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SAM 2 scs RUSVM > Derm 3: Immune-mediated, cutaneous crusting/misc skin disorders, nodular dermatoses (E2) > Flashcards

Derm 3: Immune-mediated, cutaneous crusting/misc skin disorders, nodular dermatoses (E2) Flashcards

1
Q

How are immune-mediated skin disorders diagnosed?

A

Histopathology of multiple biopsies

+/- IHC

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2
Q

Label these layers

A

A: Stratum corneum

B: Stratum lucidum

C: Stratum granulosum

D: Stratum spinosum

E: Stratum basale

F: Dermis

Cats Love Going Sun Bathing (Daily)

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3
Q

What are the 2 first-choice immunosuppresive drugs to treat immune-mediated skin disorders?

A

Glucocorticoids

Cyclosporine A

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4
Q

_______ ______ is a vesiculobullous to pustular group of disorders of the skin or mucus membranes characterised by the loss of cohesion between keratinocytes, known as _______.

A

Pemphigus complex

Acantholysis

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5
Q

What is the benign form of pemphigus? Which breeds are predisposed? What are the classical clinical signs and where do they occur?

A

Pemphigus erythematosus

Collies and GSD

Erythema, pusular dermatitis of face and ears

Transient lesions (oozing crusts, scales, alopecia, eorsions, epidermal collarettes)

Depigmentation of nose

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6
Q

What are the differential diagnoses for pemphigus erythematosus?

A

Bacterial folliculitis

Dermatophytosis

Demodicosis

Facial pemphigus foliaceus

DLE

SLE

Dermatomycositis

Leishmania

Zinc responsive dermatitis

Drug rxn

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7
Q

T?F: Sun avoidance and systemic glucocorticoids or cyclosporin are the accepted treatments for pemphigus erythematosus.

A

False, sun avoidance and TOPICAL glucocorticoids or cyclosporine

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8
Q

The most common immune-mediated condition is ______ ________. The major antigen is the adhesion molecule ________.

A

Pemphigus foliaceus

Desmoglein 1

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9
Q

Where are lesions typically found in a dog with pemphigus foliaceus? Cats?

A

Dogs: Starts at face and ears, commonly involves feet, clawbeds, footpads and groin

Cats: Nail beds, nipples

Also nasal depigmentation

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10
Q

Where does cellular infiltration in pemphigus foliaceus occur? Which skin layers loss adhesion in pemphigus vulgaris and bullous pemphigoid?

A

Foliaceus: Between stratum corneum and granulosum

Vulgaris: Stratum spinosum and basale

Bullous pemphigoid: Epidermis and dermis

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11
Q

Where is the most common lesion location for an animal with pemphigus vulgaris? Where are cutaneous lesions common? What is the claw bed lesion?

Which other condition causes lesions in these areas?

A

Oral cavity (75-90% have lesions in mouth)

Axillae and groin

Ulcerative parochyia (clawbeds)

Bullous pemphigoid

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12
Q

What drugs are used to treat pemphigus vulgaris?

A

High dose prednisolone an azathioprine PO

Cats: Chlorambucil

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13
Q

What condition involves autoantibodies against antigens of the basal cell hemidesmosomes of the skin and mucosa? What drugs predispose to this condition?

A

Bullous pemphigoid

Sulphonamides, Penicillins, Furosemide

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14
Q

Which cells predominate in lupus erythematosus? Which specifically in DLE and SLE?

A

T-cells

DLE: T-Helper

SLE: T-Suppressor

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15
Q

Damage to which cells activate T cells in DLE and what do the damaged cells have high levels of? What type of antibody is often formed?

A

Keratinocytes

ANA (Anti-nuclear antibody)

IgM

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16
Q

Pemphigus vulgaris can involve antibodies reacting against a certain molecule, what is this molecule and in what species is it found?

A

Desmoglein 3

(“V” (vulgaris) rhymes with “Three”)

Dogs

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17
Q

What are some breeds predisposed to DLE? What are the lesions?

A

Collies, GSDs

Shetland sheepdogs, Siberian huskies, Brittany spaniels, German shorthaired pointers

Lesions: Depigmentation, erythema, scaling of nose, progress to erosions, ulceration and crusting

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18
Q

What part of the skin is thickened in DLE due to cellular infiltration?

A

Basement membrane

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19
Q

What clinical signs occur in dogs with SLE? Is there a sex prediliction in dogs or cats?

A

Fever

Polyarthritis

Proteinuria

Alopecia, erythema, vesciculobullous to ulcerative lesions

Dogs- males over-represented

Cats- no sex prediliction

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20
Q

Your canine patient with SLE has developed glomerulonephritis. What do you expect and what is the prognosis?

A

Progressive renal failue

Poor prognosis

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21
Q

What is the drug that most commonly causes cutaneous adverse drug reactions? What does it mean if this reaction is idiosyncratic?

A

Penicillin

Idiosyncratic: unpredictable, dose-independent, related to host immune system (opposite of predictable reaction which is drug- and dose-dependent)

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22
Q

Your patient acutely develops erythematous macules which have spread peripherally and cleared centrally. There are also urticarial plaques. Lesions are primarily on the ventrum, axillae, and groin. What type of degeneration is occuring and what is this condition called? How is it treated?

A

Hydropic degeneration (all levels of epidermis)

Erythema multiforme

Tx: Eliminate trigger, wait for it to spontaneously regress.

23
Q

What will a skin biospy from an animal with toxic epidermal necrolysis reveal?

A

Full-thickness epidermal nercolysis

Minimal inflammation

24
Q

What do the lesions that characterize vasculitis look like and where do they occur?

A

Purpura, wheals, edema, papules, plaques, nodules, alopecia, scarring, necrosis and ulceration (punched out ulcers)

Extremities- paws, pinnae, lips, tail, scrotum, oral mucosa

25
Q

Other than determining the underlying disease, what drugs are used to treat vasculitis?

A

Pentoxifylline (increases erythrocyte flexibility and reduces inflammation.)

Immunosuppressive and immunimodulatory drugs

26
Q

What 3 conditions commonly cause seborrhea, crusts or scales WITH pruritus? What if there is no pruritus?

A

Allergies (FAD, AD, FA)

Parasites (sarcoptes, cheyletiella)

Infections (pyoderma, malassezia) *+/- pruritus*

No pruritus: demodicosis, dermatophytosis, endocrine diseases (hypothryoid, HAC, alopecia X)

27
Q

What is the difference between syndrome 1 and syndrome 2 of zinc-responsive dermatosis?

A

Syndrome 1 is decreased capacity to absorb zinc from GIT

Syndrome 2 is RARE and caused by dietary deficiency

28
Q

What breeds get breed-related zinc-responsive dermatosis?

A

Siberian huskies

Alaskan Malamutes

Bull terriers

29
Q

What clinical signs are associated with zinc-responsive dermatosis? Where do they occur and when do they start?

A

Pruiritus and scales/crusts

Mouth, chin, eyes, ears, elbows, pressure points, scrotum, prepuce, vulva

Hyperkeratotic foodpads

Signs begin around 1-3yrs of age

30
Q

What are some speculated causes of sebaceous adenitis?

A

Inherited sebaceous gland destruction

Cell-mediated immunological rxn

Defect in keratinization/obstruction of sebaceous ducts

Abnormal lipid metabolism

31
Q

What clinical signs occur in dogs with sebaceous adenitits? Cats?

A

Dogs: Bilaterally symmetrical alopecia and/or dry brittle coat, ‘moth eaten’ look, silvery dandruff, ceruminous ottitis externa, some get rat tail, non-pruritic

Cats: multifocal annular lesions of scale, crust, brokem hair casts, alopecia (starts around head and moves caudally)

32
Q

What is primary ideopathic seborrhea? What does it cause?

A

Vitamin A responsive dermatosis - hereditary disorder of keratinization that starts weeks to months after birth as mild scaling which worsens with age

Causes abnormal cornification and desquamation with prominent follicular casts and ceruminous otitis

33
Q

Categorize these as either moisturizing or degreasing (shampoos):

Chlorheiderm

Allergroom

Oxydex

Selsun Blue

Epi-soothe

A

Moisturizing:

Chlorheiderm

Allergroom

Epi-soothe

Degreasing:

Oxydex

Selsun Blue

34
Q

A schnauzer presents to you with comodones covering its back. The eruptions are sharp crusted papular lesions that span from the neck to the base of the tail. What inherited disorder could this be and what seocndary lesions do you expect?

A

Schnauzer Comedo Syndrome

Folliculitis and furunculosis

(Inherited dysplasia of hair follicle)

35
Q

A dachshund presents with scaly lesions around the edges of the ears. You note follicular casts and alopecia on most of the ears. Considering the breed, what condition could this be? How would you treat it if it was mild? What if the condition is complicated by other organisms?

A

Ear Margin Dermatosis

Mild: moisturizers, sulfur salicylic acid shampoo, topical glucocorticoid cream

Complicated: Pentoxifylline

36
Q

A 10 year old Yorkie presents with hyperkeratotic, crusty, cracking footpads. The lesions are also infected with yeast. What diseases do you fear may develop in this dog? What condition does the dog have?

A

Hepatic or pancreatic disease

Superficial necrolytic dermatitis

37
Q

What blood chemistry changes can be caused by SND? What unique liver pattern may you see on US?

A

Increased ALT, ALP, AST, Bilirubin

Decreased BUN, ALB, GLU

US Liver: Honey-comb pattern

38
Q

What is the behavioral dermatosis caused by self-induced trauma of the skin through excessive licking and chewing?

A

Acral lick granuloma

39
Q

What lupus-like disease resuts in acute claw loss? In what species is this the most common nail disorder?

A

Idiopathic Lupoid Onychodystrophy

Cats

40
Q

What sample would you submit for histopathology if you suspect idiopathic lupoid onychodystrophy? Aside from treating secondary infections, what is used to treat this condition? If that doesn’t work, what can you try next?

A

Amputated dew claw (best) or P3

EFAs and vit E

Niacinamide/Tetracycline and steroids

41
Q

What should you include when creating a cytology to diagnose a nodule?

A

FNA of nodule and LN draining the area

Make impression smear of discharge or ulcerated lesion

42
Q

T/F: Papillomatosis usually causes solitary lesions.

A

True

43
Q

You sample a nodule and find that it is made up of necrotic fat. What is this called and what does it indicate?

A

Nodular panniculitis or steatitis

Indicates systemic disease

44
Q

How does a histocytoma usually look and how is it diagnosed?

A

Round, alopecic, red

Aspiration cytology

45
Q

What histocytic proliferative disease causes single to multiple non-pruritic firm papules, nodules or plaques on the legs, feet and face of cats?

A

Feline Proliferative Histiocytosis

46
Q

A 5 year old GSD presents with multiple cutaneous nodules consisting of mature collagen hyperplasia. What is the disorder and what underlying condition do you fear may be affecting the dog as well?

A

Nodular dermatofibrosis

Renal disease

47
Q

What disorder to which young Gordon Setters, Golden Retreivers, and Dachshunds are prediposed, causes acute, non-pruritic, pyoderma-like clinical signs, as well as facial and submandibular swelling? What are the key rule-outs?

A

Juvenile Cellulitis/Puppy strangles

R/O: Demodex, deep bacterial pyoderma, angioedema

48
Q

Should juvenile cellulitis be treated and if so with what?

A

Yes, mjst be treated or could cause scarring or death

Pred 2mg/kg SID q1-4 weeks (remission) then EOD q2-3weeks

49
Q

What do you call an epithelial lined cavitiy with either solid or fluid material within?

A

Cyst

50
Q

What causes a sebaceous cyst and how is it treated?

A

Hair follicle or skin pore gets blocked by dirt, debris, scar tissue or infection

Excision is curative

51
Q

T/F: Keratin inclusion cysts should be manually expressed to hasten resolution.

A

False, can cause subepidermal rupture and subsequent furunculosis (can just monitor or remove it causing problems)

52
Q

What is attracted to the smell of urine and feces and causes myiasis? What is the predilication site?

A

Cobylobia anthrophaga (Tumbu/Mango fly)

Tail base, ventral abdomen

53
Q

Where does myiasis caused by biting flies usually occur and how do the lesions look?

A

Tips of ears

Erythema, bleeding, oozing, crusting lesions

54
Q

How is fly bite dermatitis/myiasis treated generally and if caused by Tambu flies or mosquitos? What if there are maggots?

A

Topical fly repellants

Tambu: Cover breathing holes with vasoline, gently squeeze out if problematic but avoid damaging larvae

Mosquito: avoidance, ectoparastitic drugs

Maggots: clip and clean, flush out maggots, extra-label ivermectin

SAM 2 scs RUSVM (14 decks)

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