derm Flashcards
Ehlers danos syndrome
group of genetically heterogenous connective tissue disorders linked with genetic defects affecting collagen or other extracellular matrix proteins
Hereditary equine regional dermal asthenia (HERDA) is seen in what breed
American quarter horses
Hereditary equine regional dermal asthenia (HERDA) gene mutation
PPIB: peptidyl prolyl isomerase B gene
** acts as a chaperone involved in proper folding of collagens
Hereditary equine regional dermal asthenia (HERDA) C/S
usually seen at 2 years old when broken into saddle– skin tears, or wounds with prolonged healing times
**develop disfiguring scars
-skin is loose and hyperelastic
What is the prevalence of Hereditary equine regional dermal asthenia (HERDA) in
Quarter horses?
3.5%
**inc prevalence in cutting horses (up to 28%)
**w/in pleasure/working-cow horses (up to 12.8%)
Warmblood fragile foal syndrome gene mutation
PLOD1 (procollagen lysin, 2-oxglutarate 5- dioxygenase 1) gene
**codes enzyme for collagen biosynthesis
Warmblood fragile foal syndrome C/S
is af atal defect of connective tissue involving severe skin malformations in enonatal foals
Chronic progressive lymphadema is seen in what breeds?
draft breeds: clydesdales, belgian drafts and shires
chronic progressive lymphadema lesions
start at early age
-progressive swelling of legs & development of severe chronic skin changes such as hyperkeratosis & dermal fibrosis with thick skin folds & nodules
-secondary skin infections– contrib to chronic changes
-severe discomfort
Junctional epidermalysis bullosa gene mutations
- LAMA 3: american saddlebreds
- lamC3– belgian and other drafts
Junctional epidermalysis bullosa clinical signs
mechanobullous dz: development of ulcers adn bilsters in the skin at pressure points (hocks/stifle) or mucocutaneous junctions (mouth & anus)
oral lesions: premature eruption of teeth & loss of enamel= bleeding mouth
Hypotrichosis is a disease of what breeds?
curly coated breeds: american bashkir, culry horses and missouri fox trotters
hypotrichosis clinical signs
alopecia @ birth or develops early during neonatal period
defects in ectodermal structures: teeth, hooves, eyes or seat glands
– normal shedding periods, some permanent loss of main & tail
Pemphigous foliaceus describes a group of what disorders?
autoimmune vesiculobullous disorders characterized histologically by:
-intraepidermal acantholysis
-intercellular deposition of immunoglobulin
What are the clinical lesions primarily recognized in Pemphigous foliaceus?
-scaling
-crusting
–>generalized exfoliative dermatitis, ventral or peripheral edema, fever depression
What are characteristic histologic findings of Pemphigus foliaceus?
-intragranular to subcorneal cleft and vesicle formation assoc with acantholysis
Why is recommended to review on slide exam of biopsies in cases of pemphigus foliaceus?
certain strains of Trichophyton spp of dermatophytes may also cause acantholysis
**any histology suggestive of pemphigus foliaceus must be stained for fungi
What are recommended treatments for pemphigus foliaceus?
-immunosuppressive doses of corticosteroids
-prednisolone: 1 mg/kg
-dexamethasone: 0.08-0.1 mg/kg PO q24h, then tapering
-gold salts (historic tx)
-azathioprine: 1-3 mg/kgPO q24-48h
Why is oral prednisole preferred to prednisone?
–some horses are unable to metabolize prednisone into active metabolite of prednisolone
What is the prognosis for horses diagnosed with pemphigus foliaceus?
–lifelong administration of steroids required
Pemphigus vulgaris is a rare autoimmune skin disease ancedotally reported in horses characterized by:
-circulating IgG directed against the epidermal transmembrane protein desmolgein-3
What are clinical signs of pemphigus vulgaris?
vesicles
ulcerations– @ mucocutaneous & cutaneous areas
What is bullous pemphigoid?
an autoimmune vesiculobullous and ulcerative disorder that affects the cutaneous basement membrane zone (BMZ)
What is the pathophysiology of bullous pemphigoid?
complement activaitng anti-BMZ antibodies bind to glycoprotein ag in lamina lucida of BMZ
–collagen activation results in degranulation of mast cells & chemotaxis of neuts &eos
-eosinphils release tissue destructive enzymes with resultant injury to the BMZ, loss of demoepidermal adherence & blister formation
Equine bullous pemphigoid is characterized clinically by:
-painful, crusted or ulcerated lesions of skin (face & axilla), mucous membrane and mucocutaneous junctions
Besides the skin, bullous pemphigoid lesions can occur where?
GI tract
in horses alopecia areata occurs in what areas?
–areas of nonpruritic alopecia
–most common affected i nhorses: mane, tail & face
What is seen in biopsy in cases of alopecia areata?
lymphocytic infiltrated surrounding the base of the hair follicle
In cases of alopecia areata does hair regrow?
most horses regrow hair, but this. may take up to 2 to 3 years
alopecia areata is often mistaken for what other differential?
ringworm
What is the definition of atopic dermatitis?
abnormal immunological response to environmental allergen like pollens, barn dust, and molds
What is the etiology of atopic dermatitis?
type I (immediate) hypersensitivity response mediated by IgE– allergen specific IgE
What are clinical signs of atopic dermatitis?
-pruritus
-alopecia
-erythema
-urticaria
-papules
Confirmation to formulate allergen-specific immunotherapy is based on what diagnostic tests?
-intradermal testing (IDT)
-serum allergy testing
with intradermal skin testing, what does a positive reaction mean?
the horse has antibodies ot the allergen that , on intradermal exposure, cause wheals to form
–>does not necessarily mean the horses clin signs are caused by reacting allergen
What is the benefit of performing intradermal skin testing?
-hyposensitization
– should be performed for 12 months to assess success
What are treatments recommended in atopic dermatitis?
-corticosteroid (dex, pred)
-antihistamine hydroxyzine pamoate: cetirizine, doxepin, diethylcarbamazine
-essential fatty acids
Urticaria is characterized by
transient focal swellings in the skin or mucous membranes (wheals– areas of dermal edema)
Wheals result from:
vasodilation and transudation of fluid from capillaries and small blood vessels
What is the immunologic mechanism that causes urticaria?
type I hypersensitivity (IgE)
Non-immune mediated urticaria may be induced by:
Type II: cytotoxic, involving antibody and complement
Type III: immune complex
Urticaria can be seen in what other diseases?
–pemphigus foliaceus
-dermatophytosis
-vasculitis
Milk allergy is urticaria usually seen in cows when?
cows during the drying off period
What is the pathogenesis of milk allergy?
-INC intramammary pressure presumably causes milk proteins to gain access to circulation
-induce type 1 hypersenstiivity
Milk allergy is seen in what cattle breeds?
Channel Island breeds
Diagnosis of Milk allergy is made how?
by observing an edematous swelling at site of intradermal injection of cows milk or milk protein casein diluted 1:1000
What are recommended treatments for cattle with milk allergy?
antihistamines
**culling d/t cows are likely to suffer recurrence of milk allergy
Erythema multiform is an immunologic skin reaction, what is seen on skin bopsy?
programmed keratinocyte cell death (apoptosis) in prominent change seen on biopsy
What are clinical lesions of erythema multiform?
macules, papules, urticarial lesions, vesicular bullous lesions
–target-like lesions
-scaling, crusting, erosions or ulcers
–variable pruritus and pain
What are DDx for erythema multiforme?
-urticaria
-amyloidosis
-other nodular papuler diseases
–> drug eruption should be considered
What are characteristic histologic lesions of erythema multiforme?
lichenoid pattern with keraitnocyte apoptosis
describe the histopathologic changes seen iwth vasculitis
inflammatory changes in the walls of blood vessels
in what cases are cutaneous vasculitis seen?
-photoaggravated dermatitis
-drug reactions
-purpura hemmorrhagica
What are cutaneous lesions of vasculitis?
crusts
scales
edema
purpura
necrosis
ulceration
what are the treatment recommendations for vasculitis?
-corticosteroids: dexamethasone
-reducing UV light exposure
-topical corticosteroids
-pentoxyifylline
–antibiotics– prone tos econdary bacterial infections
Drug eruptions can occur when:
–initial administration as a immunologically mediated hypersensitivity reactions
OR
–repeated exposure to a drug
What medications are seen to cause drug eruptions
-antibacterial agents (semisynthetic penicillins & sulfas)
-local anesthetics
-anticonvulsants
-antipyretics (esp phenylbutazone)
Drug eruptions can present as a wide variety of cutaneous manifestations including
-urticaria
-angioedema
-diffuse erythema
-papular rashes
-intense pruritus
-sharply demarcated ulcers secondary to vasculitidies
-vesicular & bullous eruptions
-photosensitization
When are drug eruptions typically seen?
–cutaneous lesions are typically seen 24 to 48 hours after drug administration
define irritant contact dermatitis
cutaneous reaction to an irritating concentration of an offending agent
**chemically damages skin
Define allergic contact dermatitis
represents cutaneous reaction in a sensitized animal to nonirritating concen of the offending agent
**delayed type hypersensitivity (type IV)
Treatment of contact dermatitis
-symptomatic treatment
-washing the affected region with water
-pentoxifylline
What is the causative agent of rain scald, lumpy wool, strawberry foot rot?
-gram-positive , non-acid-fast, branching filamentous, aerobic bacteria
**parallel rows of coccoid zoospores
What are the 3 conditions that must be present for Dermatophilus to manifest?
-carrier animal
-moisture
-skin abrasions