Dermatology Flashcards
Pruritis
Itch - unpleasant sensation of the skin that provokes the urge to scratch
What can lead to Pruritis in dogs?
Infection
Allergies
Parasites
What are the types of allergens that cause pruritis in dogs?
Flea allergen Atopy Food hypersensitivity Verminosis/mites Contact hypersensitivity
Atopy
environmental allergen
What Ectoparasites cause pruritis in dogs?
Sarcoptes Demodecosis Secondary pyoderma Cheyletiella Lice Chiggers
What infections are the causes of pruritis in dogs?
Pyoderma - bacterial infections
Dermatophytosis
Yeasts
What is responsible for alopecia of the caudal dorsum in dogs?
Flea allergy dermatitis
What is responsible for feet licking and chewing in dogs?
Food allergy
atopy
What is responsible for alopecia of the Elbows and ears in dogs?
Sarcoptic mange
What causes seasonal pruritis?
Flea allergy
Atopy
Insect allergy
What causes non-seasonal pruritis?
Scabies Food allergy Flea allergy Atopy Secondary infections Demodecosis
What is the scale used to Grade Pruritis?
Scale 1-10
What diseases are extremely pruritic?
Scabies
Flea bite allergy
Food allergy
If pruritis came before the lesions consider:
Allergies
Scabies
If lesions showed up before the pruritis consider:
Demodecosis
Dermatophytosis
What antibiotics cause allergic reactions?
Sulfonamides
Penicillins
Cephalosporins
What is the most common cause of skin disease?
Fleas
Primary Dermatological lesions
initial eruption that develops spontaneously as a direct reflection of the underlying disease
Appear and disappear quickly
Secondary Dermatological lesions
Evolve from primary lesions or are artifacts induced by the patients or by external factors such as trauma/biting/licking and medication
Stay around for a much longer time period
What are primary skin lesions?
Macule or Patch Papule or plaque Pustule Vesicle or bulla Wheal Nodule Tumor or cyst
What are characterized as primary or secondary lesions?
Alopecia Scale Crust Follicular casts Comedo Pigmentary abnormalities
What are secondary skin lesions?
Epidermal collarette Scar Excoriation Erosion or ulcer Fissure Lichenification Callus
Macule
Flat spot (<1cm) on skin with change in skin color
Patch
Macule >1cm
Papule
Small, solid elevation in skin up to 1 cm in diameter
Plaque
Coalition of papules forming flat-topped elevation
What causes a plaque?
a Hotspot
Vesicle
Elevation of epidermis filled with clear fluid
Bulla
Vesicle > 1 cm in diameter
Wheal
Sharply delineated lesion of edema
What causes Wheals?
Hypersensitivity
Nodule
Solid raised palpable lesion > 1cm. Can include abscess (fluctuant lesion in dermis or SQ from pus)
Nodule: Tumor
Large palpable mass - neoplastic
Cyst
Epithelial lined cavity with solid or fluid material
Alopecia
Absence of hair from area where it is normally present
Scale
Accumulation of loose fragments of horny layer of skin
Crust
Accumulation of dried serum, exudate on surface of skin
Follicular casts
Accumulation of keratin and sebaceous material stuck to a hair shaft
Comedone
Dilated hair follicle filled with debris
What breed is predisposed to Comedone?
Schnauzers
What causes Comedones?
Hyperthyroidism
Hyperadrenocorticism
Epidermal Collarette
Scale arranged in circular pattern
What is an epidermal collarette associated with?
Pustule
Vesicle
Bullae
Scar
Fibrous tissue has replaced the damaged dermis or s/c tissue
Excoriation
Linear abrasion of the skin
Erosion
Shallow ulcer that does not break the basal layer
Ulcer
Break in epidermis with exposure of dermis
Fissure
Linear cleavage (crack) in the epidermis or dermis caused by disease or injury
Lichenification
Thickening and hardening of the skin, note exaggerated skin lines
Callus
A localized hyperplasia of the stratum corneum of the epidermis caused by pressure or friction.
What is a common sites of Callus formation in dogs?
Elbows
lateral hock areas
What two dermatological parasites lead to eggs in the feces?
Hookworms
Sarcoptes
What are the surface mites seen on superficial skin scrape?
Sarcoptes Notoedres Otodectes Cheyletiella Demodex gatoi in cats
What are follicular parasites?
Demodex spp.
Anagen hair
active growth phase for the hair
Telogen hair
the hair has achieved maximum growth and is dying
What can you see on Acetate tape impression smear?
bacteria
fungi
yeasts
What type of hypersensitivity is Flea Allergic Dermatitis?
Type 1 Hypersensitivity
What is the most common allergic skin condition in dogs and cats?
Flea Allergic Dermatitis
Where is Flea Allergy Dermatitis distributed?
Lumbo-sacral distribution Tail base Caudo-medial thighs Ventral abdomen Flanks
What do cats present with with Flea Allergy Dermatitis?
Miliary dermatitis
What can be seen with Flea Allergy Dermatitis?
Pruritic crusting eruption secondary erythema seborrhea excoriation pyoderma hyperpigmentation lichenification
Seborrhea
Scaly skin
What is a more definitive diagnostic test for Flea allergy dermatitis?
Flea Antigen Test Intradermal flea allergy test
What is the treatment for Flea Allergy Dermatitis?
Flea eradication
What are the three types of flea eradication products?
Knock down product
Insect growth regulator
Environmental control
What does Advantage treat?
kills adult fleas before they lay eggs and prevent eggs from being shed
What does Revolution treat?
Kills adult fleas and prevents eggs from hatching
What does Vectra 3D treat?
prevents development of flea eggs and Larvae
What does Promeris treat?
kills fleas
What type of hypersensitivity is Atopy?
Type 1 Hypersensitivity
Atopy
Allergic dermatitis
What is the most common cause of Atopy?
House Dust Mites
What are the characteristic signs of Atopy?
Pruritis
Chronic or relapsing/seasonal signs
What is the age of onset for Atopy?
4 months to 7 years
Where is Atopy distributed?
Paws Face Distal extremities elbows ventrum otitis
How do you diagnose Atopy?
Serum test (RAST and ELISA tests) Intradermal skin tests
What do Allergy tests detect?
Allergen-specific IgE
What is the gold standard for diagnosing Atopy?
Intradermal allergy testing
What are the three possible therapies for Atopy?
ASIT (Allergen-specific immunotherapy)
Allergen avoidance
Symptomatic relief
What are the two forms of allergy shots?
Subcutaneous immunotherapy
Sublingual immunotherapy
What is a weak therapy for the treatment of Atopy?
Antihistamines
Antidepressants
Essential fatty acids
Topical therapies
What is a fair therapy for the treatment of Atopy?
Skin lipid therapy
What is a strong therapy for the treatment of Atopy?
Glucocorticoids
Cyclosporine A
Oclacitinib
How does Skin Lipid complex work?
restores the epidermal barrier
What are the side effects of Corticosteroids?
PU/PD Polyphagia Weight Loss Iatrogenic hyperadrenocorticism Iatrogenic hypoadrenocorticism with sudden withdrawal Susceptible to infections Urinary incontinence Behavior changes
What is Cyclosporine A?
Anti-allergic and immunosuppressive
What are the side effects of Cyclosporine A?
V/D
exacerbates skin infections
How does Oclacitinib work?
Janus kinase inhibitor - JAK1 and JAK 3 enzymes
Decreases itching and inflammation
What are the first antihistamines used?
Hydroxyzine and Citirizine
What are the second antihistamines used?
Clemastine
What are the clinical signs associated with Adverse food reactions?
Vomiting diarrhea abdominal discomfort bloat Dermatological signs
Food idiosyncrasy
Resembles food allergy but does not involve immune system
Food poisoning
Direct non-immune response to a food or toxin
Pharmacological reaction
Drug-like or pharmacological effect of food on host
Food indiscretion
Gluttony, pica, or ingestion of indigestible material
What does Lactose intolerance cause?
diarrhea
bloating
abdominal discomfort
What fish contains histamine and vasoamine?
Mackerel
Tuna
What does Acute Food Allergy cause?
Systemic consequences
Respiratory distress
Vascular collapse
Urticaria
What are the antigens related with Food allergies?
Proteins
Glycoproteins
Carbohydrates
What are the most common food antigens in dogs and cats?
Beef protein
What food is food allergy in dogs related to?
Beef protein
What food is food allergy in cats related to?
Beef protein
Fish
What type of hypersensitivity are food allergies commonly?
Type 1 hypersensitivity
What are the clinical signs of food allergies?
Pruritis
Hyperemia
Angioedema
Local reaction in GIT: Diarrhea, Abdominal discomfort/bloating, vomiting
What is the third most common hypersensitivity skin disease?
Food Allergies
What is the age of onset for food allergies?
less than 1 year of age
What time of year does food allergies happen at?
Non-seasonal - more in summer when wet and humid
What Primary type of lesions do you see with food allergies?
local or generalized pruritis Recurrent moist dermatitis Papules Erythema Wheals Plaques/pustules
What secondary type of lesions do you see with food allergies?
Excoriation Crusting Hyperpigmentation lichenification ulcers due to deep scratches
Where are the lesions localized with food allergies on dogs?
Muzzle Ears Distal limbs Paws Axillae Groin region
Where are the lesions localized with food allergies on cats?
Head
Face
Pinnae
Neck
What clinical signs are sometimes seen with food allergies?
Vomiting
diarrhea
Colic
What is the treatment for food allergies?
Positive response to an elimination diet
How long does it take for food allergies to improve in dogs?
3 weeks
What is the biggest limitation for food allergy treatment?
Owner compliance
How do you diagnose food allergies?
Intradermal skin testing
ELISA Serology
Colonoscopy allergen provocation
Skin biopsy
What are the three options available for treatment of food allergies?
Low allergy commercial diet
Homemade hypoallergenic diet
Hydrolyzed protein diet
Hydrolyzed protein diet
Protein is hydrolyzed into small particles less than 10,000 Daltons
Urticaria
Hives
Angioedema
Swelling of the subcutaneous tissue of the neck and face
How do you treat Urticaria and Angioedema?
Remove the antigen
Injectable antihistamines
Injectable steroids
Dyspnea
What is the type of hypersensitivity for Contact Dermatitis?
Type 4 Hypersensitivity reaction
What causes contact dermatitis?
Prolonged exposure with an offending surface
What are the clinical signs of contact dermatitis?
Pruritic lesions
Hairless areas
Lips affected if food bowl is the cause
Neck lesions if the collar is the problem
How do you diagnose Contact Dermatitis?
Rule out differential
Patch Test
Histopathology
What is the treatment for Contact Dermatitis?
Identify and remove the offending allergen
What are the common ectoparasites of dogs?
Sarcoptes Demodecosis Cheyletiella Lice Chiggers
What results in intense pruritis?
Sarcoptic mange
Clinical signs of Sarcoptic mange?
Positive pinnal pedal reflex intensely pruritic poorly steroid responsive sparsely haired areas Secondary weight loss
What areas are affected by Sarcoptic mange?
Hocks
elbows
pinnal margins
ventral abdomen and chest
How do you diagnose Sarcoptic mange?
Response to treatment
Positive pinnal-pedal reflex
Fecal Flotation
How do you treat Sarcoptic mange?
Topical dips: anti-seborrheic shampoo
Topical spot on or systemic: Selamectin, Moxidectin, Ivermectin, Milbemycin, Fipronil
How is demodex transmitted?
during the first three days of life during suckling
What does Demodex cause?
Parasitic folliculitis
Clinical signs of Demodex
Focal and patchy alopecia
Pododermatitis
Inflammation between the paws
Localized Demodecosis
One to several well circumscribed erythematous, scaly, non-pruritic areas of alopecia on the face and fore-limbs
Generalized Demodecosis
less than 12 lesions Coalescing over the general body
How do you diagnose Demodecosis?
Deep Skin scrapes
Biopsy
Histopathology
What is the treatment for Localized Demodecosis?
Heals spontaneously
What is the treatment for Generalized Demodecosis?
Long term treatment of Amitraz for 3 weeks
What should you avoid with Demodecosis?
Steroids
What are the clinical signs of Cheyletiella?
Walking dandruff
Scaling
Pruritis
Papular crusts
How do you diagnose Cheyletiella?
Seen with the naked eye crawling on fur
Acetate tape test
Treatment of Cheyletiella
Topical: Shampoos, Spot-ons
Treat environments
What causes Hookworm dermatitis?
Ancylostoma
Uncinaria
What are the clinical signs of Hookworm dermatitis?
Interdigital areas areas in contact with the ground Intensely pruritic Erythema alopeica thickening
How do you diagnose Hookworm dermatitis?
Fecal flotation
Where on the body do you find Chiggers?
legs
head
abdomen
Where on the body do you find chiggers on cats?
inside the ears
How do you diagnose Chiggers?
Skin scrapes
Red color
Clinical signs
How do you treat Chiggers?
Two pyrethrin dips spaced 2 weeks apart
Topical antiparasitic drugs
What are the four types of surface pyoderma?
Pyotraumatic pyoderma
Intertrigo
Mucocutaneous pyoderma
Bacterial overgrowth
Impetigo
a condition that occurs in puppies on their ventral abdomen from bacterial overgrowth
Furunculosis
infection has broken through follicle and into the skin
Cellulitis
infection of the fat under the dermis
What is an exampled of Surface pyoderma?
Hotspot
Surface pyderma
Surface of skin
Superficial pyoderma
Epidermal layer and/or hair follicles, papules, pustules, epidermal collarettes, crusts
Deep pyoderma
Dermal layer or subcutis plus follicles. Exudation of blood and/or pus, crusting, odor ulceration, tract fistula, swelling
How do you treat surface mixed pyoderma?
Topically
How do you treat superficial staphylococcus pyoderma?
Systemic and topical
How do you treat deep pyoderma?
Systemic, long term, topical
What are the clinical signs of pyoderma?
Pustules
Papules
Crusts
How do you diagnose pyoderma?
Cytology of bacteria
Culture
When is a bacterial culture mandatory for pyoderma?
less than 50% improvement within 2 weeks of treatment New lesions Residual lesions at 6 weeks Intracellular rods on cytology History of MRSA or MRSP
What do you culture for pyoderma?
Pustules
Under crusts
Epidermal collarettes
Why is Topical therapy important?
Decreases duration of systemic Antibiotics
When do you use Benzoyl Peroxide with pyoderma?
Pyoderma with oily seborrhea or comedones
When do you use Chlorhexidine with pyoderma?
Pyoderma with dry seborrhea or normal skin/coat
Mupirocin
bacteriostatic/bacteriocidal used topically and effective against Gram-positive including MRSA
Silver Sulfadiazine
topical antibacterial used topically on wounds, burns, and ear infections including Pseudomonas
What do you use for 1st tier pyoderma therapy?
Cephalosporins
Clavamox (Amoxicillin + Clavulanic acid)
Clindamycin
What do you use for 2nd tier pyoderma therapy?
Sulfas
Erythromycin
Lincomycin
Doxycycline
What is used as a LAST RESORT for pyoderma therapy?
Fluoroquinolones
3rd generation cephalosporins
For how long do you treat superficial pyoderma?
1 week beyond resolution
For how long do you treat deep pyoderma?
2 weeks beyond resolution
What type of pyoderma is Acute traumatic pyodermatitis?
Surface pyoderma
What type of pyoderma is Puppy pyoderma/ impetigo?
Superficial pyoderma
What type of pyoderma is Nasal folliculitis/furunculosis?
Superficial and deep pyoderma
What type of pyoderma is Chin acne or chin pyoderma?
deep pyoderma
What type of pyoderma is Lick granuloma (acral lick dermatitis)?
deep pyoderma
Mucocutaneous pyoderma
Bacterial infection of the lips
What are the clinical signs of Mucocutaneous pyoderma?
Mucocutaneous swelling
erythema
crusting
painful pruritic fissures
How do you treat Mucocutaneous pyoderma?
Clip and clean the area
Mupirocin
What are the clinical signs of Pyotraumatic dermatitis?
Lesion, red, moist, exudative crusting
Alopecia
painful lesions
How do you treat Pyotraumatic dermatitits?
Clip and Clean area
Clean with antibacterial disinfectant
Topical treatment: Antibiotic/steroid
What causes Impetigo?
Staphylococcus spp.
What is the pathogenesis of Impetigo?
Poor husbandry
What are the clinical signs of Impetigo?
Vesicles/pustules
Non-follicular pustules
Ventral hairless areas
How do you diagnose Impetigo?
Cytology
How do you treat Impetigo?
Antibacterial shampoos
Topical antibiotics washes/creams
What causes Superficial pyoderma?
Staphylococcus pseudintermedius
What is the underlying cause for superficial pyoderma?
Self trauma
Parasitic infestation
What are the 3 most common causes of folliculitis in dogs?
Bacterial
Dermatophytes
Demodex
What can folliculitis progress to?
Furunculosis
cellulitis
What are the clinical signs of Superficial pyoderma?
Tiny pustules with hair shaft protruding from center Follicular papule Patchy focal alopecia Epidermal collarette Scaling Seborrhea Hyperpigmentation excoriation
How do you diagnose Superficial pyoderma?
Recognition of lesions
Cytology from skin scrape
How do you treat Superficial pyoderma?
Antibiotics for a minimum of 21-28 days
Antibacterial shampoo
What is the physical component of the defense of the skin?
Compact stratum corneum
Lipid emulsion and intercellular cement
What is the most important pathogen in deep pyoderma?
Staphylococcus pseudintermedius
What predisposes skin to disease?
Seborrhea
What are the clinical signs of deep pyoderma?
Deep draining tracts
clusters of ulcers
necro-hemorrhagic purulent bullae or abscesses
How do you diagnose Deep Pyoderma?
Cytology: Cocci found in pyogranulomatous exudate
Biopsy
Bacterial culture and antibiogram
How do you treat deep pyoderma?
Topical management
Systemic antibiotics
How long do you treat deep pyoderma?
2 weeks after resolution
What are common antibiotics used to treat deep pyoderma?
Amoxycillin - clavulanic acid Cephalexin Trimethoprim sulfas Enrofloxacin Erythromycin
What are the clinical signs of Actinomyces?
Subcutaneous abscesses, draining tracts
Thick yellow-grey hemorrhagic fowl-smelling exudate +/- sulphur granules
How do dogs get Actinomyces?
infection from trauma, penetrating wounds
How do you diagnose Actinomyces?
Anaerobic culture
Cytology
How do you treat Actinomyces?
Surgical debulking
Long term Antibiotics: Clindamycin
What type of bacteria is Actinomyces?
Gram positive anaerobic
What type of bacteria is Nocardia?
Gram positive filamentous aerobe
Clinical signs of Nocardia?
Pyothorax
How do you diagnose Nocardia?
FNA/Cytology
Histopathology
Culture
How do you treat Nocardia?
Surgical debulking, drainage
Long term antibiotics
What are the clinical signs of Mycobacteria?
Slowly developing subcutaneous nodules, non-healing abscesses, cellulitis, ulcer, fistulas
Drain sero-anguineous/purulent exudate
Regional lymph nodes enlarged
How do you diagnose Mycobacteria?
Cytology
Histopathology
Culture
How do you treat Mycobacteria?
Wide surgical excision
Long term antibiotics
What are the clinical signs of Skin fold pyoderma/Intertrigo?
Moist malodorous pruritic in between skin folds
Where do you find Skin fold pyoderma/Intertrigo?
Lip fold in spaniels facial folds in bulldogs tail root folds vulva folds body folds in Shar Pei
How do you diagnose Skin fold pyoderma/Intertrigo?
Clinical presentation
signalment
What is the treatment for Skin fold pyoderma/Intertrigo?
Topical: Shampoos, rinses, topical antibiotics
Where do you commonly find Malassezia dermatitis?
Ear Lip folds ventral neck Axilla Interdigital Perianal
What is Malassezia associated with?
Allergic dermatitis
Endocrinopathies
Keratinization disorders
Immunosuppression
What are the clinical signs of Malassezia?
Pruritis Malodor Erythema Greasy scaly plaques Paronychia
Seborrhea oleosa
Greasy skin
How do you diagnose Malassezia?
Cytology
How do you treat Malassezia?
Anti-yeast shampoos 2-3x week
Systemic: Ketoconazole, Itraconazole
What are the clinical signs of Dermatophytosis?
Circular alopecia with scaling
What is important about Dermatophytosis?
zoonotic
What is the most common fungal infection of humans?
M. canis
How do you diagnose Dermatophytosis?
Wood’s Lamp
Microscopy of hair pluck
Fungal culture
Biopsy
How do you manage Dermatophytosis?
Treat underlying diease
treat source
treat organism
How do you treat Dermatophytosis?
Topical therapy:
Systemic therapy: Griseofulvin, Ketoconazole, Itraconazole
How long do you treat for Dermatophytosis?
6-12 months
What do you do for animals in catteries with dermatophytosis?
Separate infected animals
Treat the animals
Decontaminated the environment
How does pruritis differ in cats from dogs?
Owner may not see pruritis
How are skin lesions different in cats with pruritis?
Bilateral symmetrical hair loss with normal skin
Miliary dermatitis
Eosinophilic granuloma complex
What are common skin conditions in cats?
Fleas
Ringworm
What is the reason for hair loss if the hair is granular and course in cats?
Cat is licking itself
What is the reason for hair loss if the hair is smooth in cats?
Hair is falling out by itself
What ectoparasites are seen in cats?
Notoedris Demodex gatoi Cheyletiella Ectopic ear mites Fur mites
How do you diagnose Psychogenic alopecia in cats?
Diagnosis of rule out
What causes symmetrical alopecia in cats on the medial thighs, ventral abdomen, and medial forelimbs?
Anxiety
What areas of the cat are affected by symmetrical alopecia in cats?
Medial thighs
Ventral abdomen
Medial forelimbs
What causes pruritic symmetrical alopecia in cats on the caudodersal aspect?
Flea bite dermatitis
How do you treat Psychogenic symmetrical alopecia in cats?
Behaviour modification
Antipsychotics
What areas of the cat are effected by atopic dermatitis?
medial thighs
ventrum
forelimbs
flanks
Feliway
Pheromones released during birth used to soothe anxious cats
What parts of the cat are affected by Notoedres cati?
Pinna face neck forelimbs whole body
What are the clinical signs of Notoedres cat?
Alopecia
wrinkled skin
papular rash
crusts
How do you diagnose Notoedres cati?
Skin scrapes
How do you treat Notoedres cati?
Lime sulphur dips
Ivermectin
Selamectin
Imidocloprid
What are the side effects of Ivermectin used in cats?
Neurological problems
How do you diagnose Demodex in cats?
Deep skin scrape
What are the clinical signs of Demodex gatoi?
Alopecia
crusts
scaling
pruritis
How do you treat Demodex gatoi?
Lime sulphur dips with Elizabethan collar
What are the clinical signs of Fur mites in cats?
“salt and pepper” appearance of mites
Hair falls out easily
How do you diagnose Fur mites in cats?
Acetate tape test
How do you treat Fur mites in cats?
Pyrethrin spray Lime sulphur dip Fipronil spray Ivermectin Selamectin Milbemycin
What endocrine diseases in cats cause Symmetrical alopecia?
Hyperthyroidism
Hyperadrenocorticism
What non-pruritic lesions cause symmetrical alopecia in cats?
Pancreatic neoplasia
What areas on the a cat are affect by Pancreatic neoplasia?
Ventrum and legs
What are the clinical signs of Pancreatic neoplasia symmetrical alopecia?
“shiny appearance of the skin
Hair epilates easily
concurrent anorexia
lethargy
Miliary dermatitis
Crusted papule multifocal distribution of skin lesions with no identifiable pattern Erythema secondary alopecia excoriations
What is the most common cause of miliary dermatitis?
Flea allergic dermatitis
What viruses can cause miliary dermatitis in cats?
Herpes
FIV
FeLV
What are the three presentations of Eosinophilic granuloma complex?
Indolent ulcers
Eosinophilic plaques
Collagenolytic granuloma
Indolent ulcer
well-circumscribed proliferative inflammatory lesions with a dish shaped ulcer centrally
Where do you find Indolent ulcers in cats?
Upper or lower lip
Eosinophilic plaque
well circumscribed reddish yellow ulcerated edematous intensely pruritic plaque
What is eosinophilic plaque associated with in cats?
Allergic etiology
Collagenolytic granuloma/eosinophilic granuloma
Well circumscribed linear or raised nodular firm yellow-pink lesion
Where do you find Atypical eosinophilic granuloma on cats?
over the bridge of the nose, ear pinnae
How do you diagnose Eosinophilic granuloma complex in cats?
Cytology
+/- culture
Biopsy
Histopathology
What is the treatment for eosinophilic granuloma complex in cats?
Strict parasite control
Medical therapy: Glucocorticoids, Cyclosporine A
What is the pathogenesis of Feline Acne?
Idiopathic disorder of follicular keratinization
What are the clinical signs of Feline Acne?
Comedones on the chin and lower lip
Papules and pustules
Furunculosis and scaring
What is the treatment for Feline Acne?
Treat secondary infection
Clip hair and clean the area with human acne preparation
What are the infectious causes of Feline Acne?
Bacterial: Nocardia, Actinomyces, Mycobacterium
Fungal: Dermatomycoses
What are the non-infectious causes of Feline Acne?
Panniculitis
Collagenolytic granuloma
Foreign bodies
Neoplasia
What are the clinical signs of Feline Acne?
Nodules that open up and drain
Draining tracts
Draining fluid may be serous to purulent
How do you diagnose Feline Acne?
Full dermatological examination
Skin biopsy
How do you treat Feline Acne?
Treat underlying disease
What are the two parts to the Tympanic membrane?
Pars flaccida
Pars tensa
Bulging Pars tensa
Material in the tympanic bulla
Otitis externa
Inflammation of the ear canal
Predisposing causes of Otitis externa?
Stenosis Hair in canals Pendulous pinnae swimmers ear overactive glands polyps neoplasms
Primary causes of Otits externa
Parasites Microbes Atopy food hypersensitivities drug reactions contact hypersensitivity Keratinization disorders glandular disorders autoimmune diseases solar dermatitis
Perpetuating factors of Otitis externa
Bacteria yeast topical reactions foreign bodies Epidermal hyperplasia hyperkeratosis dermal edema or fibrosis lumen stenosis cartilage mineralization tympanic membrane changes middle ear disease
What do you do if the ear is too inflamed to exam?
send home anti - inflammatories for 4-7 days
What are the main causes of otitis externa in dogs?
Allergies
What is the main cause of otitis externa in cats?
Parasites
What are the 2 important aspects of the ear that are predisposing factors?
Conformation
Hair
What does head shaking cause?
Hematoma
Clinical signs of acute Otitis externa?
Head shaking Scratching ears Rubbing ears Otic discharge Malodor Red pinna Swollen ear
What does coffee ground ear discharge mean?
Mites
What does Moist brown ear discharge mean?
Staph or yeast
What does creamy yellow ear discharge mean?
Gram negative bacteria
What does oily yellow tan ear discharge mean?
glandular disorder, hypersensitivity
How do you diagnose Otitis externa?
Ear smears
Bacterial culture and sensitivity
Radiography
Computed tomography
How do you clean Otitis externa?
Control the predisposing causes
Ceruminolytic
Removal of pus
Drying agent
Ceruminolytics
emulsify waxes/lipids so they can be flushed away
What do you avoid if you can’t seen an intact pars tensa?
Ceruminolytics
cleaning solutions
dyring agents
What are the clinical signs of a ruptured Tympanic membrane?
Deafness
Head tilt
Horner’s Syndrome
How do you treat Otitis externa?
Glucocorticoids
Antibiotics
antifungals
parasiticides
Poloxamer otic gels
change to gel at body temperature
compounded with various drugs
Reaches horizontal ear canal without puncturing the tympanic membrane
What do you used to treat Gram negative gentamycin resistant infections?
Polymixin-B
How do you treat Otitis externa?
Topical preparations Polymixin-B Topical enrofloxacin TRIS EDTA Antiseptics Silversulfadiazine Systemic therapy: Glucocorticoids, Antibiotics, Antifungals, Antiparasiticides
Persistant Otitis Externa
Greater than 2 months
Recurrent Otitis externa
Greater than 6 months
Otitis media
inflammation of middle ear
5 ways to diagnose OM
Signs: Horner’s syndrome and/or facial paralysis
Abnormal tympanic membrane: ruptured, bulging
Bullae rads/CT/MRI
Myringotomy
Cytology and culture of middle ear
How does OM causes Horner’s syndrome?
disrupts the SYmpathetic nervous system and the facial nerve traveling through the middle ear
What is common in CKCS?
Primary secretory otitis media (PSOM)
How do you diagnose Primary Secretory otitis media?
a bulging pars flaccida = PSOM
How do you treat Primary Secretory Otitis media?
Myringotomy and middle ear flush
Primary Keratinization disorders
Zinc-responsive dermatosis Sebaceous adenitis Primary idiopathic seborrhea Schnauzer comedo syndrome Ear margin dermatosis
Crusting Dermatitis
Superficial necrolytic dermatitis
Seborrhea sicca
dry skin, white or grey flakes, scales
Seborrhea oleosa
Oily skin, greasy feel to haircoat, rancid odor, brown sticky yellow scales
Zinc-responsive dermatosis Syndrome 1
Decreased capacity to absorb zinc from intestines
Zinc-responsive dermatosis Syndrome 2
Dietary deficiency
What is the treatment for Zinc-responsive dermatosis?
Oral zinc
Fatty acids
low dose glucocorticoids
What are the clinical signs of Zinc-responsive dermatosis?
Pruritis and scales/crusts on the mouth, chin, eyes, ears, elbows, pressure points, scrotum, prepuce, vulva
Hyperkeratotic footpads
Sebaceous adenitis
Uncommon idiopathic dermatosis
Sebaceous gland destruction/inherited defect
Cell mediated immunological reaction
Defect in keratinization/obstruction of sebaceous ducts
Abnormal lipid metabolism
Clinical signs of Sebacous adenitis
Bilaterally symmetrical on face, head, pinnae, and trunk
Ceruminous otitis externa
dogs have a rat tail
non-pruritic
Clinical signs of Sebacous adenitis in cats
multifocal annular lesions of scale, crust and broken hair and hair casts and alopecia starting around their head and moving caudally
Treatment for Sebacous adenitis
Keratinolytic shampoos
Omega 3/6 fatty acids
Retinoids
Cyclosporine
Primary idiopathic seborrhea (vitamin A responsive dermatosis)
Hereditary disorder of keratinization causing epidermal turnover in 7 days
causes abnormal cornification and desquamation
At what age does Primary idiopathic seborrhea happen?
starts weeks to months after birth.
Mild scaling worsens with age
Clinical signs of Primary Idiopathic seborrhea?
Follicular casts prominent
Ceruminous otitis
How do you diagnose Primary Idiopathic Seborrhea?
Exclude all other causes
Eliminate secondary factors
Biopsy
How do you treat Primary Idiopathic Seborrhea?
Oral vitamin A
Schnauzer comedo syndrome (Schnauzer bumps)
inherited dysplasia of the hair follicle resulting in the formation comedones on the back
What are the clinical signs of Schnauzer comedo syndrome (Schnauzer bumps)?
Sharp
crusted ppapular eruptions from neck to tail base
Secondary folliculitis and furunculosis
How do you treat Schnauzer comedo syndrome (Schnauzer bumps)?
Regular antiseptic and anti-seborrheic shampoo
Humectants after shampoo
Topical benzoyl peroxide gel
Isotretinoin
With what breeds are Ear margin dermatosis common in?
Dachshund
Clinical signs of Ear margin dermatosis
Follicular casts and partial alopecia on pendulous ears
Treatment for Ear margin dermatosis
Moisturizing agents
topical sulfur salicylic acid shampoo
topical g-corticoid cream
pentoxifylline
What is the age of onset for Superficial necrolytic dermatitis?
10 years old
Clinical signs of Superficial necrolytic dermatitis
Hyperkeratotic crusty cracking footpads Erythema Scaling crusting erosive
What parts of the body are affected by Superficial necrolytic dermatitis?
Mucocutaneous junctions Legs hocks elbows ear pinna
How do you diagnose Superficial necrolytic dermatitis?
Liver dysfunction seen on CBS and Chem panel
Honey comb pattern in liver or mass in pancreas
biopsy lesions
Behavioural dermatoses
Acral lick granuloma
Acral lick granuloma
Self-induced trauma of skin through excessive licking and chewing
How do you diagnose Acral lick granuloma?
Histopathology
Bacterial culture and antibiogram
How do you treat Acral lick granuloma?
treat underlying cause treat secondary bacterial infections topical analgesia Steroids tricyclic antidepressants serotonin re-uptake inhibitors
Idiopathic lupoid onychodystrophy
Lupus-like disease resulting in claw loss
Clinical signs of Idiopathic lupoid onychodystrophy
Acute nail loss
All claws affected
Nails are deformed and brittle with secondary infection
What is the most common nail disorder of cats?
Idiopathic lupoid onychodystrophy
How do you diagnose Idiopathic lupoid onychodystrophy?
Histopathology
Amputation P3/dewclaw
How do you treat Idiopathic lupoid onychodystrophy?
Essential fatty acids, Vitamin E
How do you diagnose Immune-mediated skin disorders?
Histopathology
Biopsy
What is the treatment for Immune-mediated skin disorders?
Immunosuppressive drugs: Glucocorticoids, Cyclosporine A
Pemphigus complex
Vesiculobullous to pustular disorders of the skin or mucous membranes characterized by acantholysis
Acantholysis
a loss of intercellular connections resulting in a loss of cohesion between keratinocytes
Pemphigus erythematosus
Benign form of pemphigus foliacious
What can aggravate Pemphigus erythematosus?
UV light
What are the clinical signs of Pemphigus erythematosus?
Erythema
pustular dermatitis on the face and ears
oozing crusts, scale, alopecia, and erosion bordered by epidermal collarettes
Depigmented nose
How do you diagnose Pemphigus erythematosus?
Histopathology and immunofluorescence
How do you treat Pemphigus erythematosus?
Sun avoidance
Topical glucocorticoids or cyclosporine
What is the most common immune mediated condition?
Pemphigus foliaceus
What is the major antigen of Pemphigus foliaceus?
desmoglein 1
what is the age of onset of Pemphigus foliaceus?
4 years
Clinical signs of Pemphigus foliaceus?
Pustular dermatitis
Pustular crusting
On the face, ear, feet, clawbeds, footpads, and groin
Scales
alopecia
erosions bordered by epidermal collarettes
Nasal depigmentation
How do you diagnose Pemphigus foliaceus?
Skin biopsy
Histopathology with immunofluorescence
Treatment of Pemphigus foliaceus
Topical corticosteroids or cyclopsporine
Pemphigus vulgaris antibodies
desmoglein 3
Clinical signs of Pemphigus vulgaris
Anorexic
depressed
febrile
vesiculobullous disease
erosive to ulcerative disorder that affects the oral cavity, mucocutaneous junctions, skin
Cutaneous lesion sin the axillae and groin region
ulcerative paronchyla
How do you diagnose Pemphigus vulgaris?
Skin biopsy
Histopathology
Immunofluorecence
How do you treat Pemphigus vulgaris in dogs?
High dosese of oral prednisolone and azathioprine
How do you treat Pemphigus vulgaris in cats?
Chlorambucil
Bullous pemphigoid
Subepidermal vesicle formation due to autoantibodies against antibodies of the basal cell hemidesmosomes
What are the clinical signs of Bullous pemphigoid?
Cutaneous lesion in groin and axillae and nail beds - vesicle/bullae ulceration bordered by epidermal collarettes
Oral lesions
How do you diagnose Bullous pemphigoid?
Skin biopsy
immunofluorescence
What is the treatment for Bullous pemphigoid?
Immunosuppressive therapy
Immunomodulatory therapy
Lupus erythematosus
autoimmune disease process where T-cells predominate in these disease
DLE
Discoid Lupus erythematosus
SLE
Systemic Lupus erythematosus
What aggravates Discoid Lupus erythematosus?
UV light exposure
What cells predominate Discoid Lupus erythematosus?
T-helper cells
What is the reason for Discoid Lupus erythematosus?
T-helper cells are activated by damaged keratinocytes which have elevations of ANA
What is the reason for Discoid Lupus erythematosus?
T-helper cells are activated by damaged keratinocytes which have elevations of ANA
What are the clinical signs of Discoid Lupus erythematosus?
Depigmentation erythema scaling of the nose Erosions ulceration crusting
How do you diagnose Discoid Lupus erythematosus?
Histopathology
Thickening of the basement membrane zone due to cellular infiltration
How do you treat Discoid Lupus erythematosus?
Avoid sunlight topical sunscreens Topical and systemic corticosteroids Vitamin E Immunomodulatory/immunosuppressive
What are the clinical signs of Systemic Lupus erythematosus in dogs?
Fever polyarthritis proteinuria skin disease Alopecia erythema vesiculobullous to ulcerative disorder
How do you diagnose Systemic Lupus erythematosus?
ANA test
Histopathology/immunohistochemistry of the skin or oral mucosa
How do you treat Systemic Lupus erythematosus?
Immunosuppressive therapy
Immunomodulatory agents
What are the cutaneous effects of a Cutaneous adverse drug reaction?
ALopecia purpura poor wound healing hyperpigmentation pruritis Erythema multiforme toxic epidermal necrolysis Urticarial plaques vesciles or bullae
Where are the lesions distributed with Erythema multiforme?
Ventrum axillae groin Mucocutaneous junction Oral cavity Pinnae Footpads
How do you diagnose Erythema multiforme?
Clinical signs
Histopathology
How do you treat Erythema multiforme?
Eliminate trigger
What is the cause of Toxic epidermal necrolysis?
Drugs
Flea dips
What are the clinical signs of Toxic epidermal necrolysis?
Multifocal or generalized vesiculobullous disease
How do you diagnose Toxic epidermal necrolysis?
Skin biopsy - full thickness epidermal necrolysis with minimal inflammation
How do you treat Toxic epidermal necrolysis?
Find underlying causes
systemic glucocorticoids
Clinical signs of Vasculitis?
Purpura wheals edema papules nodules alopecia scarring necrosis ulceration of the extremities
How do you diagnose Vasculitis?
Histopathology
How do you treat Vasculitis?
Find underlying disease
Pentoxifylline
Immunosuppressive drugs
Immunomodulatory drugs
Nodule
Solid, raised palpable lesion greater than 1 cm
Tumor
Larger, palpable mass of neoplastic origin
Diagnostic approach to nodules
FNA of nodule and the lymph node draining the area
impression smear of any discharge
Biopsy
Culture
What is the etiology of Papillomatosis in dogs?
Papilloma virus or idiopathic
What is the signalment of a dog with oral papillomatosis?
Young or immunosuppressed
Diagnostics for Papillomatosis
FNA
Excisional biopsy
Treatment for Papillomatosis
Crushing Laser or cryotherapy Azithromycin for 3 weeks Topical Imiquimod for 1-2 days Interferon Surgical excision
Nodular panniculitis/steatitis
Solitary to multiple, Firm to floculant, Raised, well demarcated and can ulcerate and scar
Inflamed S/C fat caused by systemic disease
Where do you find Nodular panniculitis/steatitis?
Dorsal trunk, neck, prox. limbs
Where do you find Sterile pyogranuloma in dogs?
Head
Pinna
Feet
footpads
How do you treat Sterile pyogranuloma in dogs?
Corticosteroids
Tetracycline + Niacinamide
Azathioprine
Cyclosporine A
What is the age of animals with Histiocytoma?
Less than 4 years old
Where do you find Histiocytoma on dogs?
Cranial 1/4 of body
How do you diagnose Histiocytoma in dogs?
Aspiration cytology
How do you treat Cutaneous Histiocytoma in dogs?
Steroids
Cyclopsorine
Tetracycline + Niacinamide
How do you treat Systemic Histiocytoma in dogs?
Cyclosporine
Lomustine
Where do you find Histiocytosis on felines?
Legs
Feet
Face
Nodular dermatofibrosis
Multiple cutaneous nodules consisting of mature collagen hyperplasia seen in 3-7 year old German Shepards
What is Nodular Dermatofibrosis associated with?
Bilateral renal cysts
Cystadenomas
Cystadenocarcinomas
How do you treat Nodular dermatofibrosis?
Treat underlying disease
Remove masses if possible
no effective treatments
What is the etiology of Juvenile cellulitis?
Unknown
Maybe Immune mediated
What is the signalment of Juvenile Cellulitis?
3 weeks to 6 months in Gordon Setters, Golden Retrievers, and Dachshunds
Clinical signs of Juvenile Cellulitis
Acute non-pruritic
swelling face submandibular of the Lips, muzzle, and eyelids
What is the common name of Juvenile Cellulitis?
Puppy Strangles
How do you diagnose Juvenile Cellulitis?
Cytology
Biopsy
Culture
How do you treat Juvenile Cellulitis?
Topical: treat crusts
Systemic: Prednisolone then EOD
Sebaceous cyst
Cysts are epithelial lined cavities with either solid or fluid material that develop when a hair follicle or skin pore gets blocked by dirt, debris, scar tissue, or infection
What is the treatment for Sebaceous cyst?
Can resolve without treatment
Excision
How do you prevent Sebaceous Cyst?
Benzoyl peroxide
What should you avoid doing to Keratin Inclusion Cyst?
Lesions should not be manually expressed since such manipulation can cause subepidermal rupture and furunculosis
How do you treat Lipomas?
Surgically remove
Clinical signs of Fly Bite Dermatitis from biting flies?
Tips of ears - erythema, bleeding, oozing, crusting
Clinical signs of Fly Bite Dermatitis from Tumbu flies?
Tail base, ventral abdomen - painful, reddend nodule (3-5mm in diameter)
Treatment for Fly Bite Dermatitis?
Topical fly repellant
Remove maggots
Cover the breathing holes with vaseline