Canine Nail Pad Disease Flashcards
What diseases occur at the paw pad
1) Idiopathic footpad hyperkeratosis
2) Supericial necrolytic dermatitis
What diseases occur at the nail
1) Symmetric lupoid onychodystrophy
2) Vasculitis
What causes footpad hyperkeratosis
1) Congenito-hereditary (ie cockerspaniels)
2) Age-related (Idiopathic)
3) Conformational eg Bulldog, furuncolosis?
4) Metabolic - Zinc responsive dermatosis
5) Immune mediated - pemphigus foliaceus
6) Infectious- Canine distemper
7) Putting less pressure on a part of the paw pad
What virus causes footpad hyperkeratosis
canine distemper
How do you treat footpad hyperkeratosis
trim or dremel
hydrate (soak in water)
topical:
-Petrolatum - emollient
-Biobalm- moiturizer
-50% propylene glycol- keratolytic
-Salicyclic acid (Kerasol) - keratolytic
-Dermoscent (Essential 6, ATOP7) - keratoplastic
other names for superficial necrolytic dermatitis
Hepatocutaneous Syndrome
Metabolic Epidermal Necrosis
Necrolytic Migratory Erythema
Metabolic Dermatosis
Diabetic Dermatopathy
What will you see with superficial necrolytic dermatitis
Thickened
Firm
Hyperkeratotic
Fissuring
Pressure points
Perioral, perorbital
What causes superficial necrolytic dermatitis
1) Severe liver disease
2) Pancreatic glucogonoma (rare)
What are differentials for superficial necrolytic dermatitis
Pemphigus complex
Vasculitis
Drug eruption
Erythema multiforme
Cutaneous lymphoma
Distemper
Zinc response dermatosis
How do you diagnose superficial necrolytic dermatitis
Liver failure
Swiss cheese liver on ultrasound
hypoalbuminemia
Diabetes
Skin biopsy
Hepatocellular collapse
NOdular regeneration
What does superficial necrolytic dermatitis look like on histopathology
Red: parakeratotic hyperkeratosis
White: Edema (necrosis)
Blue: Epidermal hyperplasia
On superficial necrolytic dermatitis histopath: what is the blue layer
Epidermal hyperplasia
On superficial necrolytic dermatitis histopath: what is the red layer
parakeratotic hyperkeratosis
On superficial necrolytic dermatitis histopath: what is the white layer
edema (necrolysis)
How do you treat superficial necrolytic dermatitis
1) Manage underlying cause
2) Diet -1 egg yolk/4.5kg, Zinc methionine, fatty acid supplement, Ultamino
3) Amino acids IV weekly (500mL of Aminosyn)
4) Secondary local infection common (yeast,bacterial) - treat those
What is the prognosis of superficial necrolytic dermatitis
overall prognosis is poor
What diet is recommended for superficial necrolytic dermatitis
1 egg yolk / 4.5g
Zinc methionine 2mg/kg/day
Fatty acid supplement
Ultamino, EL
T/F: Symmetric Lupoid Onychodystrophy affects the nail of the digits
False- just the nails (most of them are effected)
What are differentials for nail disease
1) Trauma
2) infection: fungal (dermatophytosis, malessezie-allergy)
3) Bacteria (secondary)
4) Immune mediated (vasculitis, Symmetric Lupoid Onychodystrophy)
5) Neoplasia (Melanoma, SCC, MCT)
rare: pemphigus, dermatomyositis, bullous pemphigoid, SLE, cold agglutin disease, drug eruption
For Symmetric Lupoid Onychodystrophy, where do you need to biopsy
amputate P3 - inflammation is under the nail
what disease might just the keratin of the nail be helpful for diagnosis
Dermatophytosis
Symmetric Lupoid Onychodystrophy affects how many nails
man!!
secondary infection possible
Biopsy for Symmetric Lupoid Onychodystrophy requires
amputation of P3
How do you treat Symmetric Lupoid Onychodystrophy
1) Pentoxifylline - 30mg/kg BID (same treatment for vasculititis)
2) Fatty acids (omega 3) 60mg.kg q24h
3) Cyclosporine 5mg.kg q24h
4) Doxy/niacinamide
5) Steroids
treatment is slow 3-6 months
can be lifelong (taper)
goal is to eliminate pain and fracture
nails can be dystrophic forever
How fast is Symmetric Lupoid Onychodystrophy to treat
treatment is slow 3-6 months
can be lifelong (taper)
goal is to eliminate pain and fracture
nails can be dystrophic forever
Omega-3 fatty acids are _____ while omega-6 fatty acids are
anti-inflammatory ; inflammatory
What is the prognosis for Symmetric Lupoid Onychodystrophy
good
What neoplasia can occur at the nail
Melanoma
SCC
MCT
