Dermatology miscellaneous skin conditions

Question 1

What is the eosinophilic granuloma complex

Answer 1

Set of inflammatory skin conditions that are usually associated with underlying hypersensitivty e.g fleas esp, food FASS
mostly in cats

Question 2

3 presentations of eosinophilic granuloma complex

Answer 2

Eosinophilic plaque: intensely pruritic ulcerated lesions classically on ventral abdomen and medial thighs

Eosinophilic grnauloma: single, raised firm lesinos classically on chin, tongue or palate; cauliflower like
Not pruritic usually

Eosinophilic ulcer = not prutisitic; classically affects upper lip; can be disfusiruing

Question 3

Treating eosinophilic granuloma complex

Answer 3

Deal with any pyoderma with antibitoics
Deal with underlying condition e.g flea hypersensitivity
Prednisolone and cyclosporine tapeing dose

Question 4

What must we do before we start preds/cyclosporine in eosinphilic granuloma complex case

Answer 4

Test for toxplasmosis; can become life threatening if they have a primary infection at the time

Question 5

How do we know that alopecia in miliary dermatitis is self infliceted

Answer 5

Hairs are broken on trichogram

Question 6

What is the most common cutaneous reaction pattern in the cat

Answer 6

Miliary dermatitis

Question 7

What is miliary dermatitis

Answer 7

Common cutaneous reaction mattern in cats with crusted papules on the dorsum classically
Pruritic with alopecia and excoriation

Most commonly due to FAD< also food allergy, FASS, dermatophytosis etc

Question 8

Why might we not get a positive wet paper test with flea bite hypersensitivity miliary dermatitis

Answer 8

Because cat has groomed fleas out and only has very few but very sensitive to them

Question 9

What are the two version of seborrhoea

Answer 9

Dull dry hair coat with excessive scale, crusty patches etc
Or greasy malodours skin

EXCESSIVE GREASINESS OR SCALE

Question 10

WHat is primary seborrhoea and which breeds get it

Answer 10

Hereditary disorder of keratinisation
Large scales on dog, shedding onto floor
Worse with concurrent derm disease

See in cockers, springers, WHWT, basset
GOlden retrievers can have ‘golden retriver ichythosis’ = where outer layer of skin doesn’t form properly

Question 11

What is secondary seborrhoea

Answer 11

Scale/grease due to underlying dermatological disease
Most commonly parasites, also allergic etc
Should treat underlying disease and use antisoboreehoic shampo

Question 12

What is sterile nodular panniculitis

Answer 12

Idiopathic (immune-mediated) inflammatory disease of subcut gat causing subcut nodules that are painful and uclerating
May be pyrexic

Associated wiht pancreatitis

Question 13

Treatment of sterile nodular panniculitis; and what ddx must we be sure it isn’t first

Answer 13

Surgical excision if solitary lesion
Prednisolone +/- other immunosuppressive agent

Must be sure it isn’t deep bacteria pyoderma before immunosuppressing

Question 14

What is erythema multiforme

Answer 14

Cutaneous inflammatory pattern of cell mediated immune reaction directed at basement membrane

In dogs most related to drug reactions; potentiated sulphonamides, penicillins, cephalosporins

Question 15

Diagnosis and treatment of erythema multiforme
What is the spectrum it is on

Answer 15

BIopsy
This is minor end of spectrum to steven johnson syndrome < toxic epidermal necrolysis based on how much epidermis is detached

remove identified cause
Immunosuppress
= guarded prognossi

Question 16

What is hepatocutaneous syndrome and what is it assocaited with

Answer 16

Rare syndrome assocaited with systemic metabolic disease

Most have concurrent hepatopathy
Could also be pancreatic neoplasia
Or intestinal disease (PLE)

Common thread = REDUCED AMINO ACIDS; signiicant hypoaaminoacidoaemia
(occasionally with phenobarbitoe)

Question 17

Signalment of hepatocutaneous syndrome

Answer 17

Older dogs; more so male
WHWT, shis tzus, cockers, shelties, scotties

Question 18

Clinical signs of hepatocutaneous syndrome

Answer 18

Footpad hyperkeratosis and fissuing,erythema, ulceration, crusting, exudation, alopecia

See issues on periocular area, perioral area, pressure points e.g feet

Lameness associated with foot lesions
Concurrent weiht loss, inappetance, PU/PD, encephalopathy possible

Question 19

What might signs of intermittent collapse with seizure like episodes, hindlimb trembling, recent onset pedal pruritis be suggestive of

Answer 19

Insulinoma signs
+ dermatolgical manifestation of ‘hepatocutaneous syndrome’ = footpad hyperkeratosis

Question 20

Treatment of Hepatocutaneous syndrome

Answer 20

• Manage underlying disease e.g hepatic, pancreatic tumour
• IV amino acids can be good for liver form
• Topic antimicrobials
  Poor surgival

Question 21

What is a positive nikolsky sign

Answer 21

Where shear force appiled to epidermis with gloved finger causes it to slide off
Suggests loss of cohesion of epidermis or junction b/w epidermis and dermis

e.g with toxic epidermal necrolysis/steven johnson/erythema multiforme

Question 22

What might we suspect with severe scale, pruritis, seborrhoea sicca, large loss of skin with lots of degenete neutrophils containing cocci

Recent history of drug administratino

Answer 22

Erythema multiforme or related syndrome
Bacteria are secondary; pyoderma

Question 23

Treatment of erythema multiforma

Answer 23

Remove cause
Treat secodary pyoderma
Immunsuppress