22.1 Anatomy and Physiology (Figure 22.1)

1. The skin is a large complex organ with many functions, including temperature regulation, vitamin D synthesis, and aiding cell-mediated immunity.

2. The skin repels potential pathogens by shedding and being dry, acidic, and toxic.

22.2 Normal Flora of the Skin

1. Skin is inhabited by large numbers of bacteria of little virulence that help prevent colonization by more dangerous species (Table 22.1)


1. Diphtheroids are Gram-positive, pleomorphic, rod-shaped bacteria that play a role in acne and body odor. Fatty acids, produced from their metabolism of the oily secretion of sebaceous glands, keep the skin acidic.


1. Staphylococci are Gram-positive cocci arranged in clusters. Universally present, they help prevent colonization by potential pathogens and maintain the balance among flora of the skin. The principal species, Staphylococcus epidermidis, can sometimes be pathogenic.


1. Malassezia sp. are single-celled yeasts found universally on the skin. Usually harmless, they can cause tinea versicolor, probably some cases of dandruff, and serious skin disease in AIDS patients. (Figure 22.2)

22.3 Bacterial Skin Diseases

Hair Follicle Infections (Figure 22.3)

1. Boils and carbuncles are caused by Staphylococcus aureus (Table 22.3), which is coagulase-positive and often resists

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