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Dermatology > Atopic Dermatitis & Dermatophytoses > Flashcards

Atopic Dermatitis & Dermatophytoses Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the definition of atopic dermatitis?

A

A genetically-inherited, relapsing, pruritic dermatitis most commonly associated with IgE environmental allergens

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2
Q

What 3 things do animals with atopic dermatitis have?

A

Type I hypersensitivity (IgE)
T cell imbalances
Primary skin barrier defect

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3
Q

What are the differences in T cell imbalances between chronic and acute disease?

A

Acute- too much T helper 2

Chronic - too much T helper 1

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4
Q

What stain and technique help you visualize lipid-based material?

A

EM

Ruthenium Tetroxide

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5
Q

What are the main routes of allergen access in atopic dermatitis?

A

Inhalation

Percutaneous absorption

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6
Q

What breeds are predisposed to atopic dermatitis?

A 
Terriers
Shar-pei
Setters
Retrievers
Beagles
Dalmatians
Cockers
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7
Q

What are the clinical signs of atopic dermatitis?

A

Onset 1-3 years old
Seasonal at first, progressive worsening with time
Pruritus and erythema
With chronicity- excoriations, lichenification, hyperpigmentation
Secondary infections

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8
Q

How do you diagnose atopic dermatitis?

A

Exclusion of other pruritic diseases

Willemse’s criteria (at least 3 major and 3 minor criteria)

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9
Q

What are the major and minor Willemse’s criteria?

A 
Major: 
Pruritus
Facial/digital involvement
Lichenification of flexor surface
Chronically relapsing
Familial history
Breed predilection
Minor:
Onset of clinical signs before 3 years old
facial erythema
Bacterial conjunctivitis
Superficial pyoderma
Hyperhydrosis
Positive skin test
Elevated allergen specific IgE
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10
Q

What are the two types of allergy testing?

A

Intradermal Skin Test (IDST)- evaluates IgE in skin

Serology- evaluates IgE in blood

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11
Q

What is hyposensitization therapy?

A

Allergy shots
Based on past positive reactions
No more than 12 allergens/vaccine

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12
Q

What does anaphylaxis look like in the dog?

A

Vomiting, diarrhea, weakness within 1-2 hours post-exposure

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13
Q

When is systemic glucocorticoid therapy indicated?

A

Short season use
No concurrent pyoderma
No concurrent demodicosis

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14
Q

What is cyclosporine?

A

An immunomodulant (suppresses T cells and cytokine production) used as a lifelong therapy

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15
Q

What is oclacitinib?

A

Apoquel
Recently released drug that targets pruritus of various causes (Janus Kinase (JAK) inhibitor)
Extremely effective and fast acting

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16
Q

What is IL-31 monoclonal antibody?

A

Injectable 1x/month
Blocks IL-31 which is important in the transmission or pruritus
Used in combination with other therapies

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17
Q

Why are essential fatty acids used in therapy for atopic dermatitis?

A

Are anti-inflammatory

Contribute to barrier function and restoration of normal lipid composition

18
Q

What is capsaicin used for?

A

Active ingredient in chili pepper
Used for localized dermatitis (e.g. Lick granuloma)
Initial worsening followed by prolonged relief

19
Q

What is tacrolimus?

A

Topical calcineurin inhibitor, mechanism similar to cyclosporine
Minimally absorbed so extremely safe
Initial burning sensation followed by improvement after 1-2 weeks

20
Q

What is phytosphingosine used for?

A

Restore barrier function

21
Q

What are the most common dermatophytes for cats and dogs and what are their reservoirs?

A

M. Canis (cats)
M. Gyseum (soil)
T. Mentagrophytes (rodents, rabbits, pocket pets)

22
Q

Predisposing factors for dermatophytoses?

A 
Lack,decreased grooming
*Presence of  microtrauma*
Excessive hydration,maceration
Warm temperatures and humidity
Lack of sun exposure
Strong cell-mediated immunity
23
Q

What types of animals are pre-disposed to dermatophytoses?

A

White persians and himalayan cats
Terriers
Immunosuppressed animals

24
Q

What is a common clinical sign for all dermatophytoses?

A

Pruritus

25
Q

What is kerion?

A

A well-circumscribed nodular mass

26
Q

A wood’s lamp is positive in what percent of dermatophytosis cases?

A

50%

27
Q

What are common diagnostic tests for dermatophytosis?

A

Wood’s lamp
Trichogram
Fungal culture
Skin biopsy/histopathology

28
Q

What is one important thing to do when culturing dermatophyte?

A

Need to check daily

29
Q

What is the Mackenzie technique?

A

Use toothbrush to collect hairs/dermatophyte from animals coat

Useful for asymptomatic feline carriers

30
Q

What special requirements are needed for horse or cattle fungal cultures?

A

Horse- dermatophytes need niacin

Cattle- dermatophytes need thiamine

31
Q

How do you tell the difference between M. Canis and M. Gypseum on a microscope slide?

A

M. Canis has thick wall and 6 or more cells within organism

M. gypseum has thin wall and less than 6 cells within organism

32
Q

What are the steps in treatment of dermatophytoses?

A

Elimination of infection from host

Prevention of further dissemination of infective spores

Removal of infective spores already in environment

33
Q

What are some topical therapies for dermatophytoses?

A

Ketoconazole
Miconazole
Chlorhexidine
Lyme sulfur

34
Q

What are some systemic therapies for dermatophytoses?

A 
Ketoconazole
Itraconazole
Fluconazole
Terbinafine
Griseofulvin
35
Q

What drug is the preferred choice for feline fungal infections?

A

Itraconazole

36
Q

What is the safest systemic anti-fungal therapy?

A

Fluconazole

37
Q

What is the triple cleaning technique for environmental fungal decontamination?

A
  1. Mechanically remove spores and hairs
  2. Wash and rinse surfaces 3 times
  3. Disinfect target areas with 1:10 bleach
38
Q

How long should you continue anti-fungal therapy?

A

No growth on two sequential weekly cultures

39
Q

What therapies should you use for patients with onychomycosis?

A

Itraconazole and terbinafine

40
Q

What is the most common therapy for dermatophytoses in large animals?

A

Lime sulfur spray
Decrease crowding
Increase UV exposure

Dermatology (8 decks)

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