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Small animal > Derm > Flashcards

Derm Flashcards

1
Q

How to sample wet/greasy skin for microbiology

A

Impression smear or indirect (with swab)

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2
Q

How to sample dry skin for microbiology

A

stained acetate tape strip

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3
Q

Staining protocol for
Impression smear
Acetate samples
Waxy ear smears

A

IS = ABC
AS = BC (no fixative)
WES: C (Only methylene blue)

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4
Q

How to view cytology V parasites on microscope

A

Cytology = 4-100X with oil
Parasites = 4-10X

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5
Q

Name the four cutaneous reactions patterns of cats

A

Head and neck pruritus (often fleas)
Self induced alopecia (Bilateral and symmetrical)
Eosinophilic granuloma complex (can be ulcerated)
Miliary dermatitis (on the dorsal)

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6
Q

Common reasons to see the 4 reaction patterns

A

Common reasons are flea, food and environmental atopy.

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7
Q

What is the importance of knowing if the purities or the lesions came first

A

Allergic disease = pruritus precedes lesions
Immunosuppression or endocrinopathies = no pruritus until secondary pyoderma lesions develops

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8
Q

where are cats v dogs effeceted with Flea bite hypersensitivity

A

Dogs = Caudal half of the body (tail base, thighs, inguinal area) and dorsum

Cats = 4 rection patterns

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9
Q

Common flea treatments

A
  • Imidacloprid (A + L)
  • Selamectin (A + L)
  • Fipronil (A)
  • Isoxazolines (A)
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10
Q

Ease of treating fleas V lice

A

Fleas = can’t kill pupae and also have to treat part of lice cycle in enviroment
Live = easy as whole life is on host

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11
Q

Distinctive signs of sarcoptic mange (Sarcoptes scabiei var. canis)

A

Intense pruritis
Papules and crusts especially on pinnal margins
80% show pinnal pedal reflex!!!!

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12
Q

Difference in appearance of sarcoptes V Cheyletiella

A

S = round with 8 short legs (deep scrape)
C = hear shaped, 8 long legs, curved mouth parts (superirical scrape_

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13
Q

Signs of Cheyletiellosis

A
  • Pruritus and scale, esp dorsal trunk
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14
Q

Signs and appearance of Otodectes

A
  • Ear irritation, head shaking
  • Excessive ear wax
  • Occasional irritation of face, body

idk why they’re always in pairs and shaggin

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15
Q

How to perform a deep skin scrape

A

Scrape into liquid paraffin and put a cover slip on

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16
Q

Treatments for arachnids (mites)

A

Sarcoptes = isoxazolines (Sarolaner, afoxolaner, fluralaner) are licensed. Also selamectin, moxidectin can be used
Cheyletiella = nothing licensed but use the same as sarcoptes
.
Feline demodex = No licensed products
Canine demodex = isoxazolines

Otodectes = systemic isoxazolines, selemectin or moxidectin

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17
Q

Products to treat the environment for fleas

A

Pymethrin and IGR

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18
Q

4 presentations of surface pyoderma

A
  • Intertrigo (skin fold)
  • Acute moist dermatitis, pyotraumatic dermatitis (‘hot spots’)
  • Bacterial overgrowth syndrome
  • Mucocutaneous pyoderma
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19
Q

Top differential fr patch alopecia

A

Pyoderma
also see pustules and pruritus

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20
Q

what are hotspots

A
  • Acute lesion from self-trauma
  • Triggered by irritant (flea bite, classically)
  • Very rapid development of bacterial overgrowth
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21
Q

common bacteria implicated in surface pyoderma

A

Staphs - especially S. pseudintermedius

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22
Q

Difference in surface V superficial pyoderma on cytology

A
  • Surface = bacterial overgrowth, no inflamm
  • Superficial = degenerative neutrophils, high numbers of cocci
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23
Q

How does superficial pyoderma present

A
  • Impetigo (often due to immunosupression or immaturity)
  • Exfoliative superficial pyoderma (erythematous rings with central alopecia)
  • Bacterial folliculitis

all = see patchy alopecia
Short coated = moth eaten, patchy
Heavy coated = thinning undercoat

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24
Q

How to treat surface and superficial pyoderma

A

Topical ONLY (unless superficial really bad)
- CHEX washes (+ moisturiser)
- Steroids in surface, try avoid or only a short course in superficial as don’t want to dampen immune response

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25
Q

What factors predispose to malassezia

A
  • Skin folds, pendulous lips, hairy feet)  warm lipid-rich environment
  • Underlying disease (allergies, endocrinopathies)  Alter skin barrier - Breed – e.g. Bassets + Devon Rex cats with high normal mucosal populations
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26
Q

Treatment for malassezia pyoderma

A
  • Miconazole/chlorhexidine
  • Chlorhexidine shampoo or foam or wipes
  • Drying so add moisturiser
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27
Q

Other considerations when treating surface, superficial and malassezia pyoderma

A

Both infections are secondary problems – need to address underlying disease for long term control

  • Compromise of cutaneous defences, e.g.
    § Mechanical damage to skin
    § Defects in skin barrier function
    § Changes to innate/acquired immunity
  • Increased microbial adherence (e.g. with canine atopic dermatitis (CAD)
  • Changes to skin microclimate
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28
Q

What to parasiticides are topical and therefore not good for swimmers

A

Neanicitinoids (Imaclopramid (Advocate)) and Fiprinol

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29
Q

Names of isoxazalines and what they cane be used for and precaution

A

Fluranaler (Bravecto) Sarolaner (Stronghold) Afoxolaner

Literally everything: fleas, lice, ALL mites, ticks

care re seizures

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30
Q

Cautions to take if using macrocyclic lactones (selemectin, moxidectin) or Pyrethroids (On environment for fleas)

A

ML = can be toxic to collies
P = toxic to cats

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31
Q

Age of onset of CADs (e and F)

A

Environmental = 6 months to 1 year
food = any age but 1/3 under a year

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32
Q

Signs of CADs (E and F)

A

Clinically indistinguishable
- Pruritis
- Can present as pyoderma that responds to therapy
- Face, ears, ventral abdomen, perineum, Carpi/tarsi, feet
- Uncomplicated case: Erythema, Self-induced alopecia, excoriations, Primary papular eruption
- With chronicity: Lichenification, hyperpigmentation

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33
Q

Difference in lesions in CAD cases compared to sarcoptes and fleas

A

CAD = unaffected ear margins (sarcoptes), and unaffected dorsal region (fleas)

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34
Q

2 tests to identify environmental allergens for avoidance

A

Serological testing (Ensure CDD blockers used)
Intradermal skin testing to look for a reaction

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35
Q

How to diagnose food atopic dermatitis

A

Exclusion diet trial (for minimum of 8 weeks)
Hydrolysed, limited antigen (novel), or home cooked (novel)

Hydrolysed best BUT ensure fully hydrolysed and avoid chicken hydrolyse diets

  • If pruritis resolves, rechallenge with old diet to confirm. Treatment = feed exclusion diet now.
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36
Q

Presentation of feline atopic dermatitis

A
  • FASS, FFA and flea allergic dermatitis (FAD) can cause any/all cutaneous reaction patterns
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37
Q

What is FASS and FFA

A

Feline atopic skin syndrome (FASS)
- Inflammatory/pruritic skin syndrome, likely associated with IgE to environmental allergens
- Usually young adult – 6mo-5y onset

Feline food allergy (FFA)
- Can occur at any age (3mo+) but 30% cats <1yo

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38
Q

name the 4 drugs commonly used to control inflammation and pruritus

A

prenisalone (steroid)
Oclacitinib (Apoquel) (JAK inhibitor)
Lokivetmab (Cytopoint) (Pruritus only, IL-31 inhibitor)
Ciclopsorin (Atopica) (T-cell suppressor)

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39
Q

Pros and cons of prednisolone

A

Pros: Cheap, effective, easy, anti pruritic and anti-inflammatory
Cons: Lots of side effects, need lots of monitoring, immunosupression

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40
Q

Pros and cons of Oclacitinib
(Apoquel)

A

Pros: quick to act (24 hours), for allergic dermatitis ONLY
Cons: expensive. Can’t use in dogs under 1 year, alongside preds or ciclosporin, causes immunosupression

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41
Q

Pros and cons of Lokivetmab
(Cytopoint)

A

Pros: Quick to act (24 hours), only monthly dosing, safe and more specific (acts on IL-31)
Cons: Not anti-inflammatory, expensive

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42
Q

What must be done before giving cats ciclosporin
How long does it take to work?

A

Supresses T cells so test for FeLV/FIV/toxoplasmosis
Slow (1-2 months)
oral dosing every 24 hours

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43
Q

Downside of using immunotherapy

A

Takes a year to take effect and have to use other treatments in this time

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44
Q

Cytological appearance of an ulcer

A

Macrophages present, blood cells too
full thickness wound to dermis

(erosion is only superficial)

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45
Q

Tx for herpes virus

A

Support; feeding tube, anti-virals
Systemic famciclovir in severe cases
Appetite stimulants e.g. mirtazapine

Calicli = add lysine too

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46
Q

What feline viruses can present with cutenaous ulcers? and where?

A

Herpes virus: lesions make a mask. eyelids, muzzle, nose
Calicli virus: ulcers on mucous membranes, lips and nose

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47
Q

Signlament and signs of feline cowpox

A

Signalment: Male hunting in late summer
Signs: Onset of a single crusted ulcerated lesion followed by smaller lesions (satellites)
signs start at head, sometimes for feet

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48
Q

Signs of feline plasma cell pododermatitis ad treatment

A
  • Soft, swollen pads with scaling
  • Ulceration centrally in some

Immune-modulation:
- Steroids, ciclosporin
- Doxycycline commonly used

49
Q

What can cause vasculitis

A

infections (e.g. Leishmaniasis),
Food hypersensitivity
Insect bites
Neoplasia
Drugs (e.g. high dose itraconazole) and idiopathic

50
Q

Signs of vasculitis

A

lesions depend on areas effected

Immune mediated damage to blood vessels so
- Purpura, erythematous to purpuric plaques, ulcers, non-healing wounds

51
Q

Treatment for vasculitis

A

Preds + ciclosporin/chlorambucil to reduce adverse effects
+/- topical tacromilus
- Perfusion enhancing drugs (e.g. propentofylline)

52
Q

Signs of vasculitis

A

Immune mediated damage to blood vessels so
- Purpura, erythematous to purpuric plaques, ulcers, non-healing wounds

53
Q

Signalment and signs of canine cutaneous lupus

A

Signalment: 7 year old GSD
Signs: On nose
- Erythema, depigmentation, scaling
- erosions/ ulcerations, +/- crusting
- loss of cobblestone pattern

54
Q

How to differentiate canine cutaneous lupus and mucocutaneous pyoderma

A

Give antibiotics
- Disease goes away = MP
- Disease remains = CL

can perform histology after antibiotics: subtle interface reaction (cell-rich lymphocytic interface dermatitis) see with lupus

55
Q

Tx for canine cutaneous lupus V mucocutaneous pyoderma

A

CL: Topical
- ChlorHex wipe/spray/shampoo
- Topical steroid creams
- Maybe topical Tacrolimus (Ciclosporin like)

MP:
- Anti-staphylococcal antibioti
- Chlorhexidine washes for 3-4 weeks
- Steroids may reduce disease severity

56
Q

Common signs of cutaneous epitheliotropic lymphoma as well as ulceration

A

Ulceration +
- Alopecia (effects hair follicles)
- Can vibe VERY pruritic
- oral lesions common, disease of OLDER DOGS

57
Q

Common cause of Erythema multiforme and signs
And helpful diagnostic signs

A

Drug reactions
Erythematous macules or papules which may ulcerated
Rapidly acute onset helps diagnoses

58
Q

What 2 drugs can be used to treat immune mediated disease

A

prednisalone
ciclosporin

59
Q

what adjunctive immunosuppressants can help reduce the doses of preds and ciclo needed

A
  • Azathioprine (dogs only)
  • Chlorambucil (drug of choice in cats)
  • Mycophenolate mofetil (good for pemphigus)
  • Topical agents such as steroid sprays and creams and tacrolimus
60
Q

Anti-pruritic/anti-inflammatory drug summary

A

Preds: AI and AP. Cheap, side effects

Oclacitinib (Apo): AI and AP. Allergies only. ££. Can’t use with Ciclosporin, Preds, or under a year

Lokivetnab (cyto): AP. Monthly injection in dogs only. Very specific (IL-31) but spenny

Ciclosporin (Atop): Ai and AP. Slow effect, expensive, daily dosing. T cell suppression (test cats for viruses!)

61
Q

top differential for patchy alopecia

A

Superficial pyoderma (esp bacterial folliculitis)

62
Q

Which diseases cause follicular casts

A

Demodex
Dermatophytosis
Seborrhoea/ sebaceous adeninitis

63
Q

What diseases cause comedones

A

HAC
demodex

64
Q

Signs of dermatophytosis

A

Scale, alopecia, follicular casts
circular patches
Usually non-pruritic

65
Q

treatment for dermatophytosis

A

Topical:
- Chlorhexidine* / miconazole shampoo (NOT CH alone)
- Enilconazole in dogs (not licensed in cats) every 4 days
Systemic:
- Necessary to achieve cure
- Itraconazole (cats & dogs), ketoconazole (dogs)
Also treat environment

66
Q

Signs of demodex

A

Juvenile:
- Can be local or general
- Alopecia, comedones, follicular casts, scaling +/- secondary pyoderma
- Greasy and smelly

Adults:
- Often generalised with secondary pyoderma (Papules and pustules)
- Alopecia, comedones, erythema

67
Q

Dx and Tx for demodex

A

Dx: deep skin scrapes into liquid paraffin (+ cover slip)

Tx: Treat any secondary pyoderma or underlying immune suppression in adults
- Licenced isoxazolines e.g. afoxolaner, flurolaner, sarolaner
- Imidacloprid/moxidectin (Advocate®): licensed, efficacy?
- Treat until 2-3 consecutive clear skin scrapes

68
Q

Cutaneous signs of HAC

A
  • Thin skin
  • Bilateral, symmetrical alopecia (esp trunk)
  • Comedones
  • Scale
  • Prominent blood vessels
  • Calcinosis cutis
  • Poor wound healing and secondary pyoderma
69
Q

Cutaenous signs of Hypo T

A
  • Hyperpigmentation
  • Bilateral alopecia around areas of wear (trunk + pinnal)
  • Scale and brittle hair
  • Pruritis, especially if secondary pyoderma
  • Tragic face + depressed demeanour
  • Ceruminous otitis
70
Q

What tumour can cause hyperoestrognism

A

Sertoli cell tumour in entire males

71
Q

Signs of paraneoplastic alopecia

A
  • Alopecia of ventrum and legs
  • Skin shiny and translucent
  • Pancreatic and bile duct carcinomas
  • Older cats
72
Q

3 common breed manifestations of pattern alopecia

A
  • Yorkie: Dorsal nose, ears, legs
  • Daxie: Pinnae
  • Sighthouds; Bald thigh syndrome
73
Q

Treatment for any deep infection

A
  • Treat systemically for extended period to minimum 2 weeks post-resolution
  • Antimicrobial choice usually based on culture
  • +/- adjunctive topical therapy
  • Avoid immunosuppressive drugs (e.g. corticosteroids)
  • Consider underlying cause
74
Q

Anal furunculosis signalment and Tx

A

GSD with Co-existing diseases include colitis, atopic skin and ear disease

  • Clip, clean + antibiotics (Metronidazole or Cephalexin)
  • Prednisolone or Ciclosporin for immuno suppression
  • Can be surgically resected (remove anal sacs, close dead space)
75
Q

Treatment for metatarsal fistulation

A

The big pad

  • Requires long term management. Chronic condition.
  • Topical anti-inflammatory like Tacrolimus or glucocorticoids
  • NSAID for analgesia
  • Treat secondary bacterial infections if present
76
Q

Causes of Pansteatitis and signs

A

Innaproriate diet (Tuna)
Aka yellow fat disease

  • Dull/greasy coat, sensitive skin
  • Deep nodules that open as draining sinuses
77
Q

What is deep pyoderma

A

Infection outside epidermis or hair follicle epithelium

Presents as
a. Furunculosis
b. Abscess
c. Cellulitis

78
Q

what systemic antibiotics can be given for abscesses or cellulitis

A

Amoxicillin Clavunate
Lance and drain abscesses too

79
Q

Different presentations of furunculosis (deep pyoderma)

A

furunculosis = - Extension of folliculitis (rupture of hair follicle wall) = microbes + free keratin in dermis = provokes a foreign-body reaction

  • Chin: Acne
  • Nasal: Effects dorsum
  • Interdigital folliculitis/furunculosis
  • Acral lick dermatitis/granuloma from self trauma
  • Post-grooming folliculitis/furunculosis*
80
Q

Cytological findings in furunculosis

A
  • Pyogranulomatous reaction (macrophages, neutrophils +/- rbcs)
  • Deep pyos = commonly staphs (still C&S)
81
Q

Treatment for furnuculosis

A
  • Long systemic antibiotic course (after C&S)
  • Continue to 2 weeks post-resolution (min. 4 weeks)
  • Topical chlorhexidine shampoos/foams also
82
Q

why can inflammation persists are resolution of the pyoderma in furnuculosis

A

Keratin persists for a long time and continues the foreign body reaction
continue nti-inflammatory medication (corticosteroids/ ciclosporin/ tacrolimus)

83
Q

How are cats infected with mycobacterial granulomas

A

Though open wounds (oppurtunistic)
Mycobacterium tuberculosis complex (MTBC)
euthanise

84
Q

Signs of mycobacterial granulomas in cats

A

Cutaneous nodules +/- draining tracts

+/- systemic disease

85
Q

stain for mycobacteria

A

Zeihl-Neelsen

86
Q

common cause of scale?

A

Bacterial infection
scale = folliculitis = pustules = rupture and central hair loss = circle of scale moves from central area

87
Q

Common scale treatments

A
  • Sulphur (good for primary seborrhoea)
  • Salicylic acid (often combined with sulphur)
  • Selenium sulphide (old product that dies her pink!)
    topical Hydrocortisone aceponate in caine ear margin sebborhoea
88
Q

What can scale treatments be combined with

A

Moisterisers to stop water loss
use AFTER scale removeal

89
Q

Breeds and signs of Zn respsonvei dermatitis

A

Huskies are geneitically prediposed
- Hard plaques of hyperkeratotic skin around areas that are abrased often (hocks, elbows).
- Marked scale and crusting
- Tx: supplement

90
Q

Breed and signs of Ichthyosis

A

Golden retrievers
Large flakes of scale seen from a few weeks of life
Barrier function compromised so secondary infection common

91
Q

Breed and signs and treatment of ear margin seborrhoea

A

Dachshunds
Follicular casts and plugs on ear margins alone
May rub and ulcerate

Tx: topical anti-seborrheic shampoos, topical steroid (hydrocortisone aceponate) but incurable
can surgically remove

92
Q

Breed and signs of nasal parakeratosis
And important ddx

A

Labradors (usually between 6 months and 1 year)
Roughening od nasal skin and hyperkeratosis

Ddx: Discoid lupus erythematosus and mucocutaneous pyoderma. Biopsy or genetic test for this disease

93
Q

Breed and treatment of footpad hyperkeratosis

A

Dogue de Bordeaux (in first few months of age)

Need to stand in propylene glycoll for 5 minutes a day

94
Q

Signs of nasodigital hyperkeratosis

A

Older dog (senile change)
slow, bilateral, no ulcers or depigmentation

95
Q

2 paraneoplastic conditions in cats

A

Alopecia (Biliary duct and pancreatic cancer)
Thymoma induced exfoliative dermatitis

96
Q

Signs of Leishmaniasis

A

Dog has been abroad
scale
alopecia
non-pruritic
enlarged lymph nodes

can be exfoliate, ulcerative or nodular

97
Q

Cytological signs of Leishmaniasis

A

Reactive lymph node with plasma cells and intracellular amastigotes

98
Q

Treatment for Leishmaniasis

A

Allopurinol (if they have renal problems)

Monitor for side effects bcos there are loads!

Common combinations
- Meglumine antimoniate and Allopurinol
- Mltefosine and Allopurinol

99
Q

Signs of canine pemphigus foliaceus

A

Superficial pustules (larger than pyoderma ones and erythematous)
Bilateral and symmetrical

100
Q

Tx of pemphigsu

A

autoimmune diseaase abasing desmosomal proteins

preds +
Mycophenolate mofetil, or Chlorambucil, Ciclosporin, tacrolimus, Azathioprine,

101
Q

Cytology of pemphigus

A
  • Acantholytic keratinocytes (large ‘fried-egg’ cells, sometimes in rafts) + neutrophils
102
Q

What is Canine juvenile sterile granulomatous dermatitis and lymphadenitis

A

Sterile granulomatous condition of the face, pinnae and LNs
Acute swelling
Lymphadenopathy
Sterile pustules

103
Q

What disease cause superficial necrolytic dermatitis lesions

A

End stage liver disease
Pancreatic atrophy

104
Q

What can sebaceous gland tumours look like

A

Warts x

105
Q

Ddx for pigmented tumour in cats

A

Melanoma and basal cell tumour (more common)

106
Q

Common cause of feline fibrosarcomas

A

Injection sites (intrascapular)

107
Q

Signs of cutenaous lymphoma

A

Eryhemta, cruising, alopecia
nodules
pruritis and scale (generalised)

mucocutenaous junction may depigment

108
Q

When to find common pathogens in ear disease

A

Fungal: Malassezia common and is followed by
=> Acute bacterial: Gram positive staphs, streps and Corynebacterium species
=> Chronic bacterial; Gram positive enterococcus, gram negative Pseudomonas, E.coli (Pseudomonas aeruginosa is end point often)

o Predisposing factors e.g. Hairy &/or pendulous ears, stenosis
o Perpetuating factors e.g. Ear canal hyperplasia, stenosis and scarring

109
Q

Two good all purpose ear cleaning solutions

A

Cleanaural
epiotic

110
Q

Good ear cleaner for purulent otitis

A

Otodine (TRIZChlor)
Antimicrobial but no ability to remove wax. Watery cleaner

111
Q

Good ear cleaner for waxy otitis

A

Cerumaural & Otoact (Contain squalene)
No antimicrobial properties

112
Q

Use of TRIZ EDTA

A

Pre-treatment and base for other treatments only
No antibiotic or anti-wax properties aone

113
Q

use of TRIZ EDTA with added N-acetyl cysteine

A

disrupts biofilm
Pre-treat for 20mins => flush => follow with antibiotics

114
Q

Treatment for Cocci +/- yeasts, minimal inflammation

A

Only ear cleaner

115
Q

Treatment for Cocci +/- yeasts, consistent inflammation

A

Polypharmacy product with narrow spectrum ABs

116
Q

Treatment for Rods +/- cocci + yeasts, significant inflammation

A

Polypharmacy product, systemic steroids (Antibiotic with good action on pus)
ADD SYSTEMIC STEROIDS FOR RODS

117
Q

what ear treatments don’t target Rods

A

ones with Florfenicol (neptra, osurnia)

118
Q

what antibiotic is inhibited by pus

A

polymixin B (surolan)

119
Q

name 3 ear cleaners that cover all types of bacteria

A

Eostatic
otomax
canaural

Small animal (11 decks)

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