Dermatology Flashcards
predisposition of eosinophilic granuloma complex
middle aged cats
cause of Eosinophilic granuloma complex
hypersensitivity/allergies
types of Eosinophilic granuloma complex
eosinophilic ulcer/indolent ulcer
- lips affects
eosinophilic plaque
- 2- 6 years
- ectoparasites or allergies as underlying cause
- flank, tail, hindlegs
eosinophilic granuloma
- <2-3 years
- linear plaque on hind limb
- Crustous lesion, interdigital region or face and in the mouth
signs of Eosinophilic granuloma complex
most common on lips, itchy, frequently licking/biting areas
diagnosis of Eosinophilic granuloma complex
cytology, biopsy and rule out other diseases from differential diagnosis’
- ulcerated mass may be found at base of tongue/on hard palate, glossopalatine arches or anywhere else in the mouth
- deep biopsy specimen of the mass
treatment of Eosinophilic granuloma complex
- work on primary disease (flea and tick treatment)
- supportive therapy: steroids, antihistamines, (high dose) corticosteroids
- systemic antibiotics directed against staph (amoxicillin) for treating indolent ulcers
prognosis of Eosinophilic granuloma complex
good, but lesions can recur
military dermatitis
pruritic papuocrustous dermatitis
milary dermatitis predisposition
cats
cause of military dermatitis
flea allergy, other allergies and ectoparasites
signs of military dermatitis
Symptoms: pruritic lesions (can be ulcerative)
Signs: papules and crusts on dorsal part of back and neck
diagnosis of military dermatitis
mostly on history, if see flea or tick bites or hasn’t received flea prevention, wood’s lamp
treatment of military dermatitis
: primary cause and supportive therapy
- topical treatments for parasitic infection
- hypoallergenic food is suspected food allergy
- anti-inflammatory drugs (corticosteroids), antihistamines, cyclosporine
ulcerative dermatitis predisposition
very specific for cats
cause of ulcerative dermatitis
- bacterial secondary infection
- Otodectes infestation
- food allergies or other allergies
signs of ulcerative dermatitis
solitary ulcer on the dorsal neck
diagnosis of ulcerative dermatitis
rule out other causes and skin biopsy
treatment of ulcerative dermatitis
excision or high dose glucocorticoids (methylprednisolone), silver sulfadiazine (antiseptic), ciclosporin
predisposition of extensive alopecia
cats
cause of extensive alopecia
flea allergy, dermatophytosis, ectoparasites, behaviour problem, self-trauma due to pruritis
signs of extensive alopecia
: intensively licking abdominal skin
Signs: hind legs and abdomen, hair loss, poor diet, hair in faeces/vomit
diagnosis of extensive alopecia
microscopy (trichogram), wood’s lamp, microbiology, CBC and biochemistry
feline acne
Common idiopathic dermatosis of follicular keratinisation
predisposition of feline acne
cats, all ages, breeds and gender
cause of feline acne
poor grooming associated with obesity, mouth and teeth disease
- underlying seborrheic predisposition, abnormal sebum production
- hair cycle influence, stress, immunosuppression
signs of feline acne
papules, pustules, chin usual site, cellulitis, cysts, scarring, hypertrichosis, facial swelling
diagnosis of feline acne
examination and histopathology, skin biopsy, bacteriology, mycology
treatment of feline acne
- antibacterial shampoos (ethyl lactate)
- topical 2.5% benzoyl peroxide
- fusidic acid
prognosis of feline acne
can be cured but many require long-term treatment for recurrent disease
differentials of feline acen
neoplasia, trauma, eosinophilic granuloma complex
predisposition of dermatophytosis
<1 year, persian, Himalayan, terrier
cause of dermatophytosis
infection with Microsporum canis, trichophyton mentagrophytes, Microsporum gypseum
signs of dermatophytosis
localised skin lesions, nail bed infections, alopecia, miliary dermatitis, crusts
diagnosis of dermatophytosis
trichography/skin scarping, PCR, wood’s lamp (produce apple green fluorescence)
treatment of dermatophytosis
antifungal agents, application of chlorhexidine, enilconazole (dogs not cats), lime sulphur dips, itraconazole (cats),
prognosis of dermatophytosis
immunocompromised individuals is guarded, otherwise good
differential of dermatophytosis
flea bite hypersensitivity, eosinophilic granuloma, mange, staph, neoplasia
prediposositon of actinic keratosis
cats and dogs (dalmatians, beagles, bassets, bulls)
cause of actinic keratosis
excess sun exposure
signs of actinic keratosis
red scaly areas of roughened skin in regional plaques or focal spots, pruritus, pain
diagnosis of actinic keratosis
skin bipsy
treatment of actinic keratosis
surgical excision, topical treatment (Imiquimod), glucocorticoids, cryosurgery
predisposition of phemhigus complex
dog, cat, horse and goat
cause of phemphigus conpkex
autoimmune skin disease (rare)
types of pemphigus compex
- pemphigus foliaceus
- Pemphigus vulagaris
- pemphigus erythematosus
- panepidermal pustural pemphigus
- paraneoplasic pemphigus
signs of pemphigus complex
vesicles and bullae in mouth and at mucocutaneous junctions, common areas: eyelids, lips, nostrils and anus
pemphigus complex
when the bound (desmosomes) are destroyed = pemphigus foliaceous
predisposition of pemphigus foliaceous
middle to older age dogs, any breed, collies, chow chow, dachshund, etc
cause of pemphigus foliaceous
caried and unknown otherwise against desmogelin 1
forms of pemphigus foliaceous
- classical form: distribution is facial and/or pedal and usually bilateral symmetry
- generalised form: additionally affects thorax, neck, abdomen and legs
- subcorneal pustules
signs of pemphigus foliaceous
small to large, irregular and coalescing erythematous macules that progress rapidly to pustules, erosions and crusts
diagnosis of pemphigus foliaceous
- immunological tests
Cytology - aspiration, smear, swab
- acantholytic keratinocytes, no bacteria
- lack of response to antibacterial therapy
- bacterial culture and sensitivity (negative)
- skin biopsies for histopathology
treatment of pemphigus folicaeous
- reduce UV. light exposure
- oral glucocorticoids: prednisolone 1-2mg/kg 2x daily
- if no response, combination immunosuppression: prednisolone, azathioprine 2mg/kg 1x daily or cyclosporine 5mg/kg 1x daily
predisposition of feline pepmhigus folicaeous
feline (similar to dog) most common type, middle aged cats, DSH
signs of Feline pemphigus foliaceus
localisation: head, pinnae, footpads or ungual folds of claws, around mammary complex, exfoliative dermatitis, often pruritic, head shaking, anorexia, lethargy
diagnosis of Feline pemphigus foliaceus
biopsy and histopathology/immunofluorescence, neutrophilia with left shift is common
treatment of Feline pemphigus foliaceus
- oral glucocorticoids: prednisolone/ dexamethasone
- combination immunosuppression: prednisolone, cyclosporine or chlorambucil
predisposition of Mucous membrane pemphigoid
dogs older than 5 years old, GSD
cause of Mucous membrane pemphigoid
(rare) subepidermal autoimmune disease collagen 17
signs of
Mucous membrane pemphigoid
Signs: erythema, vesicles, hypopigmentation, erosion, ulcers
Localisation: oral cavity, around nose, ears, preputial region, periocular
diagnosis of Mucous membrane pemphigoid
history, clinical signs, skin biopsy, immunofluoresence
treatment of Mucous membrane pemphigoid
steroids or immunosuppression
predisposition of DLE
bored collies, GSD, Shetland, siberian husky
cause of DLE
auto immune
signs of DLE
erythema and scaling, nasal depigmentation
history of DLE
history, clinical signs, histopathology, ANA = negative
treatment of DLE
- avoid sun exposure
- topical therapy: 0.1% tacrolimus, steroids in spray, ointment
- oral therapy: prednisolone (1-2mg/kg daily), tetracisline and ninacinamid
Uveodermatologic syndrome predisposition
akitas and Nordic breeds, young adult dogs, mean 3 years
uveodermatologic casue
autoimmune
signs of uveodermatologic
- acute bilateral uveitis and losing pigment with skin inflammation, choriorenitis, poliosis, vitilgo
- losing pigment on nose, lips, skin on mucocutaneous junction
diagnosis of uveodermatologic
history, clinical signs, histopathology
treatment of uveodermatologic
prednisolone, azathiorpin, cyclosporin, long course therapy
prognosis of uveodermatologic
guarded
predispositionn of vitiligo
uncommon skin disease, rottweilers, dachshunds, golden retrievers, GSD, Doberman etc, starts at young age
cause of vitiligo
melanocytes are destroyed or die off
types of vitilog
focal (only one area, in dogs it’s the nose), generalised (multiple white patches)
signs of vitilgo
depigmentation, hair turns white, is painless, around nose others might start (lips and around eye)
diagnosis, treatment and prognosis of vitiligo
Diagnosis: CBC, skin scraping, microscopy, melanocytes
Treatment: no treatment
Prognosis: painless – it’s fine
alopecia areta
Predisposition: dachshund, chihuahuas, standard poodles, bernes mountain dogs
Cause: rare autoimmune disease
Signs: non inflamed alopecia, FOCAL AREAS of hair less, seen on head and neck
Diagnosis: CBC, physical exam
Treatment: Based upon underlying reason, keep moisturised
Prognosis: can’t be cured/treated but doesn’t affect dogs life
sebaceous adenitis
Predisposition: young adult- middle ages (1-5yr), akita, samoyed, standard poodle, vizslas
Causes: inflammation of and around the sebaceous glands leading to loss of these structures
Signs: similar to vitiligo, on sebaceous glands, dry skin, scaling and hair loss, bacterial folliculitis, pruritus
Diagnosis: histopathology, microscopy
Treatment: shampoos, sprays, immunomodulatory therapy and antibacterial (cycylocsporine)
Prognosis: guarded but variable
predisposition of pyoderma
GSD
cause of pyodewrma
local traumatisation, immunological deficit (allergy, autoimmune), hormonal disbalance, malnutrition, idiopathic
signs of pyoderma
papules, pustules, furuncles, discharging sinuses; bacterial infection of dermal and subcuticular tissues
diagnosis of pyoderma
medical history, clinical signs, cytology, antibiogram, histopath, haematology, bacteriology
cytology
- if it’s pyoderma you must see activated neutrophil, if you can see only bacteria you cannot say it’s pyoderma
treatment of pyoderma
topical therapy
- ointment cream, gel: fucidic acid, mupirocin, benzoyl peroxide
- shampoo: chlorhexidine 2-3%, benzoyl peroxide 2-3%, etyl lactate (no contact dermatitis), povidone-iodine
1st line antibiotics:
- .s pseudointermedius
cephalexin
- 15-30mg/kg BID
- broad spectrum
- excellent G+
canine aural hematoma
Is blood lying between the cartilaginous structure and skin of the pinna or within fractured aural cartilage
Cause: secondary to head shaking or scratching at the ear both secondary to ear infection, injury or disease
Signs: vary from small, fluctuant swellings on either surface of the pinna to extremely large tense structures distorting the whole ear
Diagnosis: history, signs, cytopathology (FNA), x-ray of skull
Treatment: drainage, usually surgical, and by correction of underlying problems
Prognosis: fine, but neglected cases can look like a cauliflower eat, but it’s a cosmetic concern
proliferative and necrotising feline otitis externa
Predisposition: young cats, <1 year
Cause: unknown (possibly immune-mediated aetiology)
Signs: lesions are bilaterally symmetrical, large tan – dark brown/black coalescing plaques over the concave aspect of the pinnae and extending into the vertical ear canals, head shaking, marked pruritus, pain , depression and anorexia
Diagnosis: histopathology
Treatment: topical tacrolimus, topical betamethasone, topical hydrocortisone
Prognosis: good, spontaneous resolution occurs in most cases
predisposition of otitis externa
affects 4-20% of dogs, cockers, retrievers, terriers, GSD
cause of otitis externa
numerous
- primary causes: allergies, autoimmune diseases, endocrine disorders, foreign bodies, parasites..
- secondary: bacteria, yeast
- perpetuating: chronic changes within the ear canal, tympanic abnormality
- predisposing: conformation, moisture in ear canal, obstruction
signs of otitis externa
pruritus, scratching, head shaking, aural discharge, malodour and pain
diagnosis of otitis externa
clinical signs, examination and cytology, otoscopy, microscopy, bacteriology
Otoscope
- sedation is offered required in dogs with painful and swollen ear canals or if needs cleaning to visualise the ear drum
treatment of otitis externa
topical therapy (ear cleaner and ear drops), systemic therapy, surgery, pain relief (NSAIDs), treat underlying cause
dermodex
Cause: parasitic mites: demodex gatoi + catis (cat), canis or injal (dogs)
Signs: hair loss, skin inflammation, crusting, pruritus
Diagnosis: skin scrape, acetate tape preparation
Treatment: topical treatments (lime sulfur dips), ivermectin
Prognosis: successfully treated
atopic dermatitis
Predisposition: DSH, Abyssinian and devon rex
Cause: skin disease due to an allergic reaction to environmental allergens
Signs: variable including symmetrical alopecia, miliary dermatitis, eosinophilic plaques and pruritus of head and neck
Diagnosis: elimination of other causes of pruritus, history and clinical signs, allergy testing
Treatment: prednisolone, parenteral glucocortoids, dex
Prognosis: control likely but life-long treatment required
otodectes mange
Predisposition: young
Cause: Otodectes cynotis
Signs: initiate otitis externa but remain undetected, head shaking, pain on palpation, malodour, erythema and swelling
Diagnosis: identification of mites
Treatment: ear canal cleansing, otic ectoparasiticides, selamectin, firponil
Prognosis: excellent
