Keratinization is a natural process where squamous cells produce and fill up with a protein called keratin. Keratin is a strong, protective substance that helps tissues resist damage and dehydration. As squamous cells undergo keratinization, they become tougher and thicker and eventually lose their ability to function as living cells. Instead, they form a protective outer layer.
Keratinization normally occurs in tissues containing squamous cells, such as the skin, hair, and nails. In the skin, the keratinization of squamous cells forms the tough outer layer called the epidermis, protecting the body from physical injuries, infections, and water loss. Similarly, hair and nails become tough and resistant to damage due to keratinization.
Keratinization is considered abnormal when squamous cells in tissues that do not normally produce keratin begin to do so, such as in specific internal organs or mucosal surfaces like the mouth, throat, or cervix. Abnormal keratinization can indicate changes in the tissue due to chronic irritation, inflammation, or precancerous and cancerous conditions.
Several medical conditions are associated with abnormal keratinization of squamous cells. These include:
In cancer, keratinization often indicates squamous cell carcinoma. This type of cancer involves abnormal and excessive keratin production by squamous cells, forming characteristic structures known as keratin pearls. The presence of keratinization can help pathologists distinguish squamous cell carcinoma from other types of cancers under the microscope. Keratinization typically signals that the cancer originated from squamous cells or has undergone squamous differentiation.
Under the microscope, keratinization appears as thick layers of squamous cells filled with keratin, which stain bright pink or red. These keratinized cells often form compact layers or structures called keratin pearls, particularly in squamous cell carcinomas. Keratin pearls look like small, rounded structures made of densely packed, keratin-filled cells. Observing keratin under the microscope helps pathologists diagnose and understand various skin and mucosal conditions.