Dermatology miscellaneous skin conditions Flashcards
What is the eosinophilic granuloma complex
Set of inflammatory skin conditions that are usually associated with underlying hypersensitivty e.g fleas esp, food FASS
mostly in cats
3 presentations of eosinophilic granuloma complex
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
Treating eosinophilic granuloma complex
Deal with any pyoderma with antibitoics
Deal with underlying condition e.g flea hypersensitivity
Prednisolone and cyclosporine tapeing dose
What must we do before we start preds/cyclosporine in eosinphilic granuloma complex case
Test for toxplasmosis; can become life threatening if they have a primary infection at the time
How do we know that alopecia in miliary dermatitis is self infliceted
Hairs are broken on trichogram
What is the most common cutaneous reaction pattern in the cat
Miliary dermatitis
What is miliary dermatitis
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
Why might we not get a positive wet paper test with flea bite hypersensitivity miliary dermatitis
Because cat has groomed fleas out and only has very few but very sensitive to them
What are the two version of seborrhoea
Dull dry hair coat with excessive scale, crusty patches etc
Or greasy malodours skin
EXCESSIVE GREASINESS OR SCALE
WHat is primary seborrhoea and which breeds get it
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
What is secondary seborrhoea
Scale/grease due to underlying dermatological disease
Most commonly parasites, also allergic etc
Should treat underlying disease and use antisoboreehoic shampo
What is sterile nodular panniculitis
Idiopathic (immune-mediated) inflammatory disease of subcut gat causing subcut nodules that are painful and uclerating
May be pyrexic
Associated wiht pancreatitis
Treatment of sterile nodular panniculitis; and what ddx must we be sure it isn’t first
Surgical excision if solitary lesion
Prednisolone +/- other immunosuppressive agent
Must be sure it isn’t deep bacteria pyoderma before immunosuppressing
What is erythema multiforme
Cutaneous inflammatory pattern of cell mediated immune reaction directed at basement membrane
In dogs most related to drug reactions; potentiated sulphonamides, penicillins, cephalosporins
Diagnosis and treatment of erythema multiforme
What is the spectrum it is on
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
What is hepatocutaneous syndrome and what is it assocaited with
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)
Signalment of hepatocutaneous syndrome
Older dogs; more so male
WHWT, shis tzus, cockers, shelties, scotties
Clinical signs of hepatocutaneous syndrome
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
What might signs of intermittent collapse with seizure like episodes, hindlimb trembling, recent onset pedal pruritis be suggestive of
Insulinoma signs
+ dermatolgical manifestation of ‘hepatocutaneous syndrome’ = footpad hyperkeratosis
Treatment of Hepatocutaneous syndrome
- Manage underlying disease e.g hepatic, pancreatic tumour
- IV amino acids can be good for liver form
- Topic antimicrobials
Poor surgival
What is a positive nikolsky sign
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
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
Erythema multiforme or related syndrome
Bacteria are secondary; pyoderma
Treatment of erythema multiforma
Remove cause
Treat secodary pyoderma
Immunsuppress
