Cutaneous Manifestations of Systemic Disease (NAVDF 2021 Outerbridge) Flashcards
Name 6 paraneoplastic skin lesions
1) Feline paraneoplastic alopecia
2) Feline thymoma-assocaited exfoliative dermatitis
3) Canine nodular dermatofibrosis
4) Canine paraneoplastic pemphigus
5) Canine superficial necrolytic dermatitis/metabolic epidermal necrosis (small % have glucagonoma trigger)
6) Canine Sertoli cells/ testicular neoplasia
What cancer is associated with feline paraneoplastic alopecia
Pancreatic adenocarcinoma +/- metastasis
Shiny skin, ventral alopecia
Clinical signs of feline paraneoplastic alopecia
Shiny skin, ventral alopecia
Hair epilates easily
Rapid onset
Dry, fissured, peeling pawpads
Increased grooming and SECONDARY Malassezia dermatitis
Often feel systemically unwell
Histopath of feline paraneoplastic alopecia
- Follicular atrophy w/ miniaturization
- Epidermal hyperplasia (opposite of what you’d see with hormonal!)
Prognosis of feline paraneoplastic aloepcia
Hair may grow back, but there is metastasis is already there. So cats will ultimately die from their cancer
Lethal acrodermatitis breed
White bull terriers
Lethal acrodermatitis mode of inheritance
Autosomal recessive
Cause of Lethal acrodermatitis
MKLN1
Defect in Zinc absorption/metabolism (?)
Lethal acrodermatitis copper and zinc levels
LOW
Lethal acrodermatitis IgA levels
LOW
How can you tell if a puppy has Lethal acrodermatitis
Stunted growth
Arched hard palate – food gets stuck in high in hard palate!
Crusted distal extremities, paws
Histopath Lethal acrodermatitis
Severe parakeratosis
Lethal acrodermatitis prognosis
Die <1 year old; fatal bronchopneumonia
Feline thymoma-associated exfoliative dermatitis: where on the body does it start
Head/neck, then generalizes
Clinical signs of Feline thymoma-associated exfoliative dermatitis
Erythema with dramati exfoliation
Histopath of Feline thymoma-associated exfoliative dermatitis
CD3+ interface dermatitis and mural folliculitis
Prognosis of Feline thymoma-associated exfoliative dermatitis
Good. If you remove the tumor, the cutaneous signs resolve.
NON-thymoma-associated exfoliative dermatitis in cats: treatment
Immunosuppressive glucocorticoids or cyclosporine
Renal Cystadenocarcinoma and Nodular Dermatofibrosis breed
GSD
Renal Cystadenocarcinoma and Nodular Dermatofibrosis Gene, mode of inheritance
FLCN, Autosomal dominant
T or F: if you note a cystadenocarcinoma on ONE kidney of a dog with Renal Cystadenocarcinoma and Nodular Dermatofibrosis, should you perform a nephrectomy
No, its likely to develop lesions on the other kidney
Other than the kidneys/skin, what other organ can be affected by Renal Cystadenocarcinoma and Nodular Dermatofibrosis
Uterine myoleioma in female intact dogs
Histopath of Nodular Dermatofibrosis
Dense, mature collagen
What type of cancer metastasizes to the digits in cats
Primary pulmonary carcinoma
Treatment for feline herpesviral deramtitis in cats
1) human alpha-interferon SC 3x/w
2) Famciclovir q8h
3) Lysine
4) Tx 2’ infections
What is doperidone? Which disease can it be helpful for
Doperidone = dopamine D2 receptor antagonist.
Give it CONCURRENTLY with insect repellent to help PREVENT sand flies –> Leishmania
Canine distemper virus organ systems
GI, CNS, Skin
What other species can contract canine distemper virus
Raccoons, ferrets
How much of the body’s total zinc is stored in the skin?
20%
Mostly in nasal planum, tongue, paw pads
Signalment of dog with Syndrome I Zinc Responsive Dermatosis
Arctic breeds (husky, Malamute)
Suspect GI absorption issue. Tx with Zn supplementation 1-3mg zn/d
Signalment of dog with Syndrome II Zinc Responsive Dermatosis
Puppy on poor diet– either too low in Zinc or too high in minerals (Ca2+, Fe) or phytates –> chelate zinc so not available
Which food is high in phytates, and can lead to Syndrome II Zinc Responsive Dermatosis
Cereal grains
Which zinc salt is most effective at treating Zinc Responsive Dermatosis
All have similar efficacy! It just depends on the dog individually
Resolves in 4-6 weeks with appropriate treatment
What is a more common clinical finding for hepatocutaneous syndrome: metabolic/vacuolar hepatopathy or glucagonoma?
Metabolic, vacuolar hepatopathy in >95% of cases
Pathoetiology of glucagonoma causing hepatocutaneous syndrome
Glucagon tells liver to turn amino acids to glucose (gluconeogenes) –> results in mobilization of amino acids –> amino acid deficiency
Additionally hyperglycemia, increased insulin resistance, and diabetes mellitus in about 1/3 of cases
T or F: about 1/3 of hepatocutaneous syndrome dogs have diabetes mellitus
True.
Monitor for it while treating too
What finding is present in all cases of hepatocutaneous syndrome
Hypoaminoacidemia
(also lysine uria)
Which medication has been associated with hepatocutaneous syndrome
Phenobarbital
Signalment predisposed to hepatocutaneous syndrome
Small breed, male dogs
Sheltie, Cocker spaniel, Terriers (jack russel, scottish, WHWT)
Which breed has a possible familial hepatocutaneous syndrome
Shih tzus!
Treatment for hepatocutaneous syndrome
Amino acid nutrition is KEY
-IV AA (avoid in dogs with pre-existing renal, liver dz)
-High protein, easily digestible diet
*supplement Zn, essential fatty acids (carried by albumin, so end up deficient in these)
What liver finding is classic on abdominal ultrasound for hepatocutaneous syndrome
Honeycomb liver (NOT fibrosis)
Would you find a honeycomb liver on AUS of a dog with glucogonoma-derived hepatocutaneous syndrome
NO. But you would see a pancreatic mass (or metastatic liver nodules)
HONEY COMB LIVER IS ABSENT IN GLUCAGONOMA HCS
What labwork findings would you expect with hepatocutaneous syndrome
Increased ALP (98%)
Increased ALT (71%)
+/- anemia, hypoalbuminemia, diabetes mellitus (~1/3)
What amino acid is present in the urine of dogs with hepatocutaneous syndrome
Lysine (100%)
(Proline in some cases)
Systemic diseases you should look for in vasculitis cases
*Tick titers
*Leishmania
*Bartonella titers
*FIP
Cause of cutaneous xanthoma in cats
Dislipoproteinemia
Clinical signs of cutaneous xanthoma
Pale yellow/white plaques, nodules with erythematous borders
On boney prominences, face, limbs, trunk
Next step after diagnosing cutaneous xanthoma
Identify underlying lipid metabolism dysfunction
r/o diabetes mellitus, hereditary dislipoproteinemia
Treatment for cutaneous xanthoma
Low fat diet
(Stop the macrophages from being filled with lipid!)
Diagnosis criteria for SLE
2+ organ systems involved
Fever
+/- positive ANA
Common clinical signs of SLE
Fever
Protein losing nephropathy
Polyarthritis
Thrombocytopenia
Anemia
<20% have skin lesions!
T or F: sterile nodular panniculitis can be associated with pancreatitis or immune-mediated diseases
True. Can also be idiopathic (more common)!
83% have no concurrent diseases
Breeds predisposed to sterile nodular panniculitis
Aussie
Brittany spaniel
Dalmatian
Pomeranian
Chihuahua
