Approach to pruritus Flashcards

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1
Q

List 4 clinical presentations of pruritus

A

Scratching, chewing
Licking feet (dogs)
Feather-plucking (birds)
Overgrooming (=‘self-induced alopecia’) (cats)

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2
Q

List the 4 feline reaction patterns

A

Self-induced alopecia (SIA)
Face, head and neck pruritus (FHN)
Miliary dermatitis (MD)
Eosinophilic granuloma complex (EGC)

often more than one pattern present

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3
Q

Describe self-induced alopecia (feline reaction pattern)

A

Bilaterally symmetrical alopecia in areas that cat can reach with tongue
hair often stubbly

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4
Q

Describe how to diagnose self induced alopecia

A

Trichogram- look for broken hairs

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4
Q

Describe Face, head and neck pruritus (feline reaction pattern)

A

36% causes due to ectoparasites- especially fleas

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5
Q

Describe Miliary dermatitis (feline reaction pattern)

A

Papulocrustous lesions (can’t see unless clip hair) , especially on dorsum

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6
Q

List the 3 types of Eosinophilic granuloma complex (feline reaction pattern)

A
  1. eosinophillic grauloma
    2,. eosinophillic plaque
  2. Indolent ulcer (‘Rodent ulcer’)
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7
Q

Describe Eosinophilic granuloma

A

Well-demarcated, solid, raised, yellow to pink plaques/nodules
+/- eroded or ulcerated surface
+/- crust

Any site but especially caudal thighs (linear), oral cavity, feet, chin

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8
Q

Describe eosinophilic plaque

A

Raised, flat-topped erythematous plaques
Usually ulcerated/eroded and pruritic
Usually ventral abdomen/caudal thigh

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9
Q

Decsribe Indolent ulcer (‘Rodent ulcer’)

A

Erosive/ulcerated lesion on mucocutaneous junction of upper lips

Unilateral/bilateral

Rarely painful or pruritic

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10
Q

List 3 differentials which should always be condisered with all feline reaction patterns

A

flea allergic dermatitis
feline food allergy
feline atopic skin syndrome

these are the most common causes of feline reaction patterns

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11
Q

What are the 3 main groups of causes for pruritus

A

Allergy
ectoparasites
infections

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12
Q

when does environmental allergic dermatitis generally start

A

6m- 3 yr

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13
Q

Why may endocrinopathies present as pruritus

A

Secondary microbial infection due to immunocompromise

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14
Q

If you see: Dog with dull coat, lethargy and bradycardia
what should you suspect

A

hypothyroidism

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15
Q

If you see: Dog with diffuse thinning of coat, PUPD, polyphagia
what should you suspect

A

hyperadrenocorticism

16
Q

What is pustules most common caused by

A

superficial pyoderma (staphylococcal folliculitis)

17
Q

If you see Epidermal collarettes, crusts
what is it most commonly caused by

A

superficial pyoderma
occasionally- Pemphigus F

17
Q

After treatment of ectoparasites and infection the pruitus resolves fully ….

A

this implies non-pruritic cause - e.g. immunosuppressive disease including endocrinopathies
OR
ectoparasites, if not previously on good ectoparasite control

18
Q

After treatment of ectoparasites and infection the pruitus remains…..

A

implies other pruritic underlying cause - usually atopic dermatitis (environmental or food-induced)

19
Q

Describe how to distinguish between environmental and food-induced atopic dermatitis

A

exclusion diet trial- 8 weeks minimum
but also give prednisolone or oclacitinib for first 2-3 weeks then see if pruritus reoccurs

20
Q

How do you reach a environmental atopic dermatitis diagnosis

A

exclusion
there are tests but these are not used to diagnose

21
Q

You suspect a 2yo French bulldog with generalised pruritus to be suffering from canine atopic dermatitis. You have found no evidence of microbes or ectoparasites on investigation. What is your next step?

A

Treat this dog and in-contacts with an isoxazoline, and use an environmental flea spray