29 – Dermatology History Flashcards
1
Q
How do you approach a dermatology patient?
A
- History
- Dermatologic examination
- Otoscopic examination
2
Q
Dermatology history: breed
A
- Yorkshire terrier: dermatophysis
- Persian cats: idiopathic facial dermatitis
3
Q
Dermatology history: pruritus
A
- KNOW the correct spelling
- Scratching, licking, chewing, rubbing
- Use ‘itch scale’: important for monitoring and gauge for treatment
4
Q
Dermatology history: age of when it started
A
- Young animals
o Parasites
o Allergies
o Cornification disorders
o Dermatophytosis - Middle aged
o Allergy
o Parasite
o Endocrinopathy
o Autoimmune disease - Older
o Neoplasia
o Parasites
o Endocrinopathy
o Autoimmune disease
o Allergies: WAY DOWN ON LIST
5
Q
Dermatology history: how long has it been present?
A
- How has it progressed?
- Any changes?
- Possibly a new issue?
o If for 6 years and then worse=maybe allergic but then now has cancer
6
Q
Dermatology history: is there a seasonal component?
A
- Allergic dermatitis
- Flea allergy dermatitis
- Cyclic flank alopecia
7
Q
Dermatology history: location
A
- What parts affected?
- Where did it start?
o Sarcoptic mange: elbows, ear margins, ventrum
o Flea bite hypersensitivity: rump and tail in dog
o Allergies: armpit
8
Q
Dermatology history: previous treatments?
A
- Any success? Did they improve?
- Parasite control? (all pets in household?)
9
Q
Dermatology history: diets
A
- How long has it been feed?
- Any other foods or treats?
- Any medications at the time?
- Diet trials: other animals or bowls? Children?
o Do NOT make assumptions: owners do NOT always understand the significance
10
Q
Dermatology history: other clinical signs
A
- Changes in thirst, hunger or urination?
- Changes in activity level?
- How many bowel movements a day?
- Other pets OR people have clinical signs?
11
Q
Dermatology history: lifestyle
A
- Indoor or outdoor?
- Around other animals?
- If cat: FeLV/FIV status
- Last medication administered or last bath administered
12
Q
Dermatology history: examples of specific questions to ask
A
- Medications being administered prior to onset of lesions?
- Were there any new medications?
- Is there history of skin or ear disease previously?
- **Don’t depend on owners to give you the info
- *ask owner if unsure between normal vs. abnormal (maybe have pictures)
13
Q
Dermatologic examination
A
- Do it is the same pattern to ensure you do NOT forget anything
- Skin has limited reaction patterns
o Many dermatoses present similarly - History and lesion distribution can help differentiate disease processes
14
Q
Periocular distribution: clinical signs
A
- Alopecia
- +/- erythema
- +/- lichenification
- +/- hyperpigmentation
- +/- crusts
15
Q
What are some DDx of periocular distribution in dogs?
A
- Atopic dermatitis
- Food allergy
- Demodicosis
- Bacterial infection
- Malassezia dermatitis
- Dermatophytosis
16
Q
Perioral distribution: clinical signs
A
- Alopecia
- Erythema
- +/- fissures
- +/- erosions
- +/- ulcers
17
Q
What are some DDx of perioral distribution?
A
- Demodicosis
- Atopic dermatitis
- Malassezia dermatitis
- Mucocutaneous pyoderma
18
Q
Dorsal aspect of paws in dogs: clinical signs
A
- Alopecia
- Erythema
- +/- lichenification
- +/- hyperpigmentation
- +/- crusts/exudate
19
Q
What are some DDx of dorsal aspect of paws in dogs?
A
- Atopic dermatitis
- Food allergy
- Demodicosis
- Sarcoptic mange
- Bacterial dermatitis
- Malassezia dermatitis
- Dermatophytosis
20
Q
Ventral interdigital aspect of paws: clinical signs
A
- Alopecia
- Erythema
- +/- lichenification
- +/- keratosebaceious exudate
21
Q
What are some DDx of ventral interdigital aspect of paws?
A
- Demodicosis
- Sarcoptic mange
- Atopic dermatitis
- Food allergy
- Malassezia dermatitis
- Bacterial dermatitis
22
Q
Look at a part from afar
A
- Is pruritus present?
- Does the pet appear healthy?
- General attitude?
- Weight and BCS
23
Q
Do a thorough dermatologic examination
A
- Focus on all areas (NOT just the areas the client mentions)
- Are lesions symmetrical? (if symmetrical=autoimmune)
- Are lesion localized? Or generalized?
- Where are the lesions located?
- How does the haircoat feel?
- Odor? (often can indicate infection)
o Can NOT diagnose yeast from smell!! (bacteria smells too) - *NOTE ALL LESIONS APPRECIATED
24
Q
What different conditions can haircoat changes indicate?
A
- Sebaceous adenitis
- Endocrinopathy
25
Otoscopic examination
- Usually do it LAST
- Ask questions
o Is there history? any medications? Any issues with medications? Other dermatological issues?
- Look at ‘good’ ear first
- Examine pinna first and record changes
o Is there erythema? Crusts? Are lesions present on distal margins?
- If worried about sarcoptic mange: is there pinnal-pedal reflex?
- Palpate base of ears (firm or soft? Pain=deeper infection)
- Open mouth to see if pain present
- Neurological signs?
- *need to use pinna to straighten canal
26
Normal otoscopic exam
- Visualize vertical canal, horizontal canal, tympanic membrane
- Hair and/or wax
- *sometimes cannot perform a through ear exam
o Do NOT try and force exam
27
Otoscopic exam: record any abnormalities appreciated
- Stenosis
- Exudate
- Ulceration
- Does the tympanic membrane look abnormal?
- Are the ears firm on palpation?
