex things such as the abnormalities later on.

Overall, I thought that the developmental timeline was extremely well done, and a highlight of your project. The rest of the developmental overview was quite well done, however I think in areas it was a bit sloppy, and it would be of great benefit to clear this up so as to improve the clarity of your work. Further, I enjoyed the succinctness of your paragraphs, it made it easy to read and wasn’t too much to take in at once. I think that currently, your use of colour is a bit random in the recent findings. I think that this could really boost your project if you applied it to more areas of the page. As far as the content goes, I think that the recent findings is just too wordy and I began to lose my concentration a bit. I think maybe by forming more succinct dot points- you will be able to convey your message more clearly.

I think the historic findings could do with a bit more beefing up, but what you have so far is well done. The abnormalities is also very well done, and I think that your use of images really grab the readers attention.

I think that overall this project is shaping up to be a great one. I think you need to be careful and consistent with your referencing though as I noticed some sections lacked in-text citations.

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This page seems to be done extremely well. It looks very visually appealing as multiple images are used, information is presented in tables, bullet points and very few slabs of text. The introduction is short and to the point. You could possibly add to this area a tiny bit of info concerning the embryonic development of this system, where it first started, then mention how you will expand on the fetal development. Otherwise it just seems way too short.

Explanation of the organs in this system is well done and concise. In the glands section, I would suggest not using dot points for the function of the vernix caseosa as it looks as though the dot points continue from those of the glands, therefore can be confusing when first looked at. Other than that, I would suggest that you make sure your referencing is correct and is used within the text.

The recent findings area is nicely done, but I still can’t help but feel the amount of text is just too much, even though the section is made better looking by making it purple (keep the colour, it looks awesome). The slab of text is just too much, so you should try and simplify it a bit. Historic findings are few but there is at least one for every organ which is good (more would be better). The abnormalities covered are done well, going into detail and providing a good image to describe what it looks like. I would suggest having at least 5 abnormalities, one for each organ discussed.

Overall, this page is very well done, with lots of images and colour used. The main thing I would suggest would be to make sure correct referencing is used. There were some paragraphs were no references were used at all. Also, all references should be at the bottom of the page, not within individual sections.

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This page has great overall structure and presentation. The introduction gives good insight of the overall contents of the page, however it is very brief and should be expanded upon.

The table included in the developmental overview serving, as a timeline is excellent, really well done. It’s easy to follow and looks very neat. I like how there is an image for each of the weeks mentioned, just don’t forget to add in-text citations for its contents. The glands sub-section is very brief and would benefit if there were more contents added. Great job on the images though. The nail section is the same, more contents needs to be added and image would look really good.

The developmental overview and historic findings sections also seems to lack in-text citations. There is also has an image with a broken link. The subsection hair seems to be well researched, however I would also suggest either bolding or underlining the words you want to emphasize such as “structure” for a neater look.

The recent findings section looks superb I love the purple background colour. Its very well researched and the link to more research papers are very helpful for readers. I would suggest you put the image at the bottom of the mentioned content though, just to avoid the big gap on the page, or even if you can manage to wrap the text around the image, it would look much better in terms of presentation.

Although disturbing, the abnormalities section I could not fault. Very well done. It is evident that it has been research well and the images allow for great visualization of the diseases mentioned.

Overall, excellent page just needs a very formatting edits and some expanded contents mentioned above. Good luck!

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Integumentary
The introduction seems really over formal and non friendly. Maybe try rewording some parts to make it more reader-friendly and welcoming.
The developmental time line is absolutely BEAUTIFUL! It shows the week of development, a brief explanation of each, and a picture to visually explain what is happening! I think it’s the best developmental timeline of all the wiki pages! Awesome job :)
The references should be put together at the end of the wiki page before final submission.
Hair and nail sections are very well done, teeth section are in dot points; this should be converted into paragraphs to match the wiki page format.
The section on recent findings seem to be copy pasted? Or not yet converted into the students’ own words. The formatting is very different to the whole of the wiki page as well which should be changed. On the section on historic findings, you should try to find a picture to supplement the information you have.
The abnormalities section is very well done, pictures visually supplementing each of the abnormalities. The picture of the infant with harlequin ichthyosis especially helps the reader understand the degree of extremity of the abnormality.
Overall, very informative and well done!

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This is a really well done project. You have made sure that that you have ticked all the boxes as well that Mark has asked for. The abnormalities section is really good. You have done well with most of your images as when you click on them there is a good description and they are well referenced. The development overview table is exceptional and makes the project easy to understand. For the week 22 maybe include the study in which you got your information from.

Apart from the abnormalities section it appears as though the referencing is a bit all over the place. Need to follow the abnormalities section and put references into the specific parts of the information you are using it for. Because otherwise it becomes difficult to know exactly where you got your information from. The historic findings are really good and well done however there is probably a space for more information to be included as I feel as though some of the findings are a bit hard to follow at times. It may have just been my computer I couldn’t see the picture of ‘fetal hair development’.

I think it would give a nice touch to the project if you were to add some student images because it would give the page a more ‘student’ and also make it easier to understand. Don’t mind the purple background on the ‘some recent findings’ part but it just looks a bit out of the blue. It’s certainly unique and attracts the eye but it puts a lot of emphasis on this section which I’m not entirely sure you want.

Overall though a really good project with excellent information. There needs to be a bit more focus on referencing technique, some minor edits which I have mentioned and maybe introduce some student pictures to make the project more student-like. Great work though and good luck in finishing it off.

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The introduction of this page was good as it provided a great overview and insight into what the project would later go on to discuss. Perhaps a little information on defining the integumentary system itself would be valuable though, to let the reader know the constituents.

The sub-sectioning of the page’s content into ‘introduction, ‘development overview’, ‘recent findings’, ‘historic findings’ and ‘abnormalities’ was clever, as the development section then went on to describe each component such as skin, nails etc. This effectively segmented the information into smaller chunks that could easily be navigated to. I especially liked the use of the table in the ‘skin’ section, showing the week of development, description and image corresponding alongside it, as it provided a holistic approach to that section. However, there were no in-text citations in the ‘skin’, ‘hair’, ‘nail’ or ‘teeth’ sections, hence the source of the information is unclear. To do this correctly, Dr Hill’s Wiki help page should be consulted.

The use of various images with labelled captions was a strength of this project, as the pictures were effective in balancing the text components to make the page more visually appealing. Most of the sections under ‘development overview’ have a decent amount of content, however the ‘nails’ part is a bit lacking and also needs to be correctly cited. The use of the table of images alongside the description of developmental stage in the ‘teeth’ section was very good to include, however the image is captioned ‘The stages of embryonic teeth development’. This may be irrelevant as the project’s focus is on fetal development. Further research into this area may uncover more relevant information.

Although the section on ‘recent findings’ contains a lot of information, the use of chunky paragraphs detracts from the readability of the page and the purple boxes could be summarised into dot points to help the reader understand the content more quickly. The section on historic findings seems concise and relevant, however the image included says it has been removed/deleted, so this requires editing. Lastly, the ‘abnormalities’ section was very well-structured and written, as each example had a captioned image accompanying it to help the reader visualise. This section was also well-done in terms of in-text citations, with an extensive reference list provided at the end. Perhaps consider adding some student-drawn images and possibly a relevant video, but otherwise it is very good as it is. Overall, the project has a good layout and a decent amount of content; with some editing and formatting it can be improved further.

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Overall this is an impressive and well researched wiki page incorporating lots of pictures and tables to keep the reader engaged and interested. However there are a few areas that have the potential to be tweaked. Firstly there are references scattered throughout the page. A more attractive way of presenting the references is as a long list at the end of the page. The introduction is clear, concise and short. All the organ development section is well presented and has the right amount of information. It is well structured in the sense that the student introduces the organ, it’s embryonic origin, the fetal growth stage and then goes into slightly more depth in a bullet point form. Along with complementary pictures, this is a very effective way of presenting their topic. This page could be improved by adding student-drawn schematic diagrams to summarise the layers of the skin in particular since histological images can be confusing and unclear to a non-expert embryology student.

The skin development section appears to dwell on the content that was covered in lectures. Considering there appears to be only three references associated with the entire integumentary organ development section, the depth of the information is limited. By doing some more research you might be able to find interesting additional information that can be added. The recent findings section is interesting and the images are great. However the dense block of information and slightly odd formatting make it hard to follow. Perhaps using diagrams to explain the differing gene expression and breaking down the information into bullet points would make it more readable.

The historic findings and abnormalities section is particularly well done. The images complement the minimal yet important points made. I was left wanting to read more into it so that suggests there’s room for further development and a deeper explanation of skin abnormalities.

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*Great overview given in the introduction. Maybe look to replacing the words "this page" to something else to avoid repetition
*I'm really liking how everything has been simplified into dot points and tables where relevant. Don't forget to include relevant references all throughout though, to justify all that you've included in each section
*I can't express how much I love your first table. Great work!
*Proofread so that you don't repeat the same things in your table though. You mention "in a study" numerous times but there's no indication to which studies they are
*I'm sure Mark would be thinking this same thing, but look to getting different references outside of this Embryology website, maybe from textbooks or otherwise for preliminary information on development
*The "recent findings" section looks nicely formatted but just a bit wordy. Maybe think of dividing the text up with bullet points or images
*Really liking your "historic findings" section! Great research
*Maybe think of re-creating some of the simpler pictures by drawing them yourselves. That way you're not using too many pictures from this Embryology website, Mark warned our group about this point
*Great choices for the "abnormalities" section. Traumatising at first, but very well-researched and presented

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The presentation of this page is very well with multiple images being used and text organised into tables and dot points. The introduction is short however includes necessary information regarding what is being included in the project. I recommend adding background information on anatomy of the skin (explaining on different layers) and other structures as well as a brief summary on the embryonic development of the system so that fetal development can be further expanded throughout the project.

The development overview section is done very well and is divided into different sections each explaining the development of a different structure. The use of table, images and bullet points has made the page look very interesting. The table of the timeline in the ‘Development Overview’ is done very well and the use of histological images is excellent as it helps in visualising the anatomy at each stage. There is however no proper referencing, copyright information or student template for any of the images. The table under “teeth” is also a very good summary of events during fetal period. I recommend including self-drawn diagram as well, since this is the only feature missing from your project. You can include a drawing of the different layers of skin (possibly in the introduction section). I also suggest putting all the references under one reference list at the end of the page instead of having references at the end of each section.

The “some research finding” section is presented well with a different background colour to other sections (it is similar to recent findings in mark’s wiki pages). This makes the page look very visually appealing! You have elaborated on two out of four research papers which is very good. However I recommend describing the other two papers as well and even including more papers (It would be perfect if you could provide research papers for different structures). I like how the “more research papers” can be expanded for anyone interested.

Historic findings section is very well researched considering it is difficult to find information for this section. The ‘Abnormalities’ section is also perfect and complete with all four diseases having sufficient information and appropriate references. The images are also relevant and illustrate the clinical manifestations well. Overall this page is very well-organised and only minor issues mentioned above need to be fixed.

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The introduction to this page offers a brief insight into the information presented in this wiki and is a good way to start your page. In the ‘Developmental Overview, the use of dot points to break up the text is a great way of presenting the information in conjunction with the table. The table is a really good piece of work and the images make it really interesting addition to the page.

The ‘Recent Findings’ section contains a good selection of articles but I think it could benefit from a brief description of each paper to reveal the relevance of the studies. The ‘Historic Findings’ section is well written but could also be improved by including some historic images to make it more interesting.

Overall this page is really well written with plenty of detailed text. The strong point of this page is the ‘Abnormalities’ section - it has great information and really good images to support it. It could be made even better if some more abnormalities were included. This page also benefits from its neat presentation and plenty of references.

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The project page contains a decent amount of information in the introduction section as it introduces what sections of the integumentary system will be covered below, but does not give a brief description of the system. For example, listing of the organs involved as well as function and their changes in position as development progresses in the embryonic period. The content general has been written well as it is clear and concise and readers that are not in the field of embryology are able to understand ideas presented. The use of tables and well-structured images further complements this and hence shows that there is a good project page structure adopted.

====Strengths====

• Good images are used to further show ideas and improve understanding.

• Bullet points used to great effect in summarising information and making it easier to read.

• Tables are used to great effect as the timeline is easy to read and right to the point

• Recent findings are an ‘eye opener’ for information as it summarises the article quite well as well the images displaying the results.

• In-text citations are used quite well as they are distributed.

====Weaknesses====

• Consistency needs to be ensured regarding references as some references are written after paragraphs. Hence, they should be put in the reference list at the end of the project page.

• Most images have an image name but some lack an image description.

• Structural error such as some bullet points needs to be fixed up.

• Historic finding research article should be mentioned as they are highly relevant to the current knowledge possessed today.

• References from the embryology website should be used scarcely.

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This is one of the best pages so far.
Introduction clear, concise, however maybe have a little more about the integumentary system in the introduction. Also maybe consider an image or video here, if you can not find a photo perhaps think of getting one of the group members to draw.
For the development overview, your table is fantastic as it is informative, concise and also has relevant images to help visually learn and understand. Dot points for format is a great idea, making it less overwhelming for readers. The subheading for glands and hair is small however detailed, clear and effective in being informative. Also the image brightens up your page and is inviting. I could say the same for the section on teeth.
Nail seems to be small section maybe consider an image here, and more content- maybe some more research.

Recent findings, very colourful at first glance. Again inviting , once you read very detailed and obvious research has been done. Images are referenced and have a detailed caption leading tot the knowledge behind the image.

Abnormalities has great references throughout the content that has been uploaded. However this is the only section that has done this and if the rest of the group would take note of this referencing format they would better this page. Great images related to the abnormality and content in information.

Overall great page, just need to work on more images in some sections and also referencing within the content of the sections. A fantastic job!

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You have covered the main topics. I very much like how you have simply listed the relevant topics. It is very useful how you have put in the introduction what the page is mainly focusing on and that it is focusing on fetal development. This is very useful for readers that may come across your website in the future in giving context. Your page has a particularly good use of tables. The first table with the weeks, description and phase diagrams is very good. It really helps in understanding. And I can say that it is good method of explaining the fetal skin development to peers. It is also innovative and gives the reader a comprehensive understanding of the topic. It shows that the group understands the topic as they can express it so simply and effectively. Again the combination of images and descriptive tables for the teeth section is very useful. There is an image in the historic findings section where it has not worked. As you guys must it can be fixed by referring to the referencing manual on the website (https://embryology.med.unsw.edu.au/embryology/index.php/Help:Reference_Tutorial ). The recent findings sections use of coloured boxes is a good visual change. It is helpful for reading and attracting towards this section.

It is also evident that your group has done a lot of research and I your group has gone past the normal teaching level knowledge. Possibly more information could be added to Historic Findings section. There are a few minor things like spelling of Mammillary as ‘Mamailliary’ in the Historic Findings section. There are a lot of references and in text citations which is good. However there are separate reference lists for each section. This could be modified by putting them all together into a main reference list. This can easily be done before the dead line.
Overall this page is awesome!

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Good use of table and images to map out the stages of skin development. Try and wrap the text around the diagrams to incorporate them more into the text. Good descriptions of abnormalities associated with integumentary development. You could put all of the references at the end to make the main text flow better. The descriptions about development are detailed and easy to understand which is good.
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Group 5

The page is well organised, key points relating to topic is clearly described in the “development overview section”. Not only do they put in dot point keeping it short and to the point there is also table and diagrams appropriately used to enhance understanding of development of skin in fetal stage. It shows they have understood the topic. Particular liked the teeth table as it showed good understanding of the phase in its development and it was clear and to the point. Hair section could be written in dot point just to have consistency with rest of information and the diagram in gland section could be placed on the opposite side, it disorganise the information when placed in the middle. Overall good overview nail section could include picture.

Recent findings although incomplete there is good research provided on skin and hair follicle. There should be 1 or 2 more research findings included for either for nail or gland however with what it written on the page it is relevant and in-depth. Could put it in dot points so that readers don’t lose interest in reading the whole thing and also so it’s easier to understand. Diagram is labelled and relates to the second recent finding information showing sufficient level of research. Although mentioned mouse model there is no other models mentioned for any of the Integumentary development, should make a subheading for it and try including 2-3 models.

In historic findings the hair section is well written shows good understanding and appropriate subheadings have been used (structure, Development). Its in chronological order and key points have been addressed, other structures doesn’t sure enough research being done its basic and incomplete for example Skin. In this section some labelled diagram would make it more engaging to read.

Abnormalities is well written it is clear and they are all defined with real life pictures associated with the abnormalities making it easier to visualise. Thorough research is evident in this section and it is of appropriate length. Overall the project page is well organised and quite engaging having table format, historic pictures as well as real life picture and even adding colour to the page. Could maybe include video onto the page. Reference is in the correct format and it’s good that there is list at the end of the page, maybe for consistency just have reference at the end instead of both (throughout the page and at the end). Recent findings could be simplified further while more information could be added for recent model and for historic findings for some structures.

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This page is laid out really well in its organization of each heading and then corresponding subheadings. A well-developed introduction, clearly establishes what will be covered. The development overview is written really well and images are incorporated adequately. The use of a table with images is really good effort, might consider using it on our group page. Try to be more consistent with the formatting in each subsequent component of the overviews, e.g the ‘nails’ are dot points but then the ‘teeth’ section is a paragraph. This is just a minor observation that could be changed later.
The in text citations seem to be only in some parts of the page, this could be due to the reference not being a pubmed site. Here are some tips that may be helpful with referencing; for the pubmed sites it’s the following format <ref name=PMIDnumber><pubmed>pubmedIDnumber</pubmed></ref> and then for all others its <ref> “insertsource” </ref>. Then after those are inserted, add an additional referencing heading and under it write <references/>.

The ‘recent findings’ section is written well, with in depth detail, might want to consider using a few dot points to avoid lengthy paragraphs. Once this section is completely filled with info, it will prove to be really great as it seems a lot of research has been carried out here. There seem to be more referencing issues and the lack of in text citations, try to fix these with the use of the formatting mentioned above. A well written section on ‘historic findings’, again the use of formatting would complete this part. The abnormalities section is done exceptionally well as the cause, risk and management has all been covered. The in text citations are used well as well as the structure of the paragraphs. Some confronting images but well done for finding them for each abnormality, consider adding a few more abnormalities and this will be a really great section.

Finally the work that has been conducted so far is really well done, there are minor adjustments in regards to formatting, referencing and the in text citations. Once these are completed it will look really great. Also some of the sections seems to have info missing, however once this is all filled out it will be sufficient. Good work so far everyone , keep it up and good luck completing the rest of it ☺.

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A clear and concise introduction to the group project allows us to know what to expect to see throughout the group project. It clearly outlines what will be covered.

The development overview section is really well laid out, with information split up by breaks to allow for easier reading and for readers to recognize the different stages of development. The tabulated data, timeline and diagrams are extremely well put out! The information in the table description is adequate and explains what needs to be explained about the diagram (week 18 just says example?)

Recent findings section is nice a purple :) Informative and well broken down, however some more uses of paragraphing would help with the overall structure of this section. great use of diagrams with the recent findings. Last 2 Recent finding articles have yet to be explained right?

Historical findings have been covered with lots of good information, use some use of text formatting '''(bolding words)''' to help with the different sub-subheadings in this section :) Some in-text citations would be helpful in understanding where the information came from.

Abnormalities have been extensively covered with some interesting information and nice use of diagrams as well as the descriptive text which accompany them. Adding a few more abnormalities and diagrams would help with the project :)

Overall great work on your group project! Looking very good so far! Fix up some citation errors and place all your references at the bottom of the page and you should be all set to go

==Week 5==
Hey guys!! I found some research material that we can use to construct our time line!

Historic information is hard to find! I might go look at some text books in the library
--[[User:Z3418340|Z3418340]] ([[User talk:Z3418340|talk]]) 12:50, 27 August 2014 (EST)
How is everyone else going?

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 12:52, 27 August 2014 (EST) Hey!! That's great! I also found some material for abnormalities. There seem to be a lot about septal defects. I'm gonna try to look up for more defects.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 22:53, 30 August 2014 (EST)Woo!! Nice to see more links in the page! Rehmina and I also thought that it would be easier for marking if one of the two people in current research do timeline instead because that would make marking easier and less confusing. But that's not final, it's only a suggestion. Also, Dr. Hill gave us some tips on what to focus/include in our research such as:
*Remodelling during the fetal period
*Changes during ossification - haematopoietic elocution from liver to bone marrow
*Early development of WBCs — hot topic right now!!

Hey everyone, yeah that sounds good with me.. :) so rather each person focuses on 1 of the 4 topics right? --[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 12:35, 31 August 2014 (EST)

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 18:36, 1 September 2014 (EST)Yep, exactly! I'm really glad that's alright with you but we can still talk about more in the lab.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 12:14, 2 September 2014 (EST)Hey everyone! I just asked Dr. Hill about using review articles. He said it's alright to use review articles as long as you say that the information came from a review article when citing. We can also use images from review articles and there is no need to say that it came from a review article.

==Week 6==
--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 20:19, 3 September 2014 (EST)Hey guys, I had a good talk with Mark today after the lab. Since we're doing the Cardiovascular system, it incorporates the (i) development of the heart, (ii) development of the blood vessels and (iii) the formation of red blood cells/white blood cells. But Mark said that as a group, we would be able to create and produce this web-site in a manner that we thought was appropriate. We could focus on one of the specific areas or more broadly on each area, if we chose to. But, MOST IMPORTANTLY, our project should be cohesive. What we talk about should be introduced well at the start and should be cohesive through out all of the subsections that we're working on. He really stressed the importance of us having a single, unified vision of our end product and that it should be succinct throughout it all. Im proposing that we actually decide what to focus on very soon.

: --[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 20:19, 3 September 2014 (EST) I'd particularly like to just focus on the development of the heart? Maybe incorporate the formation of blood cells if the research in the other areas is interesting and notable?

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 20:24, 3 September 2014 (EST)In regards to the use of the textbook, we are allowed to use the information from it if we cite it properly, but he really want us to be using articles (and even Review articles) to discuss our information.

I agree, the heart should remain our focus, but of course other aspects such as blood vessel formation/ blood cells would naturally fall into it as well- maybe just a brief mention wherever appropriate? --[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 21:22, 3 September 2014 (EST)

==Week 7==
--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 21:05, 8 September 2014 (EST) Hmm. I agree. Let's try and focus on the heart for now and see how we go? And if time permits, maybe we will be able to include the development of blood vessels and blood cells. Sorry I didn't reply so soon, kinda busy week for me haha!
: --[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 00:24, 10 September 2014 (EST)Ok that sounds really good and reasonable! I'd be happy to follow that plan. And yeah, same! Very busy week for me as well! But yeah, I think lets just focus and refine our research to just the development of the heart at the moment

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 00:40, 10 September 2014 (EST)Hey guys, Im having difficulty knowing whether the use of an article is fine or not?! If it says "Full-free-text" does that mean we're allowed to incoporate it? Because a lot of the copyright information, is very brief. Thanks heaps, if you guys know an answer haha
: --[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 00:55, 10 September 2014 (EST)Ok, never mind.. I find out the answer haha. If it says "Open-Access" or "Full-free-text" it is only free to read online and may/may not be allowed for re-use. You'; have to read carefully or apply for permission lol. I guess i'll just be sticking to mainly the Public Library of Science (PLoS), Biomed central (BMC) and Springer Open... which we are pretty much able to use, with the right referencing and acknowledgement. I read this on the 'Copy rights' page on this wiki. http://php.med.unsw.edu.au/embryology/index.php?title=Help:Copyright_Tutorial. Can someone verify or correct me if i'm wrong haha?

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 11:56, 10 September 2014 (EST) I thought copyright only applied on images and not on content. It would be really difficult to write a report when the most papers have copyright. We can ask Dr. Hill in the lab just to confirm.

==Week 8==
--[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 12:56, 17 September 2014 (EST) Hey guys, so Carl and I had a talk with Dr. Hill and he has agreed to allow us to change topics from Cardio to Integumentary. To finalise the change all members have to personally email him saying we all agree to the topic change. Carl and I have started thinking about our approach to the topic and we think we should have a main focus on skin and smaller sub-topics on hair, nails, glands and teeth. Each members role just remains the same and any problems we will all still help eachother :)

==Week 9==
--[[User:Z3417796|Z3417796]] ([[User talk:Z3417796|talk]]) 12:46, 22 September 2014 (EST)Hey guys, I've added some headings for our new page just to get a start, we've got alot to catch up on, I guess we still have to talk about it as a group for the overall layout, we should all start adding some content soon.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 12:41, 23 September 2014 (EST) Thank you for fixing it! Yeah, we have a lot to do but that's okay. Midsem break is next week and hopefully we can get most of the bulk done before week 10.

==Midsem Break==
--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 23:24, 29 September 2014 (EST) Just wanted to let you guys know that Dr. Hill gave us some tips on what to look at a few weeks back. He mentioned "vernix caseosa and fetal hair." Here's a wikipedia link to vernix caseosa (http://en.wikipedia.org/wiki/Vernix_caseosa) just to give you guys an idea on what it is. I'm aiming to finish before the end of the week so that I could help anyone with their parts. Anyway, I hope everyone's having a good break!

==Week 11==
--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 15:02, 15 October 2014 (EST) So the review is done and we're getting lots of good feedback! Yay to us! Here's the list of things we need to get done before handing in the project:
*student drawn images have to be referenced and add student copyright
*more info on skin, glands, nails
*table for glands
*timeline of ALL organ development (drawing)
*reorganise development section (from most content - least content)
*find more articles on historic findings (before 1950s)
*add 1 more abnormality
*get references organised/unified
*fix links in development and recent findings
*fix introduction - list the outcomes of what the page wants to achieve e.g. “understand the development of the integumentary organs…, etc.”
*add a video https://embryology.med.unsw.edu.au/embryology/index.php/Help:Movies
*make usage of dot point and/or paragraphs consistent (recent findings)
*Add external links

We do have quite a bit to get done but that's okay! I'm pretty much done with my section, I just need to add one more. Lastly, since Dr. Hill extended the deadline to Friday next week (5:00pm), we'll aim to finish the content by Sunday 12:00pm. Then we can spend the rest of the week make it pretty/neat.

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 17:04, 18 October 2014 (EST)Hey Carl, could I get your help in finding information for gland and nail development? Could help beeef up that section? Haha only if possible please! Thanks heaps!

--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 17:04, 18 October 2014 (EST)And yeah just a reminder guys, that Rehmina needed help with dot-point 6 above! Just remember to try find good historic articles and just post them here. We'll try to get a good collapsable table like in the recent findings section!

--[[User:Z3418340|Z3418340]] ([[User talk:Z3418340|talk]]) 19:20, 19 October 2014 (EST) Thanks Cart, if you feel that your section is almost done, I would really appreciate a few suggestions on how to improve my section.
Barbra, Im going to change the name of your section from "Some Recent Findings" --> "Current Research" I hope thats okay, if you have any other suggestions then thats cool too.

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 19:33, 19 October 2014 (EST)Sure thing, I'll see if I can find some information on both development and historic findings now. And to Rehmina, yeah sure, happy to give you suggestions. :) I've also found a few articles for the presentation. I'll post them on the Facebook page since I don't know how to post the PDFs here.

==Week 12==
--[[User:Z3418488|Z3418488]] ([[User talk:Z3418488|talk]]) 18:18, 22 October 2014 (EST)
*Add outcomes to introduction (similar style to Mark in lectures)- Carl
*Everyone fix overall intext referencing- everyone do it for themselves
*Create general timeline- Carl
*Rehmina to tell Jerome about Hair follicle stages
*Barbara to complete and fix references in her section and nail development
*Carl to add a collapsable table to other abnormalities
*Jerome to add a table to Gland development
*Jerome change nail-development code
*Rehmina and Jerome to upload images

--[[User:Z3417843|Z3417843]] ([[User talk:Z3417843|talk]]) 19:09, 22 October 2014 (EST) Great! I'll get those done as soon as I can. Jerome, I found this article about hair development. I haven't read it yet but I figured it might help you with the hair section. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2561923/

- Hey gusy on the basis of the feedback, Im removing this image that we got from the UNSW Embryology page. I'm in the process of uploading the images now, Thanks for the checklist carl!
[[Image:Hair_development_stages.jpg|frame|center|middle|300x250px|The stages of hair development]]

2014 Group Project 5

2014-10-23T04:43:08Z

Z3418340: /* Development Overview */

{{ANAT2341Project2014header}}
=Integumentary=
==Introduction==
This page concerns the development of the integumentary system in the fetal stage of development, particularly its organs i.e. the skin, glands, hair, teeth, and nails. It explores the mechanism of development as well as the timeline of development. This page also outlines some recent findings on the development of the integumentary system, as well as historic findings. Finally, this page also explores some of the congenital abnormalities of the integumentary system, its mechanism or pathogenesis, clinical manifestations, and how they are treated or managed.

==Development Overview==
===Skin===

The skin consists of 2 layers: the outer layer (epidermis) and a deeper connective tissue layer (dermis).
*The epidermis is derived from the ectoderm. Initially it exists as only a single layer of ectodermal cells at 7-8 days of gestation. However, by about 13-14 weeks after gestation, a 3- layered structure of fetal epidermis exists- consisting of the stratum basale, 1 or 2 intermediate layers and the periderm. The peridermal cells eventually become desquamated and form part of the vernix cervix.
** The 5 definitive layers of the adult skin are evident in the human fetus after 22-24 weeks of gestation. Indirect influences form the dermis help differentiate the epidermis into: stratum basale, stratum spinosium, stratum granulosum, stratum lucidum and stratum corneum.
*The somatic mesoderm is the embryonic origin of the dermis. The mesoderm of the dermatones of the body, also contribute to the development of the dermis. Specifically though, in the head and neck region of the body, the dermis is derived from neural crest cells.
** The dermis is initially composed of just mesenchymal cells- loosely aggregated mesodermal cells. These mesenchymal cells later develop into fibroblasts- which function to secrete collagen and lay-down elastic fibers into the extracellular matrix.

3 other specialised cells of the epidermis also exists- these include melanoblasts, Langherhan cells and Merkel cells.
*Melanoblasts- are derived from neural crest cells that have migrated into the stratum basale. Mid-pregnancy, melanosomes are observed, differentiating the melanoblasts into melanocytes
*Langheran cells- are derived from bone marrow (originally form mesoderm) and migrate into the epidermis. They have the function of antigen presentation.
*Merkel cells- still have an uncertain origin. They have a function related to mechanoreception.

{| style="width:60%; height:125px" border="1" align="center"
|-
! Week !! Description !! Phase Diagram
|-
| Week 6-8|| In an electron micrograph study of the epidermis, the periderm and and basal layer of the developing skin was observed. || [[Image:Human_embryo_skin_8-9_week_EGA.jpg|100x100px|Weeks 6-8]]
|-
| Week 7-9 || In an electron micrograph study of the epidermis at weeks 7-9 of development, the stratified three-layer structure of the epidermis was observed. Kertain filaments have been encircled. || [[Image:Human_embryo_skin_9-11_week_EGA.jpg|100x100px| Weeks 7-9]]
|-
| Week 14 || By week 14, the basal layer, the intermediate layer/s and the periderm 3-layered structure can be observed in the fetus. By week 14, K17 can also be found in the basal and intermediate layers of the epidermis (In adult skin, K17 was not observed) || [[Image:Fetal_integumentary_histology_14w.jpg|100x100px| Week 14]]
|-
| Week 16 || In a study, by week 16, developing blood vessels were observed. CD31 and a sub-type of smooth-muscle actin stained positive in these observed developing blood vessels. || [[Image:Inaugumentary_week16.jpg|100x100px| Week 16]]
|-
| Week 18 || Example || [[Image:542px-Fetal_integumentary_histology_18.jpg|100x100px| Week 18]]
|-
| Week 19 || In a study, by week 19, as opposed to week 14, K17 was found present in the basal, intermediate and periderm layers. K17 also stained positive in the developing hair follicles. || [[Image:Inaugumentary-_Week_19.jpg|100x100px| Week 19]]
|-
| Week 20 || By week 20, hair follicles can be already be seen in the epidermis. The total number of intermediate layers has also increased || [[Image:Fetal_integumentary_histology_20.jpg|100x100px|Week 20]]
|-
| Week 22 || In an electron micrograph study at week 22 of development, kertanised epidermis was analysed. It was observed that glycogen was abundantly present throughout all epidermal layers. The included arrows, highlight the keratin filament bundles, which are now organised and peripherally placed. || [[Image:Human_embryo_skin_24_week_EGA.jpg|100x100px| Week 22]]
|-
| Adult|| In adult skin- a greater diversity of cells can be seen as more cells differentiate. Basal, spinous, granular and cornified cells are all example of such. In another study, chondroitin sulphate was observed in the basement membrane zone of the adult epidermis. In the same study, chondroitin sulphate was only observed towards the upper-part of the dermis. Also, elastin was present in the adult specimens, but not in the earlier fetal samples. || [[Image:Fetal_integumentary_histology_Adult.jpg|100x100px| Adult]] [[Image:542px-Fetal_integumentary_histology_Adult.jpg|100x100px| Adult]]
|}

===Hair===
Hair originates from the ectoderm. At about 12 weeks, it is believed that specific signals from the dermis are released- signaling for the induction hair follicle formation <ref name= PMID1566372><pubmed>1566372</pubmed></ref><ref name= PMID20590427><pubmed>20590427</pubmed></ref>

{| style="width:75%" border="1" align="center" style="text-align:center"
|-
! Stage !! Description
|-
| Undifferentiated Epithelium || Through reciprocal interactions and ‘first dermal signaling’, cells from the stratum basale grow into the underlying dermis. The signaling pathway, however, has not been fully identified<ref name= PMID11841536><pubmed>11841536</pubmed></ref>
|-
| Placode || The ‘first dermal signals’ influence epithelial cells to develop a placode- a thickening of the columnar cells. It is theorised that varying intrinsic dermal signals lead to the expression of various placodes and consequently, the differences in the expression of hair thickness/size throughout the body<ref name= PMID10529418><pubmed>10529418</pubmed></ref>. The specific combination of promoter and repressor activators for hair development, is also theorised to characterise for the regional differences in eventual hair expression<ref name= PMID10431226><pubmed>10431226</pubmed></ref>
|-
| Germ || WNT Signalling is believed to have a role in the induction of the dermal condesate<ref name= PMID11841536><pubmed>11841536</pubmed></ref>. Platelet-derived growth factor-A molecules from the placode, also contributes to the induction of the dermal condensate. The development of the dermal condensate helps further induce the downward growth of the placode.
Through secreted proteins such as Sonic Hedgehog, the placode continues to proliferate and enclose the dermal condensate. This eventually forms a deep, club-shaped hair bud, with an invaginated dermal papillae <ref name= PMID11841536><pubmed>11841536</pubmed></ref>. These dermal papillae are rapidly infiltrated by blood vessels and nerve endings.
|-
| Peg || Sonic Hedgehog and the induction of a ‘secondary dermal signal’ (characterisation unknown) leads to a significant down-growth and proliferation of the follilular epithelium<ref name= PMID9768360><pubmed>9768360</pubmed></ref>.
In this stage, it is also believed that the polarity of the hair follicle (the angle at which hair-follicles grow in relation to skin) and the architecture of the hair follicle itself (straight hair, wavy hair, etc) is regulated in part by Sonic Hedgehog and TGF-a signaling respectively<ref name= PMID11841536><pubmed>11841536</pubmed></ref>.
|-
| Bulbous Peg || This stage is characterised by the appearance of the hair follicle bulb. Further and significant differentiation of the inner root sheeth and the hair shaft also characterises this stage<ref name= PMID11841536><pubmed>11841536</pubmed></ref>.
The epithelial cells within the hair bulb, begin to differentiate into the germinal matrix – which grow, proliferate and keratinise to form the hair shaft and internal root sheet<ref name= PMID11841536><pubmed>11841536</pubmed></ref>. Other epithelial cells outside of the hair bud, form the external hair sheeth. Mesodermal cells of the dermis that surround the invaginating hair follicle form the dermal root sheeth and the arrecrtor pili muscles for hairs.
Proteins such as Notch1 are believed to help regulate the phenotype of keratinocytes as they differentiate<ref name= PMID10804183><pubmed>10804183</pubmed></ref>.
|}

{| style="width:100%" border="1" align="center" style="text-align:center"
|-
| [[Image:---|frame|right|middle|180x150px|Undifferentiated Epithelium|]]||[[Image:---|frame|right|middle|180x150px|Week 8-12|]]||[[Image:Fetal Hair Follicle Development - Week 12-14.JPG|frame|right|middle|180x150px|Week 12-14|]]|| [[Image:---|frame|right|middle|180x150px|Week 13-16|]] || [[Image:---|frame|right|middle|180x150px|Week 19-21|]]|| [[Image:---|frame|right|middle|180x150px|Week 23-28|]]
|}

[[Image:Hair_development_stages.jpg|frame|center|middle|300x250px|The stages of hair development]]

===Nail===
Together, fingernails and toenails are modifications of the epidermis, embryologically derived in humans from the same origin of ectodermal skin cells <ref>Pansky, B. (1982). Review of Medical Embryology. Embryome Sciences, Inc 1301 Harbor Bay Parkway, Alameda, CA, 94502</ref>.

* Nails commence development at the tips of the digits around the stage of 10 weeks, with the initiation of fingernail growth preceding that of toenails by approximately 4 weeks <ref>Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Nail Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Nail_Development</ref>. The earliest recognisable stages of nail development by week 10 are thickenings of epidermis, known as the primary nail fields, repositioning from the initial ventral surface to the eventual dorsum of each digit <ref>Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2011). The developing human: clinically oriented embryology (9th ed.). Philadelphia: Saunders. </ref>.
* The nail fields are bounded by folds of epidermis: the shallower lateral nailfolds, which adjoin into the much deeper proximal nailfold <ref>Pansky, B. (1982. Review of Medical Embryology. Embryome Sciences, Inc 1301 Harbor Bay Parkway, Alameda, CA, 94502</ref>.
* The true nail is developed via the keratinization of cells within the proximal nailfold that proliferate over nail field, developing into the nail plate.
*Initially the developing nail is covered by a thin layer of epidermis, the eponychium (corneal layer of epidermis) that at later fetal stages declines to expose the free nail, however endures as the cuticle. Beneath the free end of the nail, epidermal cells aggregate to form the mass known as the hyponychium <ref>Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2011). The developing human: clinically oriented embryology (9th ed.). Philadelphia: Saunders. </ref>.
* By 32 and 36 weeks of development, the fingernails and toenails respectively reach the tips of the digits and toes <ref>Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Nail Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Nail_Development</ref>.

{| style="width:30%" border="1" align="center" style="text-align:center"
|-
! Week !! Event
|-
| Week 9 || The primitive nail beings to from
|-
| Week 10|| The primary nail field is establish
|-
| Week 11 || Distal ridges of nail bed keratinise.
|-
| Week 13 || Early nail matrix.
|-
| Week 20 || Nail plate begins to grow over the nail bed.
|-
| Week 24 || Free nail plate is visible to the naked eye.
|}

{| style="width:100%" border="1" align="center" style="text-align:center"
|-
| [[Image:Feta Nail Development - Week 9-10.jpg|frame|right|middle|180x150px|Week 9-10|]]|| [[Image:Fetal Nail Development - Week 11-12.jpg|frame|right|middle|180x150px|Week 11-12 |]] || [[Image:Fetal Nail Development - Week 13-14 .jpg|frame|right|middle|180x150px|Week 13-14|]]|| [[Image:Mature Nail .jpg|frame|right|middle|180x150px|Mature Nail|]]
|}

===Glands===
{| style="width:75%" border="1" align="center" style="text-align:center"
|-
! Gland Type !! Description !! Image
|-
| Sebaceous Glands || *Sebaceous glands develop from the epithelial wall of the hair follicle.
*secretes vernix caseosa

Vernix caseosa is a material secreted by sebaceous glands in the foetus in the last trimester of development <ref name="PMID15830002"><pubmed>15830002</pubmed></ref> and is characterised by it’s cheese-like appearance around the neonate at birth. The functions of vernix caseosa include:
*thermal regulation <ref name="PMID15830002"><pubmed>15830002</pubmed></ref>
*barrier to water loss (to keep fetal skin hydrated)<ref name="PMID21504444"><pubmed>21504444</pubmed></ref><ref name="PMID15830002"><pubmed>15830002</pubmed></ref>
*prevents the epidermis from water contact while epidermal cornification and formation of the stratum corneum occurs<ref name="PMID21504444"><pubmed>21504444</pubmed></ref>
*antioxidant<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*anti-infective<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*moisturises the skin<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
*assists in wound-healing<ref name="PMID19881987"><pubmed>19881987</pubmed></ref>
|| [[Image:Newborn - vernix caseosa.jpg|frame|right|middle|250x187px|Vernix caseosa on a neonate.<ref>Image source: JazlynRoseVernixByPhilKonstantin.jpg‎ http://en.wikipedia.org/wiki/File:JazlynRoseVernixByPhilKonstantin.jpg</ref>]]
|-
| Mammary Glands || *Mammary glands develop from the mammary ridge- a downgrowth of the epidermis (ectoderm) into the underlying dermis (mesoderm). This occurs at about week 6 of development. Prior to puberty, the mammary glands are anatomically indistinguishable. || Image
|-
| Sweat Glands || *Eccrine and apocrine sweat glands develop from the downgrowths of the epidermis into the underlying dermis. It has been seen and detected in studies from week 21. || [[Image:Integumentary_histology_02.jpg|frame| 250x250px|Histology of eccrine sweat gland]]
|}

::: Cite this page: Hill, M.A. (2014) Embryology Integumentary System - Gland Development. Retrieved October 7, 2014, from https://php.med.unsw.edu.au/embryology/index.php?title=Integumentary_System_-_Gland_Development

===Teeth===

The ectoderm and the associated underlying layer of neural crest cells, are the origin for teeth development. As the oral epithelium grows and proliferates, it has a downward movement into the underlying neural crest layer. This leads to the formation of the dental lamina. These dental lamina, then, gives rise to tooth buds. These tooth buds, later form and develop into enamel organs. With further development, these enamel organs give rise to ameloblasts- which produce enamel. The dental papilla, on the other hand is formed by the neural crest cells which underlie the enamel organs <ref name= PMID19266065><pubmed>19266065</pubmed></ref>. These dental papillae than give rise to the dental pulp and odontoblasts- which produce predentin and dentin, in the adult body.

[[Image:Tooth development stage.jpg|frame|left|middle|425x300px|The stages of embryonic teeth development]]

{| class="wikitable"
|-
! Stage!! Week !! Description
|-
| (A) Lamina|| Week 6 || The oral ectoderm, closely interacts with the neural crest ectomesenchyme. In the Lamina stage, teeth may grow only within the epithelium.
|-
| (B) Placode|| Week 7 || The dental lamina and and the dental placodes arise, due to specific signals from adjacent epithelial cells
|-
| (C) Bud || Week 8 || Tooth buds are formed, as the epithelium cells interact with the messenchyme. This occurs at the sides of the dental placodes. Also, as opposed to the earlier Lamina stage, in the Bud stage, teeth may now only grow within the ectomesenchyme
|-
| (D) Cap|| Week 11 || After folding, the bud takes upon the shape of an inverted cap
|-
| (E) Bell|| Week 14 || The bud refolds once again, this time taking upon the shape of a bell
|}

===Video===
<html5media height="300" width="400">https://www.youtube.com/watch?v=nRH8M-arC58</html5media>

==Some Recent Findings==
{|
|-bgcolor="F5FFFA"
|
* '''Expression of caspase-14 and keratin-19 in the human epidermis and appendages during fetal skin development:''' <ref name=PMID23377137><pubmed>23377137</pubmed></ref> In recognition of the vital roles of CASP-14 and CK-19 in human skin development and maturation, the purpose of this study was to primordially investigate the expression of these two molecular factors throughout the stages of human fetal skin development from gestation to the postnatal period in order to evaluate their singular and collective functions in epidermal and associated appendage maturation and processes of differentiation and re-modelling of human fetal skin. The results of the immunohistochemical study showed the expression of CASP-14 to be a biochemical marker of human epithelial differentiation during gestation, whilst CK-19 was a marker for epidermal stem cells nests of the stratum basale of the fetal epidermis and appendages. CASP-14 was concentrated within the more differentiated fetal epidermal layers, progressively declining from the basal layer toward term whilst CK-19 showed reduced expression with progressive epidermal development of the fetal stages and was a biochemical marker for epidermal stem cells nests of the stratum basale showing marginal conservation in basal cell nests at term and postnatally. Expression of CASP-14 within the epidermal appendages of the hair follicles and sebaceous glands were concentrated within the greater differentiated inner root sheath whilst CK-19 was greatly concentrated within the outer root sheath. Inconsistent patterns of expression of both molecules CASP-14 and CK-19 were demonstrated within eccrine sweat glands.
|}

{|
|-bgcolor="F5FFFA"
|
* '''Cxcr4 is transiently expressed in both epithelial and mesenchymal compartments of nascent hair follicles but is not required for follicle formation:''' <ref name= PMID25066162><pubmed>25066162</pubmed></ref> Cellular signalling between mesencyhmal and epithelial layers of the developing skin initiate an assortment of morphogenetic events throughout embryogenesis, involving the formation of the skin and in particular, the development of hair follicles (HF). The aims of this study was to identify the specific signalling pathways associated with HF morphogenesis during the primary stages of mouse hair follicle development through the investigation of the precise expression patterns and role of the Cxcr4 receptor in two specialised cell types- mesenchymal dermal condensate (DC) cells and epithelial placode cells. Staining patterns of the Cxcr4 receptor in the budding HF revealed a high concentration within epithelial placode cells and later DC cells in developing HF’s, signifying a shift of expression between epithelial and mesenchymal layers during HF morphogenesis. The functionality of the Cxcr4 receptor was tested through Cxcr4 receptor ablation in both the mesenchymal and epithelial layers of the developing embryonic skin of conditional knockout mice (cKO) and was verified through immunofluorescence staining techniques. Normal HF development was still induced despite the absence of Cxcr4 expression in the skin of the cKO mice and numbers were comparable to those found in the wild-type (WT) control group in embryonic and postnatal skin groups demonstrating that the chemokine signalling through the Cxcr4 receptor is inessential for normal early HF development (Figure 1).
|}

{| style="width:40%; height:170px" align="center"
|-
| [[Image: Eosin_staining_of_mouse_embryonic_skin.png|frame|250x250px|Figure 1: Hematoxylin/ eosin staining of embryonic skin sections and macroscopic view of external hair shafts of mouse. Cxcr4 receptor ablation in condensates and placodes show no effect on mouse HF morphogenesis. Hair follicle and shaft develop normally and in comparable numbers in both Tbx18cre (a) and Krt14-cre (b) Cxcr4fl/fl cKO mice.]] || [[Image:- compound mouse mutants demonstrate partially rescued upper and lower molars.png|frame|right|middle|300px|Figure 2: Msx1-/--;Tbx2+/-mouse mutants showed rescue from bud to cap phase transition in embryonic dental development. Both upper and lower molars showed an enlargement in the tooth buds (H, K, L), with few upper molars progressing to cap stage (G). The arrowheads indicate enamel knots (E,G,I).]]

|}

{|
|-bgcolor="F5FFFA"
|
* '''The ventral proximal nail fold: stem cell niche of the nail and equivalent to the follicular bulge--a study on developing human skin:''' <ref name= PMID22804461><pubmed>22804461</pubmed></ref> In comparison to the characterization of the stem cell niche within the folliculosebaceous-apocrine unit, the local microenvironment of stem cells within the human nail organ is yet to be characterized. The aims of the current study was through immunohistochemical analysis to describe the expression pattern of six follicular stem cell markers; cytokeratin 15 (CK15, two clones), cytokeratin 19 (CK-19), PHLDA1, CD200 and nestin within the developing human nail and compare it with the embryonic and fetal human hair follicle. In addition, locations of vast proliferative activity within the nail were assessed using labeling with Ki-67. The stem cell markers CK15 (both clones), CK19, PHLDA1, CD200 and nestin showed no staining within the nail and hair matrix samples, however were present within the central proximal nail fold and follicular bulge. The biochemical marker for proliferation, Ki-67 showed the highest concentration of proliferative cells within the hair germ, lower regions of the hair peg and in the hair matrix. In the developing human nail the expression of Ki-67 was most prominent within the nail bed epithelium and the later nail matrix. In contrast the lowest numbers of kI-67 positive staining cells were located in regions of stem cell niches of the follicular bulge and proximal ventral nail fold as stem cells divide infrequently. Throughout the course of embryonic development these stem cell markers exhibit a highly specific expression pattern both within the nail and the hair follicle. The results seem to suggest that during embryonic envelopment the proximal ventral nail fold is the niche for nail stem cells.
|}

{|
|-bgcolor="F5FFFA"
|
* '''Msx1 and Tbx2 antagonistically regulate Bmp4 expression during the bud to cap stage transition in tooth development:''' <ref name= PMID23720046><pubmed>23720046</pubmed></ref> The expression of Bmp4 is essential for the bud to cap phase transition in embryonic dental development and is accordingly firmly regulated, with earlier stages of expression localised within the dental epithelial placode developing in to a later forms of expression in the dental mesenchyme. Numerous transcription factors including Pax 9, Osr2, Barx 1, Msx1, have been identified to prompt and maintain Bmp4 expression in these critical stages of tooth development. In particular Msx1 is one such transcription factor induced through epithelial Bmp4 expression and in turn is essential for the induction and regulation of dental mesencyhmal Bmp4 expression. The results of this investigation have demonstrated the expression of an additional transcription factor, Tbx2, induced through epithelial Bmp4, within the dental mesenchyme at bud stage of dental development. To determine a functional connection between the Msx1 and Tbx2 transcription factors, a cross was made between Tbx2 and Msx1 mutant mice. The data demonstrates that bud phase tooth arrest in Msx1-/- mice is moderately restored in Msx1-/-. Tbx2+/- compound mutants. The maintenance of Tbx2 expression in the Msx-/- arrested tooth buds exhibits that the expression of Tbx2 is not dependant on that of Msx1. This restoration in the developmental process is associated with the establishment of the enamel knot (EK) and the reinstatement of mesencyhmal Bmp4 expression (Figure 2). Knockout of Tbx2 resulted in an increase mesencyhmal Bmp4 expression. This data demonstrates that subsequent to the induction of epithelial Bmp4, both transcription factors Msx1 and Tbx2 in turn antagonistically regulate odontogenic activity that results in EK formation as well as mesenchymal Bmp4 expression at the vital bud to cap phase transition in embryonic dental development resulting in appropriate morphogenesis and patterning.

|}

{| class="wikitable mw-collapsible mw-collapsed"
! More Recent Papers
|-
|
<pubmed>23826487</pubmed>
<pubmed>22342389</pubmed>
<pubmed>24911066</pubmed>
<pubmed>25143675</pubmed>
<pubmed>23271751</pubmed>
<pubmed>25249463</pubmed>
<pubmed>23097355</pubmed>
|}

==Historic Findings==

Knowledge of the Integumentary expands in conjunction with technological developments that allow observation of microscopic structures. Historically animal models have been used to map the stages in the development of the fetal integumentary system.

===Skin===

* '''1900''' - Bardeen used the pig animal model to study the histogenesis of the dermomyotomes and nervous appratus. Bardeen and other scientists established that the human skin results from the union of the epithelial material derived from the ectoderm (epidermis) and the connective tissue origination from the mesoderm (dermis).

http://journals.lww.com/plasreconsurg/Citation/1949/07000/CLINICAL_ASPECTS_OF_EMBRYOLOGICAL_SKIN.8.aspx
Bardeen, C. R. (1900). The development of the musculature of the body wall in the pig, including its histogenesis and its relations to the myotomes and to the skeletal and nervous apparatus. Johns Hopkins Hosp. Rep, 9, 367-399.

===Glands===

Sebaceous glands / Sweat glands / Mammary

In the 1968 Robins and Breathnatch investigated the development on the sebacious and apocrine swelling in the skin, which where closely associated with development of the hair follicle. They observed differentiation of desmosomes and development of cytoplasmic contents of the cell.

===Hair===

The major anatomic details of hair development in the human foetus have been established by studies with light microscopy. Electron microscopy was not commonly used to until recently and so little was known about the ultrastructure of the skin. Over the past few years, reports have been published on the epidermal melanocytes and periderm.

* '''1958''' - Pinkus established the following stages of fetal hair follicle development: pre-germ, hair-germ, hair-peg,andbulbous-peg stages. Pinkus also determined that the developed hair fibres grow through the epidermis and appears at the level of the skin at around 19-21 weeks of development. The lanugo (foetal) hair is extremely fine with no medulla and a tip free of pigment.

* '''1968''' - Breathnach and Smith determined the fine structure of the cells of follicle and dermal papilla in the first two weeks of fetal development. The Peripheral Nerves, the sweat duct and nail development were also explored and the interrelationship of cells at particular foetal stages was deduced. These studies, and other laboratory animals, have provided information on the differentiation of cells and tissue of some functional importance and underline the role of cells and tissues.<ref name= PMID5656140><pubmed>5656140</pubmed></ref>

Robertson, J. R. (Ed.). (2002). Forensic examination of hair. CRC Press.

* '''1959''' - Chase and Eaton's investigated fetal hair follicle development. With key observations in understanding the cycling nature of hair follicle growth, following development. Development begins with the downwards growth of the follicle structure from the level of the dermis. The follicle is a processes during the quiecent phase thought he adipose layer during gowth and differntiation. They also established that upward movement of hair inovlves the addition of next cells from the matrix of the follicle and an enlargement of each cell. Furthermore their research also showed that the epidermal and dermal layers were dynamic and interacting with each other. The most significant developments in the understanding of hair follicle development came from studies investigating the differentiation pattern of cells as the follicle develops. <ref name= PMID5656140><pubmed>5656140</pubmed></ref>

<pubmed>5656140</pubmed>
<pubmed>4097391</pubmed>

Determined that the hair fibre finally breaks through the epidermis and appres about the skin at around 19-21 weeks of development. The lanugo (foetal) hair is extremely fine with no medulla and a tip free of pigment.

===Nail===

Microscopy and staining techniques have been essential tools in study of nail development, anatomy and physiology. Thus, as such technology advances scientists have been able to uncover the morphological details of the nail and understand the changes that occur during nail development. A review of the history allows us to recognize the major contributor to this field. History of research on nail development also reveals the interesting debate on the origins of keratinized cells which migrate to form the nail palate in weeks 20-24 of fetal development.

[[Image:Nail Plate Development - Pinkus .jpg|frame|right|middle|180x150px|Nail Plate Development - Pinkus|]]

* German scientists Unna and Pinkus were both highly reputable dermatologists who conducted a great deal of research on the development of the skin and associated structures. They were (<ref name= PMID12581143><pubmed>12581143</pubmed></ref> <ref>Roberts, H. L., & Walker, N. (1929). PAUL GERSON UNNA. British Journal of Dermatology, 41(4), 157-160.</ref>)
* '''1883''' - Unna published a chapter on the anatomy and development of the human nail in the German textbook "Ziemsssen's Handbuch der Speciell Pathologie und Therapie" - Ziemsssen 's manual of special pathology and therapy.
* '''1927''' - Pinkus conducted his earliest investigations into fetal nail development. His findings were published in the "Handbuch Der Haut und Geschlechtskrankeiten” - Manual of Skin and Venerail Disease.
* Based on their findings both scientists proposed that the nail matrix structure gives rise to the entire nail plate during normal fetal development. <ref name= PMID5556500><pubmed>5556500</pubmed></ref>

[[Image:Nail Plate Development -Lewis .jpg|frame|right|middle|170x145px|Nail Plate Development -Lewis|]]

* '''1954''' - Barton and Lewis conducted a through investigation on the microscopic features of the fetal and mature nail and surrounding soft tissue. Lewis challenged the current thought and proposed a "tri-partite" origin of the nail plate from three tissue origins (1) the proximal nail fold (2) the matrix and (3) bed. <ref name= PMID5556500><pubmed>5556500</pubmed></ref>
* Prior to the 1900’s it was difficulty in obtaining normal fetal specimens. Furthermore, the histological staining techniques used to prepare slides of nail tissue often damage the specimen and little detail could be seen during the microscopic examinations. Barton and Lewis conducted this investigation in hopes that a better understanding of the normal developmental anatomy and physiology would assist physicians in diagnosing and treating abnormalities. <ref name= PMID13206419><pubmed>13206419</pubmed></ref>

* '''1959''' - Samman carried out an investigation on the blood supply of the human toe nail. It was thought that a deeper understanding of morphology of the vasular supply might allows us to infer the mechanism of nail plate genesis. Samman studied the morphology and distribution of blood vessels with in the nail found capillary loops through out the nail fold and concluded that this supports the theory of multiple sites giving rise to the nail plate. <ref name= PMID14441224><pubmed>14441224</pubmed></ref>

* '''1963''' - Zaias conducted a number of studies on the embryology of the human nail. This investigation contributed to our understanding of different stages in foetal nail development. Zaias studied an number of foetal specimens at different stages in development. As a result, Zaias was able to propose a rough timeline highlighting morphological hallmarks in normal nail development. <ref name= PMID14003041><pubmed>14003041</pubmed></ref>

The current understanding of fetal nail development is a summation contributions of many researches in the international scientific community. Today research continues, technology allows exploration beyond macroscopic and microscopic morphological changes in the fetal nail. Now the aim is to understand the molecular signalling with in the epidermal cells which drives this process.

===Teeth===
<ref name= PMID5267156><pubmed>5267156</pubmed></ref> -- <pubmed>5267156</pubmed>

==Abnormalities==

===Aplasia Cutis Congenita===
[[Image:Cutis aplasia.jpg|frame|right|middle|250x187px|Aplasia cutis congenita at the scalp]]
Aplasia cutis congenita (ACC) is a rare skin abnormality, characterised by the absence of all layers of the skin. It is most common to occur on the scalp (70%), specially the vertex. In severe cases, the defect can go as deep as the bone or the dura. Other sites of ACC include the skin of the limb regions. “ACC occurs in approximately 1 in 10000 live births, with a female-to-male ratio of 7:5.” The specific aetiologic agent for ACC is still unknown. It has been suggested to be genetic and/or environmental. The damage to the vertex is suggested to be the result of the biomechanical stretch at this area when the fetal brain is growing.<ref name= PMID22549580><pubmed>22549580</pubmed></ref>

Presently, ACC is managed via conservative treatments or surgical treatments. Conservative treatments refer to basic wound treatments and preventing infection with the use dressings and antibiotics. Surgical treatments, specifically scalp reconstruction procedures, aim to reconstruct the damage to the skin through skin grafts, local scalp flaps, and pericardial scalp flaps. Large defects are often treated using surgical treatments.<ref name= PMID23147310><pubmed>23147310</pubmed></ref>

===Dystrophic Epidermolysis Bullosa===
[[Image:Dystrophic Epidermolysis Bullosa lesions.jpg|frame|right|sub|270x230px|Severe skin lesions due to Dystrophic epidermolysis bullosa.<ref name="PMID23739692"><pubmed>23739692</pubmed></ref>]]
Dystrophic Epidermolysis Bullosa (DEB), a type of epidermolysis bullosa, is a genetic disease of the skin, usually present at birth or at an early age. Currently, around 400,000 - 500,000 people are affected with the disease<ref name= PMID252845240><pubmed>25284524</pubmed></ref>. It is characterised by the fragility of the skin<ref name= PMID252845240><pubmed>25284524</pubmed></ref>, where it blisters upon minimal trauma and scars<ref name= PMID19945622><pubmed>19945622</pubmed></ref>, usually at the extremities<ref name= PMID252845240><pubmed>25284524</pubmed></ref>. It is caused by a mutation in collagen VII gene (COL7A1)<ref name= PMID19945622><pubmed>19945622</pubmed></ref><ref name= PMID24860657><pubmed>24860657</pubmed></ref>, which is responsible for the the formation of anchoring fibrils<ref name= PMID19945622><pubmed>19945622</pubmed></ref>. Anchoring fibrils are responsible for dermal-epidermal adherence<ref name= PMID19945622><pubmed>19945622</pubmed></ref>, that is why it’s loss of function results to blistering of the skin. In some cases, even teeth and nails are affected. Teeth of patients with DEB have enamel defects and when combined with poor oral hygiene, it may lead to decay. Nails of DEB patients are often dystrophic and will eventually be lost.<ref name= PMID252845240><pubmed>25284524</pubmed></ref>

There are currently no known cures for DEB; however there are techniques to manage the clinical manifestations of the disease, which include:
*wound care<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*preventing factors that may cause blistering<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*using aqueous disinfectants - highly effective<ref name= PMID19945622><pubmed>19945622</pubmed></ref>
*dental care<ref name= PMID252845240><pubmed>25284524</pubmed></ref>:
:-use of topical fluoride
:-careful prophylaxis
:-use of topical antibiotics to prevent secondary infections<ref name= PMID24860657><pubmed>24860657</pubme></ref>

One study is currently exploring the potential of protein therapy as a treatment for DEB. Their results show that intradermal injection of recombinant human collagen 7 in mice with DEB led to “restoration of C7 and anchoring fibrils.”<ref name= PMID19018253><pubmed>19018253</pubmed></ref> Other techniques that aim to restore C7 include:
*bone marrow transplant- improved blistering in mice specimen and increase survival rates<ref name= PMID24860657><pubmed>24860657</pubmed></ref>
*hematopoietic cell transplant (HCT)- increased deposition of C7 in injured skin<ref name= PMID24860657><pubmed>24860657</pubmed></ref>

===Congenital Alopecia Areata===
[[Image:Alopecia Areata.jpg|frame|right|middle|270x220px|Patches of hair loss: a sign of alopecia areata.<ref name="PMID23960401"><pubmed>23960401</pubmed></ref>]]
Alopecia areata (AA) is an abnormality of the hair affecting anagen hair follicles, characterised by well-demarcated patches of hair loss. It is non-scarring and can occur on the scalp and/or the body. 90% of AA cases occur on the scalp. 5%-10% of patients with AA lose all hair on their scalp; this is called alopecia totalis. While others lose all of their body hair, this is called alopecia universalis. <ref name= PMID17269961><pubmed>17269961</pubmed></ref> Its pathogenesis is considered to be both genetic and autoimmune. There is an abnormality with the genes related to the immune system and to the hair follicles. And histopathology shows signs of lymphatic infiltration of the hair follicles and the loss of these scalp lymphocytes allow hair follicles to recover.<ref name= PMID16338213><pubmed>16338213</pubmed></ref> High frequencies of catagen and telogen hair follicles are also present in areas affected by AA.<ref name= PMID17269961><pubmed>17269961</pubmed></ref>

There is currently no cure for AA. There are several treatments to combat AA but none of these have led to remission of the disease, the most effective being corticosteroids and topical immunotherapy.<ref name= PMID17269961><pubmed>17269961</pubmed></ref> A new method of treating alopecia areata is currently being studied. Transepidermal drug delivery (TED) is a new treatment that functions by creating micro-channels in the epidermis. By doing so, drug delivery to the skin is improved. This treatment was highly effective and had lower rates of side effects, e.g. pain, compared to previous treatments.<ref name= PMID25260052><pubmed>25260052</pubmed></ref>

===Harlequin Ichthyosis===
[[Image:Harlequin Ichthyosis.jpg|frame|right|middle|250x200px|A baby with harlequin ichthyosis.<ref name="PMID24520234"><pubmed>24520234</pubmed></ref>]]
Congenital ichthyosis is an autosomal recessive disease of the skin, characterised by visible and excessive scaling of the skin and hyperkeratosis, i.e. thickening of stratum corneum layer of the epidermis and in some cases, hypohidrosis, i.e. the lack of ability to sweat. <ref name= PMID19824737><pubmed>19824737</pubmed></ref> Harlequin ichthyosis (HI) occurs only in 1 in 1,000,000 babies. It is life-threatening in the first few weeks and/or months of the neonate.<ref name= PMID19824737><pubmed>19824737</pubmed></ref> The thick skin can restrict movement of the baby and sometimes constrict extremities and lead to necrosis then autoamputation.<ref name= PMID23419760><pubmed>23419760</pubmed></ref> Babies with HI are also characterised by bilateral ectropion (everted eyelids), eclabium (everted lips), and underdeveloped nose.<ref name= PMID23419760><pubmed>23419760</pubmed></ref> In 50% of HI cases, respiratory failure is often the cause of death.<ref name= PMID24124810><pubmed>24124810</pubmed></ref> This disease is caused by a nonsense mutation in the ATP-binding-cassette A12 (ABCA12) gene, which is responsible for encoding a lipid transporter essential for the regulation of lamellar bodies. <ref name= PMID19824737><pubmed>19824737</pubmed></ref><ref name= PMID23419760><pubmed>23419760</pubmed></ref><ref name= PMID24124810><pubmed>24124810</pubmed></ref>

There is currently no known cure for this disease. Management techniques include:
*Monitoring in neonatal intensive care units.
:-Temperature within the incubator is controlled to avoid fluctuation in body temperature and to stop sweating. <ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Mechanical removal of excess scales from the skin <ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Bathing to remove excess scales from the skin<ref name= PMID19824737><pubmed>19824737</pubmed></ref>
*Topical therapy - to reduce hyperkeratosis. <ref name= PMID19824737><pubmed>19824737</pubmed></ref><ref name= PMID24124810><pubmed>24124810</pubmed></ref>
*Use of oral retinoids - known to have high rates of survival.<ref name= PMID24124810><pubmed>24124810</pubmed></ref>

===Hypohidrotic Ectodermal Dysplasia===
[[Image:Oligodontia.jpg|frame|right|middle|250x187px|Oligodontia: a clinical manifestation of HED.<ref name="PMID21165248 "><pubmed>21165248 </pubmed></ref>]]
Hypohidrotic ectodermal dysplasia (HED) is the most of all ectodermal dysplasias, caused by an abnormality in the development of ectodermal tissues, which inlude skin, hair, teeth, sweat glands, and nails.<ref name= PMID20682465><pubmed>20682465</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref> Patients with ectodermal dysplasia often have sparse hair and oligodontia, which is a condition where teeth are missing and are poorly developed.<ref name= PMID20682465><pubmed>20682465</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref> Sweating is a very important function in the body in terms of thermoregulation. HED is mainly characterised by hypohidrosis due to the lack of sweat glands in the skin, which could lead to hyperpyrexia and sometimes death. In neonates, the mortality rate of HED reaches up to 30%, with the first year of life having the highest risk. <ref name= PMID20682465><pubmed>20682465</pubmed></ref> HED is caused by a genetic abnormality of the ectodysplasin A gene (EDA) and passed on by X-linked inheritance. The mutations of this gene results in the poor sweating ability or none at all in a person. The effects of this abnormality is usually more severe in males than in females. <ref name= PMID21357618><pubmed>21357618</pubmed></ref><ref name= PMID24678015><pubmed>24678015</pubmed></ref>

There is currently no pharmacological therapies for HED but there are methods applied to prevent the disease from aggravating. Neonates with HED are placed in incubators and monitored to prevent them from overheating. Management of this disease gets easier as the patient ages. Adults with HED can control their thermoregulation by staying in cool environments or drinking cold drinks to lower the body temperature. Currently, there are studies that aim to find a cure for this abnormality, e.g. gene replacement therapy in animal models.<ref name= PMID24678015><pubmed>24678015</pubmed></ref>

==References==
<references/>