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RUSVM SAM 2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

18month male neutered Daschund has been itching and scratching over the lumbar-sacral region for a week

Exam shows erythema, excoriation, and alopecia

What would your problem list be and DDX for this patient?

A

Problem list

  • alopecia
  • moderate excoriation/hyperaemia
  • severe pruritus

DDX

  • flea bite hypersensitivity
  • demodecosis
  • superficial bacterial pyoderma
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2
Q

18month male neutered Daschund has been itching and scratching over the lumbar-sacral region for a week

Exam shows erythema, excoriation, and alopecia

What would your further work up include?

A

Skin scrape
Plucks
Smear
Fetal dirt test

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3
Q

What are primary skin lesions

A

Initial eruption that develops as a reflection of the underlying dz

Macula/patch 
Papule/plaque 
Pustule 
Vehicle/bulla 
Wheal 
Nodule 
Tumor/cyst
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4
Q

What is a secondary skin lesion?

A

Evolve from primary lesions or are induced by patient/external factors

Epidermal collarette 
Scar 
Excoriation 
Erosion or ulcer
Lichenification 
Callus
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5
Q

What lesions can be either primary or secondary?

A 
Alopecia 
Scale 
Crust 
Follicular casts 
Comedone 
Pigmentary abnormalities
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6
Q

Flat spot <1cm on skin with change in skin colour

A

Macule

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7
Q

Flat spot >1cm on skin with change in colour

A

Patch

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8
Q

What are types of macules caused by bleeding into the skin ?

A

Purpura
Petechia
Ecchymosis

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9
Q

Small solid elevation in skin up to 1cm

A

Papule

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10
Q

Coalition of papules forming a flat topped elevation

A

Plaque

Hot spot -red and inflamed

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11
Q

Elevation of epidermis with clear fluid (<1cm)

A

Vehicle

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12
Q

Elevation of epidermis with clear fluid >1cm

A

Bulla

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13
Q

Sharply delineated lesion of edema

A

Wheal

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14
Q

Solid raised palpable lesions >1cm

These can include…?

A

Nodule

Abscess, cyst, tumor, or granuloma

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15
Q

Absence of hair from a normally a haired area

A

Alopecia

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16
Q

Accumulation of loose fragments of horny layer of skin

A

Scale

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17
Q

Accumulation of dried serum, exudate on surface of skin

A

Crust

18
Q

Accumulation of keratin and sebaceous material stuck to a hair shaft

A

Follicular casts

19
Q

Dilated hair follicle with debris

A

Comedone

20
Q

Scale arranged in a circular pattern?

This lesion is associated with reminants of what other lesions?

A

Epidermal collarette

Pustule, vesicle, or bullae

21
Q

Fibrous tissue has replaced the damaged dermis or s/c tissue

A

Scar

22
Q

Linear abrasion of the skin

A

Excoriation

23
Q

Shallow ulcer that does not break basal layer?

A

Erosion

24
Q

Break in epidermis with exposure of dermis

A

Ulcer

25
Q

Linear cleavage (cracks) in the epidermis or dermis caused by disease or injury

A

Fissure

26
Q

Thickening and hardening of the skin

A

Lichenification

27
Q

A localized hyperplasia of the stratum corneum of the epidermis caused by pressure or friction. Common on elbows and lateral hock.

A

Callus

28
Q

What laboratory tests are available for skin conditions?

A 
Superficial/deep skin scrap 
Hair pluck 
Surface skin cytology 
Bacteria culture and sensitivity 
Comb for flea 
Woods lamp/ fungal culture 
Scotch tape test 
Fecal float 
Skin biopsy
29
Q

What is the method used for a superficial skin scrape?

What can you find with this?

A

Moisten blade with liquid paraffin/ KOH/ mineral oil

Scrape a large area, with 3 passes of the blade

Surface mites

  • sarcoptes
  • notoedres
  • otodectes
  • cheyletiella
  • Demodex gatoi in cat
30
Q

What is the method for a deep skin scrape and what would you be looking for?

A

Scrape a small focal area with dulled blade using mineral oil

  • induce capillary hemorrhage
  • squeeze follicles

Follicular parasites
-demodex

31
Q

You do a hair pluck/trichogram. What are you looking for?

A

Ring worm - hyphae or spores

Follicle dysplasia

Surface parasite (lice or mites)

32
Q

What is the method for acetate tape impression smear. What would you be able to visualize?

A

Scotch tape test —> onto microside —> add 1drop of diff quick

Can see bacteria, fungi, or yeast

33
Q

Why would you do a fecal float in a dermatology cases?

A

Worms can migrate through the skin — cutaneous larval migrans

Hookworms - ancylostoma or uncinaria

34
Q

What is the technique used for skin FNA?

A

21-23g needle
Attached to 5ml syringe

Put needle in lesion, aspirate, pull needle out a bit

Redirect into another site, aspirate

Release pressure on needle before withdrawing

Disconnect needle from syringe, add few ml of air to syringe. Reattached to needle and express content of needle onto microscope slide

35
Q

Woods lamps can produce false positives with what?

A

Keratin scale
Soap
Dyes
Medications

36
Q

When would you do a fungal culture?

A

All cats with skin dz

Dogs with inflammatory skin lesions

37
Q

What lesion sampling will you do for fungal culture?

A

Woods lamp —> pluck hairs that fluoresce for DTM inoculation

If no fluorescence —> comb with toothbrush to collect hair and scale

DTM is test of choice -> must check everyday
—>Can turn red if a days after a saprophytic colony grows (non-pathogenic)
—> Will turn red the SAME day if a dermatophyte colony grows (pathogenic)

38
Q

What are indications for skin biopsy?

A 
Nodule/tumor 
Ulcer/vesicle 
Severe acute generalized dz 
Mucosal lesions 
Footpad lesions 
Lesions unresponsive to normal therapy
39
Q

How will you do your skin biopsy

A

No prep, no scrub
Gently clip hair
Handle sample as little as possible

Place in formalin and culture pot

Can do

  • punch biopsy
  • wedge/excisional
  • amputation (nail or toe)
40
Q

What are indications for bacterial culture and sensitively?

A

Cytology shows cocci and rods Or just rods

Cocci but no response to right AB administered at right dose

Deep pyoderma

Chronic AB/GC therapy

GSD pyoderma

41
Q

T/F: allergy testing serology is reliable for food allergies

A

False

RUSVM SAM 2 (44 decks)

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