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MOD > Approach to alopecia 1 > Flashcards

Approach to alopecia 1 Flashcards

1
Q

What is spontaneous alopecia?

A

*No animal involvement
*Various aetiopathogeneses

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2
Q

What is self induced alopecia?

A

*Animal removes hair
*Pruritus (ectoparasites, allergic skin disease
*Psychogenic (behavioural, internal pain/inflammation)

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3
Q

How can you check if alopecia is self-induced or spontaneous?

A

Self induced = look for hair in teeth / litter trays
=Trichograms - shows broken hair shafts in pruritic animals

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4
Q

how does inflammation cause spontaneous hair loss?

A

Inflammation within hair follicle = damaged hair = hair loss

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5
Q

How would you approach diagnosis?

A

1.History
2. Physical examination - needs to be thorough
3.Differentiate spontaneous vs self-induced
4.Differentiate inflammatory vs non-inflammatory
5.List differential diagnoses
6.Make diagnostic plan

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6
Q

What skin conditions are puppies predisposed to?

A

*demodicosis
*dermatophytosis
*growth hormone deficiency

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7
Q

What alopecia causes are adults predisposed to?

A

Immune mediated disease (sebaceous adenitis)

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8
Q

What alopecia causes are older dogs predisposed to?

A

*hypothyroidism
*Hyperadrenocorticism
*Neoplasia

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9
Q

When making differential diagnoses- what should you prioritise?

A

*Common things are common
*Zoonoses - any other animals in the household

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10
Q

What are the infectious agents causing inflammation causes of spontaneous alopecia?

A

*bacterial folliculitis
*dermatophytosis

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11
Q

What are the parasites causing inflammation causes of spontaneous alopecia?

A

*Demodicosis
*Leishmaniasis

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12
Q

What are the immune mediated causing inflammation causes of spontaneous alopecia?

A

*alopecia areata
*dermatomyositis
*sebaceous adenitis

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13
Q

What is the most common cause of spontaneous alopecia in cats + dogs?

A

Bacterial folliculitis

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14
Q

What is the agent causing bacterial folliculitis?

A

Staphylococcus pseudintermedius

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15
Q

What can be associated with bacterial folliculitis?

A

*Pruritus
*Alopecia
*Scale
*Crust
*Deep infection

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16
Q

How should you take a sample of a dry/wet lesion?

A

Dry = tape strip
wet = impression smear

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17
Q

What is the most common agent causing ringworm?

A

Microsporum canis (zoophilic)

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18
Q

What are less common agents causing ringworm?

A

Microsporum gypseum
Trichophyton mentagrophytes
Trichophyton benhamiae

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19
Q

What animals are predisposed to ringworm?

A

*Young / Immunocompromised
*Puppies + kittens
*Persian cats
*Yorkshire + jack russel terriers

20
Q

What are reservoirs for ringworm?

A

Asymptomatic carriers

21
Q

Where are ringworm lesions mosrt common?

A

Head
Ears
Chin

22
Q

If a vet suspects ringworm what should be done?

A

Wear protective clothing to prevent contamination

23
Q

How is ringworm diagnosed?

A

*Wood’s lamp examination - apple green fluorescence of hair
*Trichography - on x100 magnification w oil immersion can see arthrospores (looks like soap bubbles)
*Culture = gold standard

24
Q

What is the mackenzie sampling technique for culture?

A

Use nylon brush to create electromagnetic charge which attracts spores
-then submit brush to lab / inoculate on fungal culture medium - RED=fungal

25
Q

What special stains can be used to detect hyphae?

A

Silver
PAS

26
Q

How is ringworm treated?

A

*Spontaneously resolve (12-20wks)
*Topical Tx = reduce scale = reduced contamination + shedding (miconazole / lime sulfur dip)
*environmental decontamination

27
Q

What are systemic treatments of ringworm?

A

*Itraconazole - licensed in cats
*Ketoconazole - licensed in dogs - can cause neurological disease

28
Q

What are the species of demodex?

A

Demodex canis (dog)
Demodex injai (dog)
Demodex cati (cat)

29
Q

What will happen if commensal demodex is not controlled?

A

Will proliferate + cause disease

30
Q

What are the 2 clinical syndromes of demodicosis?

A

*juvenile onset demodicosis
*Adult onset demodicosis

31
Q

What is seen with juvenile onset demodicosis?

A

*Localised to generalised patches
-Alopecia
-Scaling
-Comedones
-Blue-grey hyperpigmentation
-Follicular casts
*+/- secondary bacterial infection
*Mild cases spontaneously resolve

32
Q

Why is generalised juvenile onset demodicosis a problem?

A

Serious problem as can lead to secondary infections

33
Q

What is seen with adult onset demodicosis?

A

*Often generalised
*Often secondary bacterial infection
*Papules, pustules, draining sinus tracts, enlarged lymph nodes, +/-pyrexia
*Pruritic or painful
*Require aggressive treatment

34
Q

Is demodex cati contagious?

A

No - demodex gatoi is
Demodex cati = commensal gone wrong

35
Q

What does it mean if a condition is idiopathic?

A

Can never be cured - only handled/ lifelong treatment

36
Q

How do you confirm demodicosis?

A

*positive skin scrapings
*hair plucks

37
Q

When would you use biopsy to confirm demodicosis?

A

Only if skin is thickened

38
Q

When is a hair pluck useful to do?

A

On a conscious patient

39
Q

What do you need to do when doing a skin scraping and why?

A

Always squeeze the skin to bring the mite to the surface

40
Q

How would you observe demodex mites under a slide?

A

*Mount in liquid paraffin + use cover slip
*Most found on x4 or x10 magnification

41
Q

What is the difference micrscopically between D. canis + D. injai + D. cati?

A

D. injai = long tail
D. cati = pointy tail

42
Q

What is the treatment of demidicosis?

A

*clip long haired animals + bathe to remove debris
treat 2 bacterial infection
*Treat underlying immunosuppression
*Imidacloprid / moxidectin
*isoxazoline - afoxolaner / flurolaner

43
Q

Why do they advise spaying dogs with juvenile onset demodicosis?

A

*increased chance of disease in offspring
*periparturient reduction in immunity can result in return of disease

44
Q

How would you treat demodicosis in cats?

A

*Isoxazolines - Flurolaner
*Treat underlying disease

45
Q

How would you perform a biopsy if you suspected non-inflammatory alopecia?

A

Take a biopsy of the full alopecia, partial alopecia (edge) and a sample of the normal skin

MOD (103 decks)

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