Cutaneous Manifestations of Systemic Disease (NAVDF 2021 Outerbridge) Flashcards

1
Q

Name 6 paraneoplastic skin lesions

A

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

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2
Q

What cancer is associated with feline paraneoplastic alopecia

A

Pancreatic adenocarcinoma +/- metastasis

Shiny skin, ventral alopecia

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3
Q

Clinical signs of feline paraneoplastic alopecia

A

Shiny skin, ventral alopecia
Hair epilates easily
Rapid onset
Dry, fissured, peeling pawpads

Increased grooming and SECONDARY Malassezia dermatitis

Often feel systemically unwell

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4
Q

Histopath of feline paraneoplastic alopecia

A
  • Follicular atrophy w/ miniaturization
  • Epidermal hyperplasia (opposite of what you’d see with hormonal!)
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5
Q

Prognosis of feline paraneoplastic aloepcia

A

Hair may grow back, but there is metastasis is already there. So cats will ultimately die from their cancer

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6
Q

Lethal acrodermatitis breed

A

White bull terriers

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7
Q

Lethal acrodermatitis mode of inheritance

A

Autosomal recessive

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8
Q

Cause of Lethal acrodermatitis

A

MKLN1
Defect in Zinc absorption/metabolism (?)

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9
Q

Lethal acrodermatitis copper and zinc levels

A

LOW

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10
Q

Lethal acrodermatitis IgA levels

A

LOW

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11
Q

How can you tell if a puppy has Lethal acrodermatitis

A

Stunted growth
Arched hard palate – food gets stuck in high in hard palate!
Crusted distal extremities, paws

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12
Q

Histopath Lethal acrodermatitis

A

Severe parakeratosis

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13
Q

Lethal acrodermatitis prognosis

A

Die <1 year old; fatal bronchopneumonia

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14
Q

Feline thymoma-associated exfoliative dermatitis: where on the body does it start

A

Head/neck, then generalizes

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15
Q

Clinical signs of Feline thymoma-associated exfoliative dermatitis

A

Erythema with dramati exfoliation

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16
Q

Histopath of Feline thymoma-associated exfoliative dermatitis

A

CD3+ interface dermatitis and mural folliculitis

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17
Q

Prognosis of Feline thymoma-associated exfoliative dermatitis

A

Good. If you remove the tumor, the cutaneous signs resolve.

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18
Q

NON-thymoma-associated exfoliative dermatitis in cats: treatment

A

Immunosuppressive glucocorticoids or cyclosporine

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19
Q

Renal Cystadenocarcinoma and Nodular Dermatofibrosis breed

A

GSD

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20
Q

Renal Cystadenocarcinoma and Nodular Dermatofibrosis Gene, mode of inheritance

A

FLCN, Autosomal dominant

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21
Q

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

A

No, its likely to develop lesions on the other kidney

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22
Q

Other than the kidneys/skin, what other organ can be affected by Renal Cystadenocarcinoma and Nodular Dermatofibrosis

A

Uterine myoleioma in female intact dogs

23
Q

Histopath of Nodular Dermatofibrosis

A

Dense, mature collagen

24
Q

What type of cancer metastasizes to the digits in cats

A

Primary pulmonary carcinoma

25
Q

Treatment for feline herpesviral deramtitis in cats

A

1) human alpha-interferon SC 3x/w
2) Famciclovir q8h
3) Lysine
4) Tx 2’ infections

26
Q

What is doperidone? Which disease can it be helpful for

A

Doperidone = dopamine D2 receptor antagonist.
Give it CONCURRENTLY with insect repellent to help PREVENT sand flies –> Leishmania

27
Q

Canine distemper virus organ systems

A

GI, CNS, Skin

28
Q

What other species can contract canine distemper virus

A

Raccoons, ferrets

29
Q

How much of the body’s total zinc is stored in the skin?

A

20%
Mostly in nasal planum, tongue, paw pads

30
Q

Signalment of dog with Syndrome I Zinc Responsive Dermatosis

A

Arctic breeds (husky, Malamute)

Suspect GI absorption issue. Tx with Zn supplementation 1-3mg zn/d

31
Q

Signalment of dog with Syndrome II Zinc Responsive Dermatosis

A

Puppy on poor diet– either too low in Zinc or too high in minerals (Ca2+, Fe) or phytates –> chelate zinc so not available

32
Q

Which food is high in phytates, and can lead to Syndrome II Zinc Responsive Dermatosis

A

Cereal grains

33
Q

Which zinc salt is most effective at treating Zinc Responsive Dermatosis

A

All have similar efficacy! It just depends on the dog individually

Resolves in 4-6 weeks with appropriate treatment

34
Q

What is a more common clinical finding for hepatocutaneous syndrome: metabolic/vacuolar hepatopathy or glucagonoma?

A

Metabolic, vacuolar hepatopathy in >95% of cases

35
Q

Pathoetiology of glucagonoma causing hepatocutaneous syndrome

A

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

36
Q

T or F: about 1/3 of hepatocutaneous syndrome dogs have diabetes mellitus

A

True.

Monitor for it while treating too

37
Q

What finding is present in all cases of hepatocutaneous syndrome

A

Hypoaminoacidemia

(also lysine uria)

38
Q

Which medication has been associated with hepatocutaneous syndrome

A

Phenobarbital

39
Q

Signalment predisposed to hepatocutaneous syndrome

A

Small breed, male dogs

Sheltie, Cocker spaniel, Terriers (jack russel, scottish, WHWT)

40
Q

Which breed has a possible familial hepatocutaneous syndrome

A

Shih tzus!

41
Q

Treatment for hepatocutaneous syndrome

A

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)

42
Q

What liver finding is classic on abdominal ultrasound for hepatocutaneous syndrome

A

Honeycomb liver (NOT fibrosis)

43
Q

Would you find a honeycomb liver on AUS of a dog with glucogonoma-derived hepatocutaneous syndrome

A

NO. But you would see a pancreatic mass (or metastatic liver nodules)

HONEY COMB LIVER IS ABSENT IN GLUCAGONOMA HCS

44
Q

What labwork findings would you expect with hepatocutaneous syndrome

A

Increased ALP (98%)
Increased ALT (71%)

+/- anemia, hypoalbuminemia, diabetes mellitus (~1/3)

45
Q

What amino acid is present in the urine of dogs with hepatocutaneous syndrome

A

Lysine (100%)
(Proline in some cases)

46
Q

Systemic diseases you should look for in vasculitis cases

A

*Tick titers
*Leishmania
*Bartonella titers
*FIP

47
Q

Cause of cutaneous xanthoma in cats

A

Dislipoproteinemia

48
Q

Clinical signs of cutaneous xanthoma

A

Pale yellow/white plaques, nodules with erythematous borders

On boney prominences, face, limbs, trunk

49
Q

Next step after diagnosing cutaneous xanthoma

A

Identify underlying lipid metabolism dysfunction

r/o diabetes mellitus, hereditary dislipoproteinemia

50
Q

Treatment for cutaneous xanthoma

A

Low fat diet
(Stop the macrophages from being filled with lipid!)

51
Q

Diagnosis criteria for SLE

A

2+ organ systems involved
Fever
+/- positive ANA

52
Q

Common clinical signs of SLE

A

Fever
Protein losing nephropathy
Polyarthritis
Thrombocytopenia
Anemia

<20% have skin lesions!

53
Q

T or F: sterile nodular panniculitis can be associated with pancreatitis or immune-mediated diseases

A

True. Can also be idiopathic (more common)!

83% have no concurrent diseases

54
Q

Breeds predisposed to sterile nodular panniculitis

A

Aussie
Brittany spaniel
Dalmatian
Pomeranian
Chihuahua