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Dermatology Flashcards

1
Q

When do female fleas begin egg production after accessing a host and how many do they lay per day

A

Start laying within 24-36hrs
Lay 40-100 eggs per day

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2
Q

Why do we want flea control products with persistent activity

A

Because 5-15% of fleas won’t have emerged from pupae within 3 months; so need treatment to last longer than this with infestation

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3
Q

What parasite are fleas the intermediate host of

A

Dipylidium caninum tapeworm
(zoonotic; common cause of pruritic skin disease in cats)

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4
Q

How do neonicotinoid flea products work

A

Selective agonists of nAChR in insects causing excitation and peristent neuronal depolarisation and paralysis of fleas

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5
Q

What are two neonicitinoid flea products

A

Oral nitenpyram; very effective - kills fleas very quickly but only lasts a short time (excreted within 48hrs)

Imidacloprid (e.g in advantage); topic - more prolonged action of 1 month; takes 12 hours to be absorbed

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6
Q

What kind of products are the ‘laners’

A

Newer flea control agents
= Isooxazoline insecticides
Act to block GABA and L-glutamate gated Cl- channels

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7
Q

How are laners normally administered

A

Orally
(there is now a spot on of adoxolaner ‘nexgard’ available)

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8
Q

How can we argue against idea that laners aren’t good for FAD because flea must bite to get access to product

A

Overall still have a significantly lower cumulative salivery load compared to other flea controls and in these treatments the fleas are killed slowly and will repeatedly attempt to feed

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9
Q

What are some possible side effects of isooxazoline (laners)

A

Neurological adverse effects e.g seizures - because the neurotoxicity not strictly arthropod specific

Take care with using these in any patient with seizure history

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10
Q

How does indoxacarb (activyl) work

A

NOvel oxadiazine spot on insecticide tightly focussed on fleas with 100% efficacy in cats for 4 weeks

= metabolised within flea to more active form; = insect selective Na+ channel blocker

Just as effective as laners; good for those which are resistant

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11
Q

Dog flea products containing what chemical must not be used in cats

A

Permethrin

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12
Q

What is fox mange

A

Sarcoptic mange; from sarcoptes scabei

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13
Q

Signs of sarcoptic mange

A

Alopecia, extreme prurititis
Positive itch-scratch response

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14
Q

Why are sarcoptic mange itchy

A

Irritation directly from burrowing mite
+ hypersensitivity against mite waste

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15
Q

How to diagnose sarcoptic mange

A

Clip large patch, place liquid paraffin and scrape of surface layer - then check
- May need to go deeper if not seeing anything

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16
Q

What can adding potassium bromide before scraping for mites help with

A

Lysing keratin/blood first

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17
Q

Treatment for sarcopic mange

A

Selamectin or moxidectin
+ can use low dose prednisolone one diagnosed to reduce the irritation (but this doesn’t treat the mange itseld)

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18
Q

What is red mange

A

Demodectic mange

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19
Q

Why do we get demodectic mange on some animals

A

Overproliferation of mites (that are normally part of cutaneous flora) related to immune system suppression or defect

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20
Q

What is the classic signalment of demodex

A

young dog with lesion on face

Esp: boxer, bull terrier, bulldogs

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21
Q

Which breed has a different demodex species to others

A

Wire haired fox terriers

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22
Q

What are the two presentations of demodicosis

A

Localised: = 4 or less lesions <2.5cm diameter; tend to self resolve with extra nutrition etc

Generalised: NEED miticidal treatment or unlikely to recover

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23
Q

Where do we tend to see demodex lesions first

A

Face and front legs since puppies get this from mother

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24
Q

Signs of demodectic mange

A

Lesions (starting on face) of erythema, scaling, comedones, alopecia, papules/pustules, hyperpigmentation

Also often get dry seborrhoea of ear margin

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25
Is demodectic mange pruritic
Not due to mites BUT get pruritis due to consequences of infection e.g hair follicle rupture and contents leaking into the dermis
26
How many mites is suspicious of demodex and what is diagnostic
1 = suspicious 2 = diagnostic
27
Diagnosis of demodectic mange
Deep skin scarpins; capillary bleeding Hair blocks Skin squeezings onto scotch tape Biopsies
28
Treatment of generalised demodixosis
Best = sarolaner (simparica) or other laners MONTHLY (could also try advocate imidacloprid andmoxidectin weekly) + do antibacterial chlorexidine shampoo If significant infection can consider antibiotics
29
How often/long do we treat demodectic mange for
Reassess monthly and do samples Want to treat for 1-2 months after clinical cure (using monthly oral laner)
30
Can we use steroids with demodectic mange
NO NEVER
31
What extra consideration should we have once a patient has been treated for demodectic mange
Advise to neuter and not use for breeding since there is genetic component
32
What is cat mange
Notroectic mange
33
Signs of notroectic mange
Intense pruritis Mostly ears/head/neck affected Get excortiation with crusty thickening
34
Diagnosis and treatment of notroectic mange
Tape strips/skin scrapes Treat with selamectin spot on
35
What are the two lice that affect dogs and which is biting vs sucking
Lignognathus setosus = sucking Trichodectes canis = biting
36
Reservoir host of microsporum canis
Cats
37
Reservoir host of trichophyon mentagrophytes
Rodents
38
Reservoir of microsporum gypseum
Soil
39
Reservoir of trichophyton erinaceid
Hedgehogs
40
What must we remember about ringworm
It is zoonotic; children often present with this due to thinner skin and more time spent with pets
41
Which mange is zoonotic
Sarcoptes
42
Signs of dermatophytosis
Well circumscribed alopecia, erythema patches Crustic Licenificaiton Pruritis
43
Diagnosis of dermatophytosis
Wood's lamp shows fluorescence of microsporum canis WITHIN HAIR (do not confuse with skin scale fluorescence non speciifc) Trichogram hair puck Fungal culutre Biopsy PCR
44
Which breeds do we typically see trichophyton ringworm in
Ratting breeds e.g Jack Russel
45
Which ringworm species fluoresceses on wood's lamp
Microsporum
46
Treatment of ringworm
Start with topical enilconazole or chlorhexidine/miconazole May need systemic itraconazole (7 days on/off) Treat for minimum 3 weeks but may need longer
47
Aside from specific fungal treatments what topical treatment can we use in cats with ringworm
Lime sulphur
48
What is Dermatophyic granulomas and pseudomycetomas; which breeds
Where dermatophilic hyphae spread into dermis/subcutis and cause nodules to form Esp in persian cats, yorkies
49
What type of yeast is malassezia
Lipophilis
50
When do we get overgrowth of malassezia
Where there is changes in host defence or local microclimate e.g ear inflammation due to dermatitis can make it more humid and allow malassezia overgrowth
51
Which is the malassezia species we tend to see
M pachdermatis
52
Which breeds are most prone to malassezia
Basset hound, WHWT, American cockers, sphynx, devon rex
53
What do malassezia look like on diffquick
See peanut appearance; much larger than any staph/strep on there
54
Clinical signs of malassezia (including if chornic)
erythema, pruritis, alopecia, greasy exudate, nail bed staining  If chronic: get hyperpigmentation, licenification and malodour
55
Treatment of malassezia
identify and treat underlying cause 2X weekly shampoo with 2% miconazole/2% chlorhexidine (may need itraconazole or terbinafine systemically)
56
WHat does it show us if malassezia treatment only gives partial pruritis resolution
It was a secondary pathogen e.g to atopic skin disease
57
What is the most commonly isolated bacteria from canine skin infection
Staphylococcus pseudointermedius = resident in mares, oropharynx and perianal area but only transient on the skin
58
Is it significant if we find staph pseudointermedius on skin
Yes because only should be transient on the skin
59
What is the exception to not using steroids in managing bacterial skin infections
Surface skin infections just to reduce pruritis and inflammation
60
What is the classification of skin infections
Surface = just epidermis Superficial = extending into just the hair follicles in the dermis Deep = extending into the dermis but not contained within hair follicle - means it has transitioned from folliculitis to furunculosis
61
What do you see with superficial pyoderma
pustules, erythema --> then crusting after epidermis lifts up when pustules rupture --> epidermal collerete --> then goes to target lesion with central hyperpigmentation
62
Which breed has a defect in mucosal immunity which makes them prone to skin conditions
German shepherds
63
When do we do cytology/C and S in pyoderma
Always do cytology Can take C/S at same time as cytology and decide whether to send dependent on response
64
Types of surface pyoderma
* Pyotraumatic dermatitis; i.e hot spot * Skin fold pyoderma * Mucocutaneous pyoderma
65
How does pyotraumatic dermatitis develop
Initial trauma/irritation then lots of scratching and licking which creates a rapidly expanding area of surface pathology
66
Breed predilection of pyotraumatic dermatitis (hot spot)
Rottweilers, golden retrievers since these have dense secondary hair coat
67
What should we be thinking if animals present with multiple pyotraumatic dermatitis lesions
Another underlying issue: fleas, allergic dermatitis flare up
68
Treatment of pyotraumatic dermatitis
Treat as soon as possible; clip/clean wide area around, clean with chlohexidine and dry Give topical steroids, buster collar etc Investigate underlying cause
69
Key sites and breeds for skin fold pyoderma
Sites = lip fold covered by top lip, facial, vulval, tail folds Breeds: shar-pei, bulldog
70
Treatment of skin fold pyoderma
Clipping, cleaning with chlorhexidine + can use clotrimazole cream if there is lots of malasseiza Surgery = last resort to remove the fold
71
What is mucocutaneous pyoderma
Rare conditions of lichenoid inflammation with plasma cells, lymphocytes, neutrophils, macrophages See lip swelling, pruritis, complete antibiotic-responsiveness
72
Treatment of mucocutaneous pyoderma
4 weeks clindamycin + topical cleaning (chlorhexidine) and topical 2% mupirocin ointment
73
What is puppy pyoderma
Superficial pyoderma Non-follicular pustules mostly on ventrum, axillary region, inguinum Associated with suboptimal husbandry
74
Treatment of puppy pyoderma
antibacterial washes
75
What would we see on magnifying lens that shows us it is puppy pyoderma/impetigo
Lesions are not follicular
76
What is superficial folliculitis
Where there are inflammatory pustules centred around hair follicles See tufts of hair, moderately alopecic appearance, epidermal collarettes May have underlying issues involved: demodex, dermatophytosis
77
Treatment of superficial folliculitis
Try to manage topically e.g chlorhexidine shampoo every few days If not working for a few weeks use systemic antibiotics
78
What should we consider if we see extensive epidermal collarettes
Could be superficial spreading pyoderma
79
Which breed can have more severe cases of superficial spreading pyoderma
Shetland sheepdogs
80
What is superficial spreading pyoderma
Common pruritic lesions most often on inguinum and axilla Secondary May see with superficial folliculitis
81
What possible underlying causes should we consider with recurrent pyoderma
Fleas Atopic dermatitis Hypothyroidism Cutaneous adverse reactions
82
How does chlorhexidine work
Coagulation of bacterial proteins and degradation of bacterial membranes
83
How does benzoyl peroxide work
oxidising agent to disrupt bacterial cell walls
84
What is furunculosis
Extension of pathology from the hair follicle into the dermis (and sometimes subcutis) as the hair follicle breaks down and material released
85
Treating deep bacterial furunculosis
Antibiotics for 3 weeks minimum and reassess every 2 weeks + topical chlorhexidine washes
86
Some options of systemic antibioitcs for skin infections
cephalexin, co-amoxiclav, clindamycin, trimethoprim/sulphonamide
87
Clinical signs of deep bacterial furunculosis
Larger pustules, firm nodules +/- discharging tracts, poorly defined oedematous and erythematous plaques, crusts, haemopurulent discharge, haemorrhagic bullae, alopecia, pain, pruritis, often pyrexic
88
What dogs get muzzle furunculosis and what age
Short coated dogs e.g dobermans, great dane, bulldog, mastiff Onset around puberty 5-12 months
89
Treatment of muzzle furunculosis
Mild cases use topical treatments e.g 2.5% benzylperoxide + poulticing, gentle squeezing; if very severe use systemic antibiotics
90
Presentation of pedal furunculosis
Erythema, alopecia, uneven weight bearing on feet Firm nodules, draining fistulas in feet Often interdigital More so in short coated breeds
91
Treatment for pedal furunculosis
podoplasty, separation podoplasty to remove web b/w toes if this area repeatedly affected, fusion podoplasty If not doing surgery and not infected (i.e inflammation coming from keratin) cn use topical steroids
92
What is traumatic furunculosis
Acral lic dermatitis Due to bored, young large breed dogs licking dorsal aspect of feet; this drives hair follicle deeper, pushing keratin into the dermis and driving foreign body reaction + can get bacterial infection too = behavioural issue
93
How can we deal with resistant staphylococcus
manage topically; shampooing every 1-3 days; ethyl lactate, chlorhexidine May try 1 cup bleach in half a bathtub of warm water and bathe dog
94
What does it suggest that isolation rates of bacteria are very low in healthy cat skin
Low adherence to feline skin
95
What is a common cause of deep pyoderma in cats
Penetrating fight wounds; then infection with pasteurlla, staphs, E coli, anaerobes FIV/FeLV could also be involved
96
How does cephalexin work
= 1st generation cephalosporin beta-lactam Bactericidal Inhibits cell wall syntehsis causing osmotic instability Excellent gram +ve cover but poor gram -ve
97
How does co-amoxiclav work
Beta-lactam _ binds to beta lactamases Bactericidal Inhibits cell wall syntehsis causing osmotic instability Excellent gram +ve cover, some gram -ve against E coli
98
How does clindamycin work
Lincosamine antibiotics Bacteriostatic or bactericidal Binds 50S subunit of susceptible bacteria and inhibits protein synthesis Most gram +ve cocci susceptible
99
What antibioitic (used for skin conditions) brings risk of oesophagitis and stricture formation in cats
Clindamycin
100
How does cefovecin work
3rd gen cephalosporin Bacteriocidal Targets cell wall synthesis Good for skin infections + lasts 2 weeks
101
How do fluoroquinolones work
Bactericidal via inhibition of DNA gyrase Good effect against gram +ve and -ves (but weak on anaerobes) = protected
102
What adverse affects can fluoroquinolones cause
GI upset, rare reports of increased hepatic enzymes, can lead to articular cartilage abnormalities in growing animals
103
What can accidental overdose of enrofloxacin/marbofloxacin in dogs and cats
blindness in cats Bone marrow suppression in dogs
104

Dermatology (8 decks)

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