Stratum basale (germinativum)

Epidermis · Layer 1 (deepest) K5/K14 Only mitotic layer

Single layer of keratinocytes sitting on the basement membrane; the only epidermal layer that divides, so every corneocyte at the surface began here. It also houses the melanocytes and Merkel cells.

Detail

Cells
Mitotically active keratinocytes and keratinocyte stem cells, plus melanocytes and Merkel cells scattered between them
Keratins
K5 and K14; the differentiation switch to K1/K10 occurs on leaving this layer
Attachment
Hemidesmosomes bind the basal cell to the lamina lucida; desmosomes bind it laterally and above to its neighbours
Turnover
About 28 days from basal mitosis to desquamation; roughly 4 days in psoriasis, which is why scale accumulates
Vitamin D
Holds 7-dehydrocholesterol, converted by UVB (290-315 nm) to previtamin D3
Blood supply
None — the whole epidermis is avascular and is fed by diffusion from the papillary dermal capillary loops

When it goes wrong

Chronic UV damage to basal keratinocytes and follicular stem cells

Basal cell carcinoma: the commonest skin cancer, on sun-exposed head and neck, locally invasive but almost never metastasises; hedgehog pathway (PTCH1) driven

K5 or K14 mutation (epidermolysis bullosa simplex)

Basal keratinocytes lyse under mechanical stress: intraepidermal blistering of hands and feet from birth, worse with heat and friction

Anti-desmoglein 3 IgG (pemphigus vulgaris)

Split immediately above the basal layer, which stays anchored to the basement membrane while the rest of the epidermis lifts off

Practise this structure

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