The skin of the labium majus is keratinized on both the lateral and the medial surfaces. The epidermis shows the usual four layers of stratum corneum with basket-weave orthokeratosis (keratin), granular cell, prickle cell, and basal layers. Any parakeratosis is abnormal (11). The basal layer may show pigmentation. Rete ridges are present. The dermis is divided into the papillary and reticular dermis. The papillary dermis is superficial, thin, and composed of fine collagen. The reticular dermis is deep, thick, and composed of coarse collagen (Fig. 2). The epidermis and dermis are slightly thicker in the reproductive age group. Hair follicles, sebaceous, apocrine, and eccrine glands are present on the lateral surface of the labium majus, (Fig. 3). Sebaceous glands are situated at the mid-dermal level and open into hair follicles. The hair-bearing skin of the labium majus is one of the few sites on the body (perianal skin, axilla, groin, breast, ear, scalp, and eyelid) where apocrine glands occur. Like sebaceous glands, the apocrine glands also open into the infundibula of hair follicles. On the lateral side of the labium majus, there are fascicles of smooth muscle in the dermis, corresponding to the dartos muscle of the scrotum (Fig. 4). On the medial side of the labium majus, the only appendages found are sebaceous glands. These sebaceous glands open directly onto the skin surface, like those of the labia minora, nipples, eyelids, mouth, and anus. The subcutaneous fat is thick and contains thick-walled blood vessels (Fig. 5).
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