Approach to dermatology workshop

Question 1

Identify this lesion

Answer 1

palatine lesion

Question 2

Identify this lesion

Answer 2

Plaque

Question 3

Identify this lesion

Answer 3

plaque and ulceration

Question 4

Identify this lesion

Answer 4

plantar pedal lesions

Question 5

Identify this lesion

Answer 5

Lip ulcer

Question 6

Identify this lesion

Answer 6

excoriation on face

Question 7

Label the cytology of this skin lesion - what are the results consistent with?

Answer 7

eosinophilic granuloma

Question 8

An 11-yr old dog has severe pruritus and redness of the skin. These are his lesions.

Why is canine atopic dermatitis unlikely?

Answer 8

Based on the history:
The age of onset is very late for allergic disease 75% of cases start between 6 months and 3 ears of age

Based on the lesions:
The distribution – particularly the nose leather and the top of the head would be very unusual in cAD
The nature of the lesions – erosions, depigmentation, scale, alopecia and small hyperpigmented macules are consistent with a disease attacking the basement membrane

Question 9

Give examples of diseases affecting the basement membrane

Answer 9

epitheliotropic lymphoma, cutaneous lupus and vitiligo

Question 10

What is the most useful test to diagnose diseases of the basement membrane?

Answer 10

biopsy and cytology

Question 11

What disease is shown on this abdominal exudative biopsy?

Answer 11

epithiotropic lymphoma

Question 12

Describe this lesion. Are the lesions suggestive of endocrine alopecia?

Answer 12

There is well demarcated irregular alopecia affecting the lateral flank with hyperpigmentation of the exposed skin.
The pattern is not a worn area consistent with generalised telogenisation but localised in a ‘geographical’ distribution.
Lesions don’t suggest endocrine alopecia, where hair loss occurs due to wear & tear, often presenting with diffuse & poorly demarcated edge

Question 13

What basic tests might be useful in helping to investigate the possibility of hormonal alopecia?

Answer 13

Haematology and biochemistry can give signs suggestive of hypothyroidism (hypoT4) and hyperadrenocorticism (HAC):
- Stress haemogram and increased ALP noted in HAC
- Raised cholesterol common in hypothyroidism

Urine specific gravity is useful in considering HAC (high SG => very unlikely)
- Urine creatinine:cortisol is very useful as a rule out test for HAC

rule hypothyroidism out using T4 & TSH