Dermatology - Alopecia Flashcards

1
Q

Spontaneous Alopecia

4 types of spontaneous alopecia:

A
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2
Q

Spontaneous Alopecia

etiology of genetic defect alopecia

A

Genetic defect of hair shaft or hair follicle congenital hair loss

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3
Q

What are the dermatological and non-dermatological clinical signs of hypothyroidism?

A

Cutaneous Mucinosis: excessive production of mucin
Myxedema: non-pitting (when pressure applied) edema, tragic face

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4
Q

What 2 bacteria cause pyoderma in dogs?

A

Staphylococcus pseudointermedius & schleiferi

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5
Q

3 causes of hyperadrenocorticism

A

Pituitary tumor: keeps producing ACTH
AG tumor: keeps producing cortisol

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6
Q

What are the dermatological and non-dermatological clinical signs of hyperadrenocorticism?

A

systemic signs develop first!

  • unique: Calcinosis cutis (firm plaque on skin), muscle weakness / atrophy
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7
Q

Alopecia patterns in hypothyroidism versus hyperadrencorticism

A

Hypothyroidism: Gradual alopecia @ areas exposed to a lot of friction: collared area, the tail, truncal area

Hyperadrenocorticism: Truncal alopecia, spares the head & extremities

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8
Q

Pathogenesis of alopecia in hypothyroidism versus hyperadrencorticism:

A

Hypothyroidism: due to reduction in thyroid hormones (and thus decreased metabolism), the hair follicle cycle is slowed down

Hyperadrenocorticism: due to excess endogenous glucocorticoids, hair follicles do NOT re-enter anagen phase -> hair follicle eventually undergoes atrophy and are spontaneously expelled

hyperadreno: lack of hair shaft leads to black heads
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9
Q

Alopecia X
- etiology
- signalment
- clinical signs
- lesions
- treatment?

A
  • Unknown pathogenesis
  • Genetic mutation? Hair follicles “stuck” in resting phase?
  • pomeranians
  • DDx with Cushing’s: Alopecia lesions develop earlier in age than Cushing’s, + no systemic signs!
  • tx: cosmetic issue, not detrimental. microneedling?
Young pomeranian
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10
Q

Canine Flank Alopecia
- breeds predisposed?
- lesion location / characteristics

A
  • Boxers, english bulldogs, airdale terriers, rhodesian ridgebacks
  • lesions on the flank => hyperpigmentation
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11
Q

Color dilution alopecia
- pathogenesis
- diagnosis
- lesion location + what condition it mimics
- sequela

A
  • genetic defect of melanin transfer (via melanocytes) to the hair follicles
  • hair pluck + trichogram
  • lesion starts in caudal-half of dog
  • lesion similar to flea-allergy dermatitis
  • 2º pyoderma; no specific tx
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12
Q

Telogen Effluvium
- pathogenesis
- lesion appearance

A
  • sudden, metabolic stress (severe illness, surgery, postpartum, drugs), 3-4 weeks after the event
  • generalized hair loss
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13
Q

Primary vs Secondary Alopecia

A
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14
Q

Differentials for folliculitis in spontaneous alopecia

A
  1. Demodicosis
  2. Dermatophytosis
  3. Bacterial Infection
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15
Q

What is the natural habitat and pathogenesis of demodicosis spp.?

A
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16
Q

Juvenile versus Adult Canine Demodicosis

A

Juvenile
- develops first 18 motnhs of life, localized and tx not required but may become generalized and require tx
- < 4 SKIN LESIONS (LOCALIZED)

Adult
- develops spontaneously OR due to spotaneous alopecia coniditons (immunosuppression conditions – hypothyroidism, cushing’s, chronic steroid use)
- ≥ 5 SKIN LESIONS (GENERALIZED), +/- deep pyoderma!

Not typically pruritic, unless it develops into 2º pyoderma or hose rxn to mites

17
Q

Compare and contrast Demodex canis and Demodex injai

A

Similarities:
- both mites cause canine demodicosis
- both produce similar skin lesions

Differences:
- D. injai mites are long-bodied and over 2x the length of D. canis
- D. injai mites are found mainly in sebaceous ducts & glands
- D. injai mites produce greasiness on the dorsal trunk

D. injai
18
Q

How to diagnose Canine Demodicosis

A
  • Deep skin scrapings from multiple sites
  • Trichogram
  • Exudate smear impression
  • Adult onset: investigate if there is an underlying cause

Adult ≤ 30% of cases, the underlying condition cannot be determined!

19
Q

Canine Demodicosis treatment and how long treatment trial

A

Bravecto, Simparica, Nexgard; continue until 2 skin scrapes / hair plucks, ONE MONTH APART, do NOT yield mites and eggs. Clinical “cure” only considered after ONE YEAR w/out recurrence

20
Q

What are the 2 types of demodex sp. in CATS?

A
  1. Demodex cati - FOLLICULAR MITE - adult onset, with underlying disease/immunosuppressed condition! (FIV/FeLV, steroids)
  2. Demodex gatoi - STRATUM CORNEUM MITE- causes intensepruritis & is *contagious!!
21
Q

Demodex cati lesions versus demodex gatoi

A

Demodex cati: non-pruritic alopecia lesions, can visualize mites on deep skin scrape or hair pluck
Demodex gatoi: intensely pruritic lesions, generalized puritis, difficuly to visualize the mites!

22
Q

Dermatophytois - ZOONOTIC!!

Most common fungus in cats versus dogs

A

M. canis (cats)
Trichophyton mentagrophytes (dogs)
M. gypseum (geophilic - in soil)

23
Q

How is dermatophytosis transmitted?

A
  • Direct contact; fomites!;
  • Cats = asymptomatic carriers / reservoirs!
24
Q

Characterisitics of dermatophytosis lesions

A

Focal/localized that expand centrifugally

Lesion can become generalized if not diagnosed early enough, or if mis-diagnosed for a condition treated with glucocorticoids

25
Q

How is Dermatophytosis diagnosed (4 methods)?

A
  1. Wood’s Lamp (M. canis fluoresce)
  2. Trichogram (fungal spores, hyphae visualization)
  3. Fungal culture (Dermatophyte Test Medium: color change from yellow -> red – fungus metabolizes the protein in the media) + microscopic examination of colony
  4. PCR (DNA presence = true infection versus fomite contamination versus non-viable spores deteced)
26
Q

Dermatophytosis treatment

A

Patient: Topical treatment + Systemic treatment (Ketoconazole, fluconazole, itraconazole, etc.)

Environment: prevent spread of infection (zoonotic!), prevent false positive DTM and PCR via washing bedding, brushes, rugs, etc. 1:10 to 1:100 dilute chlorine bleach

27
Q

How does ischemia cause spontaneous alopecia?

A

The blood vessels provide nutrients required for vitality to the skin / hair follicles -> SF ischemia causes alopecia, deeper ischemia causes erosion-ulceration, and muscle-level affected ischemia causes myositis

28
Q

Which vaccine has been associated with vaccine-associated alopecia?

A

Rabies vaccine

29
Q

Which breeds are predisposed to dermatomyositis? How is it diagnosed and treated?

A

Collies & shetland sheepdogs

Diagnosis = skin biopsy

Tx = immuno-suppressive doses of cyclosporin

30
Q

Skin lesion appearance in Generalized ischemic dermatopathy? Diagnosis & tx?

A

Nearly identical to dermatomyositis, except lesions are generalized (vs. solely face/muzzle)

Diagnosis = skin biopsy

Tx = immuno-suppressive doses of cyclosporin