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SAM 2 > Dermatology 2 > Flashcards

Dermatology 2 Flashcards

1
Q

what are the 3 types of pyoderma ?

A

surface, superficial and deep

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2
Q

which pyoderma effects the surface of the skin? what are some examples?

A
  • surface pyoderma

- examples are: hot spot, intertrigo

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3
Q

which pyoderma effect the epidermal layer and/or hair follicles ?

A

superficial pyoderma

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4
Q

which pyoderma effects the dermal layer plus follicles? what are some examples?

A
  • deep pyoderma

- exudation of blood or pus, crusting, odor, ulceration, fistula and swelling

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5
Q

how do we diagnose pyoderma?

A
  • clinical signs like pustules, papules, crusts, etc.
  • cytology
  • culture
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6
Q

should we do cytology and culture on surface pyoderma?

A

cytology - yes, critical

culture - no, not really helpful, spend $ on something else

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7
Q

should we do cytology and culture on superficial pyoderma?

A

yes and no

  • cytology can be supportive
  • culture can sometimes help
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8
Q

should we do cytology and culture on deep pyoderma?

A

cytology - often negative

culture - yes, always culture!

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9
Q

when should we absolutely do a bacterial culture for pyoderma?

A
  • if less than 50% improvement or new lesions after 2 weeks of treatment
  • residual lesions at 6 weeks
  • intracellular rods on cytology
  • history of MRSA
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10
Q

what should we culture for pyoderma?

A

the pustules are best but can also culture under crusts or the epidermal collarettes

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11
Q

what type of pyoderma do we use topical antibacterial agents to treat?

A
  • surface pyoderma
  • mild or localized pyoderma
  • can be helpful for deep pyoderma
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12
Q

what type of pyoderma do we use systemic antibiotics to treat?

A
  • superficial pyoderma
  • deep pyoderma
  • rarely surface pyoderma
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13
Q

true or false.

Topical therapy may eliminate the need for systemic antibiotics.

A

true

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14
Q

true or false.

Topical antibacterial therapy is only helpful for certain types of pyoderma.

A

false, helpful in all pyodermas

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15
Q

what are some examples of topical antibacterial agents ?

A

benzoyl peroxide, chlorhexidine, iodine, gentamycin, polymyxin b, bacitracin

  • mupirocin and silver sulfadiazine
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16
Q

which has follicular flushing capabilities, benzoyl peroxide or chlorhexidine ?

A

benzoyl peroxide

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17
Q

would you use chlorhexidine or benzoyl peroxide for a pyoderma with oily seborrhea?

A

benzoyl peroxide, because it has a degreasing agent

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18
Q

what type of bacteria is mupirocin effective against?

A

gram positive bacteria including MRSA

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19
Q

what is silver sulfadiazine effective against?

A

several types of bacteria including psuedomonas

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20
Q

what are the first tier systemic antibiotics we use for pyoderma?

A
  • 1st generation cephalosporins (ex. cephalexin)
  • amoxicillin/clavulanic acid
  • clindamycin
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21
Q

what are the second tier systemic antibiotics we use for pyoderma?

A
  • empirically: sulfas, erythromycin, doxycycline

- based on c/s results: chloramphenicol, rifampin or amikacin

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22
Q

what are the 3rd tier systemic antibiotics we use for pyoderma?

A

fluoroquinolones and THIRD generation cephalosporins

  • based on results from a c/s
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23
Q

when do we use 3rd tier systemic antibiotics for pyoderma?

A

as a LAST RESORT

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24
Q

examples of a 3rd generation cephalosporin?

A

enrofloxacin, marbofloxacin, ciprofloxacin, cefovecin (convenia), cefpodoxime (simplicef)

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25
Q

how long should we treat superficial pyoderma for?

A

treat 3-4 weeks minimally and treat 1 week beyond resolution

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26
Q

how long should we treat deep pyoderma for?

A

treat 3-12 weeks and treat 2 weeks beyond resolution

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27
Q

what are some reasons for recurrent pyodermas?

A
  • not treating appropriately

- an underlying reason like immunosuppression, corticosteroid use, endocrine disease, or allergies

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28
Q

what type of pyoderma is an acute traumatic pyodermatitis (HOT SPOT)?

A

SURFACE pyoderma

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29
Q

what type of pyoderma is puppy pyoderma (IMPETIGO) ?

A

SUPERFICIAL pyoderma

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30
Q

what type of pyoderma is nasal folliculitis/furunculosis?

A

superficial AND deep pyoderma

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31
Q

what type of pyoderma is chin acne?

A

DEEP pyoderma

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32
Q

what type of pyoderma is a lick granuloma (acral lick dermatitis) ?

A

DEEP pyoderma

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33
Q

true or false.

acute moist dermatitis is a lick granuloma.

A

false, it is a hot spot or pyotraumatic dermatitis

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34
Q

where do we commonly see hot spots ?

A

hip/thigh and ear

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35
Q

what is the cause of hot spots?

A

self induced trauma

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36
Q

do we treat pyotraumatic dermatitis with steroids?

A

we can, hot spots are an exception where we can use corticosteroids to break the itch cycle

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37
Q

what do you see with impetigo (puppy pyoderma)?

A

pustular rash in axillary or inguinal areas

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38
Q

how do we treat impetigo ?

A

its usually self-limiting, can use topical antibacterial shampoos and occasionally may need systemic antibiotics

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39
Q

what happens to cause nasal folliculitis and furunculosis?

A

the hair follicle has bacteria growing in it, usually staph

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40
Q

true or false.

nasal folliculitis usually has an underlying cause

A

true but not always

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41
Q

what age do we commonly see chin acne in ?

A

young dogs < 1 year

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42
Q

what do we use to treat chin acne?

A

topical benzoyl peroxide in mild cases, can add systemic antibiotics if a severe case

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43
Q

what can cause a lick granuloma?

A
  • primary factors can be: atopy, food allergy or trauma which causes them to start licking
  • perpetuating factors that can keep the lick cycle going are: deep pyoderma, ruptured hair follicle, compulsive behavior
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44
Q

how can we treat lick granuloma ?

A

treat the underlying cause as well as stop what is keeping the lick cycle going - break the itch-lick cycle

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45
Q

where do we commonly see Malassezia dermatitis?

A

ears, lip folds, ventral neck, axilla, interdigital and perianal
check the ears and folds

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46
Q

is Malassezia frequently a primary invader of skin and ears?

A

no, SECONDARY invader

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47
Q

what are some clinical signs of Malassezia?

A
  • pruritus
  • malodor
  • erythema
  • greasy scaly plaques
  • otitis externa
  • paronychia - infection of nails
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48
Q

what clinical signs do we see with CHRONIC malassezia ?

A

lichenification, HYPERpigmentation and hyperkeratosis

49
Q

how do we diagnose malassezia ?

A
  • history of pruritus
  • clinical signs (can look like allergic dermatitis)
  • cytology - ESSENTIAL
50
Q

how do we treat malassezia?

A
  • anti-yeast shampoos: ketoconazole, miconazole, etc. (2-3x weekly)
  • creams and lotions
  • systemic ketoconazole or itraconazole

Also treat any underlying cause

51
Q

do we prefer to treat malassezia topically or systemically?

A

always use topical if possible, reserve systemics for extensive infection or if topical isn’t working

52
Q

how does feline pruritus differ from canine pruritus?

A
  • skin lesions are different

- excoriation, lichenificiation and hyperpigmentation are rare

53
Q

what is the first thing we should do when we see skin signs in a cat?

A

eliminate ringworm and fleas as ddx

54
Q

what are the 3 forms of skin lesions we see with pruritus in cats?

A
  1. bilaterally symmetrical hair loss with normal (non-inflammatory) skin
  2. miliary dermatitis
  3. eosinophilic granuloma complex
55
Q

how can we determine whether feline symmetrical alopecia was self-induced or not?

A

a trichogram

56
Q

what is a cause of self-induced feline symmetrical alopecia ?

A

psychogenic caused by anxiety or pruritic conditions

57
Q

where do we usually see signs from psychogenic alopecia?

A

areas that are easiest to reach like medial thighs, ventral abdomen and medial forelegs

58
Q

how can we tell if a cat has a flea allergy vs another pruritic condition?

A

will see caudo-dorsal alopecia but can have facial, limb and neck involvement. Will also have eosinophillic granuloma complex lesions too

59
Q

how can we tell if a cat has atopy vs another pruritic condition?

A

will see barbering of the ventrum and medial front limbs

60
Q

how can we tell if a cat has food allergies vs another pruritic condition?

A

will see persistent and year-round pruritus at any site on the body, especially face and head

61
Q

what is responsible for feline scabies?

A

notoedres

62
Q

what part of the body is affected with feline scabies?

A

pinna, face, neck, forelimbs then whole body

63
Q

how do we treat feline scabies ?

A

lime sulfur dips or ivermectin injections

can also use selamectin or moxidectin

64
Q

what type of demodex affects cats?

A

demodex gatoi

65
Q

what cause of pruritus in cats has a “salt and pepper” appearance?

A

fur mite - lynxacarus

66
Q

how do we diagnose lynxacarus?

A

acetate tape or trichogram

67
Q

true or false.

Pyoderma is never seen in cats

A

false, it is RARELY seen in cats

68
Q

what can be a cause of non self-induced alopecia in cats?

A
  • endocrine disease

- paraneoplastic syndromes

69
Q

what can cause “skin fragility” in an alopecia cat ?

A

HYPER adrenocorticism

70
Q

what can give a shiny appearance to the skin in an alopecia cat?

A

pancreatic neoplasia which causes a paraneoplastic syndrome

71
Q

what clinical signs do we see in cats with miliary dermatitis?

A

crusted papules, erythema and secondary alopecia

72
Q

what are the 3 presentations of eosinophilic granuloma complex?

A
  1. indolent ulcers
  2. eosinophilic plaque
  3. collagenolytic/eosinophilic granuloma
73
Q

how to we confirm the lesion is part of the eosinophilic complex?

A

cytology will show eosinophils, can biopsy and culture as well

74
Q

what is the cornerstone of therapy with eosinophilic granuloma complex?

A

identifying and managing the underlying cause

75
Q

do we treat eosinophilic granuloma complex in cats with topicals or systemic drugs?

A
  • topicals not ideal because cats can lick off
  • systemic glucocorticoids are main stay of tx
  • can use antibiotics for secondary bacterial infections
76
Q

if you have a dog with patchy, focal (“moth eaten”) alopecia, what is likely the cause?

A

pyoderma or an infection

77
Q

if you have a dog with diffuse, bilaterally symmetrical alopecia, what is the likely cause?

A

endocrine or follicular dysplasia

78
Q

when evaluating a dog with alopecia, what are important things to know?

A
  • age of onset and breed

- pruritic vs non-pruritic

79
Q

what is folliculitis and what are some causes ?

A
  • inflammation of the follicle wall

- demodex, dermatophytes and pyoderma

80
Q

what is furunculosis?

A

rupture of deeply infected hair follicle within the dermis

81
Q

what is injection site alopecia and how does an animal acquire it?

A
  • hair loss at injection site or in a distant location

- idiosyncratic immunological rxn with rabies and lepto vaccines

82
Q

who is the reservoir for microsporum canis?

A

CATS NOT DOGS

83
Q

what kind of animal is ringworm (dermatophtosis) more likely to effect?

A

young cats

84
Q

what happens when a cat is exposed to ring worm that causes alopecia ?

A

invades anagen hairs/skin

85
Q

how do we diagnose ringworm?

A

fungal culture (DTM culture) mostly but can use woods lamp too (not always accurate)

86
Q

what is an important point to remember about the DTM culture for ringworm?

A

we have to watch it everyday because the color change happens at the same time there is growth

87
Q

true or false.

most healthy animals will self-cure if they have ringworm

A

true

88
Q

if healthy animals can self cure, why do we treat them?

A

to minimize possibility of zoonosis and environmental contamination

89
Q

what is the treatment for dermatophytosis?

A
  • environmental decontamination
  • topical treatments (lime sulfur dips, Rx shampoo)
  • systemic drugs (itroconazole, ketoconazole, NOT fluconazole - can cross BBB)
90
Q

how long do we treat for dermatophytosis?

A

we treat until there’s 1 or more negative fungal cultures

if using systemic treatment should treat until 2 negative cultures 1 month apart

91
Q

what is the systemic drug of choice for ring worm?

A

itraconazole

92
Q

what is the pathogenesis of demodex with juvenile onset?

A
  • depressed T cell function
  • decreased Th1 response
  • mite-specific immuno-incompetence
93
Q

what is the pathogenesis of demodex with adult onset?

A

immunosuppression (can be from drugs, concurrent disease, endocrine diseases or idiopathic)

94
Q

how do we diagnose demodex?

A
  • deep skin scrapes
  • trichogram
  • biopsy if indicated
95
Q

true or false.

most cases of generalized demodicosis that occur at 2-4 years of age were likely undiagnosed juvenile-onset demodicosis

A

true

96
Q

do we usually treat localized demodex?

A

no, 90% usually resolves but if secondary pyoderma is present we treat that

97
Q

true or false.

we treat localized demodex with glucocorticoids.

A

FALSE DO NOT USE GLUCOCORTICOIDS

98
Q

how do we treat generalized demodex ? what is the average duration of treatment?

A

usually daily ivermectin or weekly mitoban dips, average duration of treatment is about 3 months but can take 6 + months in some cases

caution using ivermectin with collies - MDR gene mutation

99
Q

true of false.

we never use glucocorticosteroids with generalized demodex.

A

True, NEVER use them

100
Q

does spontaneous remission of generalized demodex happen in up to 70% of young dogs?

A

NO, up to 50% of cases

101
Q

true or false.

you should neuter a dog with generalized demodex.

A

true, neuter dog after infection is controlled

102
Q

what is sebaceous adenitis?

A

inflammation and destruction of sebaceous glands, we don’t know the cause

103
Q

what are some important clinical signs of sebaceous adenitis?

A
  • long coated dogs: follicular casts

- short coated dogs: moth-eaten appearance

104
Q

how do we diagnose sebaceous adenitis?

A

skin biopsy from the dorsal surfaces

105
Q

how do we treat sebaceous adenitis ?

A

first choice - topical shampoos, topical sprays

second choice - systemic drugs

106
Q

when do we use second choice treatment for sebaceous adenitis?

A

when there is a biopsy or if first line treatment doesn’t work

107
Q

what breeds do we see familial dermatomyositis in?

A

collie and sheltie breeds

108
Q

what is the time line of clinical signs with familial dermatomyositis?

A
  • skin lesions at 2-6 months of age

- muscle atrophy at 3-5 months of age

109
Q

is alopecia of endocrine diseases pruritic?

A

NO

110
Q

what causes calcinosis cutis?

A

hyperadreoncoricism

111
Q

what is the most common underlying cause of demodicosis?

A

CUSHINGS DISEASE

112
Q

what disease looks just like an endocrine disease but has normal endocrine tests?

A
  • alopecia X
  • pattern baldness
  • recurrent flank alopecia
113
Q

what is the difference between alopecia X and endocrine diseases ?

A
  • hair loss starts earlier (around 3 years old)

- no systemic signs

114
Q

what breed has thinning hair coat on the ears ?

A

dachshund

115
Q

how can we definitively diagnose color dilution alopecia?

A

biopsy hair for abnormal hairshafts and distorted hair follicles full of keratin and melanin

116
Q

do we need a biopsy to confirm follicular dysplasia ?

A

yes

117
Q

what is recurrent flank alopecia and where does it effect ?

A
  • seasonal follicular dysplasia
  • flank and mid-lateral thorax
  • can be uni or bi-lateral
118
Q

how long can alopecia persist with post clipping alopecia?

A

12-24 months

SAM 2 (9 decks)

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