Dermatologic Emergencies Flashcards
What is a normal history of abscessing?
Outdoor cat with trauma or foreign body perforation
What physical exam findings can occur with abscesses?
Lethargy
Fever
Sometimes necrotic skin above abscess
What additional tests should be performed with abscesses in cats?
FeLV/FIV testing
What antibiotics are good for abscesses?
Penicillins Amoxicillin Clavamox Metronidazole Chloramphenicol Clindamycin Third generation cephalosporins such as Simplicef or Convenia
What history is typically noted with burns?
Exposure to hot water, grease, tar, oil, electrocutions, etc.
What is a first degree burn?
Superficial burn involving epidermis
Painful, erythematous skin, +/- vesicles
Healing rapid when superficial desquamation occurs
What is a second degree burn?
Partial thickness with epidermis and dermis Pain Hair may be intact Severe subcutaneous edema Healing is slow after sloughing
What is a third degree burn?
Full thickness into dermis and subcutaneous tissue
Painless
Hair fall out
Skin appears black or white
Healing is slow unless graft is performed
What is a fourth degree burn?
Burns involving muscle and bone
What worsens the prognosis with burns?
If it affects the head or joints
In ole or young patients
If it affects > 20% of the body
Euthanasia should be a consideration if burns are severe
What are treatment options for first degree burns?
If they occurred in the past 2 hours, cool affected areas with cool water or saline
Pain control
Clean and clip area
Apply SSD and wound dressing once per day
What are treatment options for second degree burns?
Treat as first degree
Begin IV fluids for shock and for affected body surface area
What are treatment options for third degree burns?
Discuss euthanasia Remove lesions if small Monitor for shock and septicemia Apply hydrotherapy Give a broad spectrum under eschar if present and start IV broad spectrum antibiotics
What can be used to remove hot tar?
Polyoxyethylene sorbate and polysorbate, the emulsifiers in Neosporin and other antibiotic creams
What are differentials for a cutaneous foreign body?
Hematoma, infection, seroma, neoplasia
What is important to remember about about grass awn foreign bodies?
They tend to migrate - will cause a draining tract until removed
How should cactus spines or porcupine quills be removed?
Do not clip the area
Grasp spines with hemostats and pull out
Soak hemostats in water to remove afterward
How should fishing hooks be removed?
Cannot be backed out due to bard
Press hook through tissues until hook and barb can be visualized
Grab hook, cut off shank, pull out hook
How should treble hooks be removed?
Remove shank that attaches to hooks to separate them as separate hooks
Remove then as fishing hooks
How should bee stingers be removed?
Scrape with a scalpel blade as grasping them may push venom into wound
How should cutaneous foreign bodies be removed?
Clip an clean area
Probe with mosquitoes or hemostats
Flush tract with sterile saline
What are causing of toxic epidermal necrolysis/ erythema multiforme?
Antimicrobials (penicillins, cephalosporins, gentamicin, sulfonamides, griseofulvin) L-thyoxine Levamisole Aurothioglucose 5-fluorocytosine Diethylcarbamazine Antiserum Toxins (insecticides, flea dips, d-limonene) Endocarditis Hepatic necrosis Cholangiohepatitis
What do toxic epidermal necrolysis/ erythema multiforme appear like on physical exam?
Painful
Macular, papular, bullous, vesicular, target-like lesions
Multiple are noted and these typically coalesce and slough
Appear on the trunk (stomatitis and paw lesions noted)
Fever
Nokolsky’s sign (lesions can be moved around, creating new ulcers)
What is the prognosis for toxic epidermal necrolysis?
Guarded to poor
This is difficult to manage
