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VET 433a - Small Animal Stream 1 > Dermatology pt.2 > Flashcards

Dermatology pt.2 Flashcards

1
Q

T/F: for every food allergic dog, there are probably 10-20 atopic dermatitis dogs

A

T

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2
Q

Food Allergy (Etiology)

A
  • unknown
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3
Q

Food Allergy (History)

A
  • recent change in diet is uncommon

- most affected animals have been on the same food for > 2 years

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4
Q

Food Allergy (Dog - Signalment)

A

Age: 4months - 13 years (none)
Breed: retrievers, terriers

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5
Q

Food Allergy (Dog - Clinical Signs)

A
  • pruritus (generalized, pododermatitis, otitis externa)

- scaling, papules, erythema

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6
Q

Food Allergy (Cat - Signalment)

A
  • no age or se predilection

- breeds: Burmese, mainecoon, himalayan

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7
Q

Food Allergy (Cat - Clinical Signs)

A
  • pruritus, alopecia (face and neck @ 40-50%)
  • papules, miliary dermatitis
  • eosinophilic granuloma complex
  • self-induced alopecia
    »> same as for Atopic Dermatitis <
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8
Q

Food Allergy (GI signs)

A
  • diarrhea, vomiting (10%)
  • gi + pruritus in cats = food allergy
  • mild colitis (dogs)
  • lymphocytic, plasmacytic colitis (cats, cheetahs)
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9
Q

Food Allergy ( Neuro, Resp)

A

Neuro: malaise, epilepsy
Resp: asthma-like signs

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10
Q

Food Allergy (Diagnosis)

A
  • hypoallergenic diet

- Serologic Testing ( not all allergies are IgE mediated)

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11
Q

Food Antigens

A
  • typically attributed to protein sources

- the common food antigens often reflect what is commonly eaten by animals

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12
Q

Elimination Diet Selection

A
  • get a thorough diet history
  • ingredients must be novel to the pet
  • no single diet will work for every pet
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13
Q

Elimination Diet Selection Options

A
  • home-cooked
  • commercial hydrolyzed
  • commercial limited/ uncommon antigen diets
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14
Q

Concerns with OTC novel diets

A
  • a ton of undeclared antigens in OTC

- OTC also tend to have extensive ingredient lists

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15
Q

Vet. Therapeutic Diets

A
  • > 90% ability to diagnose food allergy

- no one will work for every animals

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16
Q

Food Allergy Diagnosis via Diet

A
  • after 8-12 weeks of new diet (with subsided symptoms), revert back to og diet
  • signs should reoccur w/in 2-3 weeks
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17
Q

Pemphigus Foliaceous

A
  • antibodies target the transmembrane proteins

- Dogs: desmocollin - 1 [humans have desmoglein-1]

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18
Q

Pemphigus Foliaceous (Clinical Presentation)

A
  • curst and pustules on nasal planum, peri-orifical, foot-pads, pinna
  • whole body crusts in retreivers, chows, cats
  • +/- pruritus, febrile, depressed
  • peripheral edema
  • 2* pyoderma
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19
Q

Pemphigus Foliaceous (Predisposed breeds)

A
  • chows, akitas, bearded collies, chines SharPei
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20
Q

Pemphigus Foliaceous (HIsto)

A
  • Acantholytic Cells
  • subcorneal pustules, often spanning multiple follicles
  • usually neutrophils, sometimes eosinophils
  • rafts
  • superficial pyoderma (fewer and smaller) [trichophyton spp. (requires special stains)]
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21
Q

Drug-Related Pemphigus

A
  • reported in dogs and cats
  • removal of drug = resolution
  • transient immunosuppressive tx may be necessary
  • drug ‘triggers’ genetic predisposition to pemphigus
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22
Q

Paraneoplastic Pemphigus

A
  • 2* to neoplasia, often lymphoma
  • histo: PV + apoptotic cells
  • removal of neoplasm may not be helpful = poor prognosis
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23
Q

Rx for PF in dogs

A
  • pred/ prednisolone/ methylpred
  • azathioprine
  • cyclosporine
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24
Q

Factors affecting survival for PF

A

Pos - abx w/ immunosuppressive therapy?

Neg - neg side effects from Rx

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25
Q

Discoid Lupus Erythematosus (DLE)

A
  • more common than PF

- Etiology: antigen-antibody complexes @ basement membrane zone

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26
Q

DLE (Diagnosis)

A
  • clinical presentation and history
  • histopathology
  • other: IHC, ANA, CBC, serum
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27
Q

DLE (Clinical Presentation)

A
  • depigmentation, alopecia
  • nasal planum, periocular, pinna, muzzle
  • collies, shelties, other
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28
Q

DLE (Histo)

A
  • Interface Dermatitis
  • thickening of basement membrane
  • basal cell edema (Hydropic degen.)
  • pigmentary incontinence
  • mononuclear inflammation just below BMZ
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29
Q

DLE (Treatment)

A
  • prevent sunlight exposure
  • Niacinamide & Doxycycline
  • Tacrolimus ointments
  • topical corticosteroids, sunscreens, EFAs
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30
Q

Exfoliative Cutaneous Lupus Erythematosus (ECLE)

A
  • german shorthaired pointer, viszlas
  • usually < 1 year of age
  • scaling and alopecia on face, hocks, generalized
  • histopath: interface derm, w/ apoptotic cells, sebaceous adentitis
  • ANAs may be (-)
  • Rx: cyclosporine is best
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31
Q

Vesicular Cutaneous Lupus Erythematosus (VCLE)

A
  • ulcerative dermatosis of collies and shelties
  • ulcers in inguinal area, axilla, ventral abdomen, medial thighs
  • Rx: poorly responsive, corticosteroids and cyclosporine
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32
Q

Canine Demodecosis

A
  • demodex is a commensal in mammalian hair follicles
  • transmitted via direct contact w/in 2-3 days of liffe
  • it is an opportunistic pathogen
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33
Q

2 species of demodex in dogs

A

demodex canis - commensal in hair follicles

demodex injai - mostly found in sebaceous glands

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34
Q

D. Canis (gen. clinical signs)

A
  • lesions ass. w/ folliculitis
  • focal to multifocal alopecia
  • papules, pustules, comedones
  • pruritus only present w/ 2* bacterial infection
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35
Q

D. Canis (Clinical Presentation)

A
  1. Localized
  2. Generalized

A. Juvenile-onset ( <2years old)
B. Adult-onset ( >2years old)

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36
Q

D. Canis (localized lesions)

A
  • generally restricted to juvenile-onset

- < 4 areas of focal alopecia that are no greater than 2.5 cm

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37
Q

D. Canis (generalized lesions)

A
  • juvenile or adult onset
  • multifocal patchy, generalized alopecia
  • erythematous, +/- pruritus
  • 2* infections are common
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38
Q

D. Canis (unusual clinical presentation)

A

Pododemodicosis (erythema, swelling, nodules, draining tract)
Otitis Externa d/t demodex

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39
Q

D. Injai

A
  • not considered a commensal spp
  • mainly live in sebaceous glands
  • mostly seen in terries
  • mild to sever pruritus
  • characteristic greasy dorsal stripe on the trunk
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40
Q

Demodex (Diagnosis)

A
  • deep skin scraping
  • trichoscopy
  • acetate tape prep (best for exudative)
  • histopathy (expensive, but useful of D. injai)
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41
Q

Demodex (Treatment - localized dem.)

A
  • benign neglect (90% spont. resolve)

- topical therapy to ‘treat the owners’

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42
Q

Demodex (Treatment - generalized dem.)

A
  • Ivermectin (considered antiquated) (Ivermectin tox)
  • Moxidectin (Advantage Multi = Moxi + Imidacloprid)
  • Isoxazolines
  • Amitraz dips
  • Pyoderma treatment
43
Q

Ivermectin (demodecosis)

A
  • considered antiquated treatment
  • can cause toxicity w/ ‘white feet don’t treat’
  • Ivermectin tox = mydriasis, ataxia, tremors, seizures
44
Q

Demodex (Treatment: monitoring)

A
  • identify and treat concurrent 2* infections
  • repeat skin scrapings from the same locations once monthly
  • dead mites =/= neg skin scraping
45
Q

Demodex (Treatment: Prognosis)

A
  • cure rate is >90% if owner compliance is good
46
Q

Feline Demodicosis (species_

A
  1. Demodex cati (commensal)

2. demodex gatoi (stratum corneum)

47
Q

D. cati (clinical signs)

A
  • usually seen in sick cats
  • non-pruritic
  • patchy, regional, multifocal alopecia
  • can be localized or generalized
  • very uncommon
48
Q

D. gatoi (clinical signs)

A
  • variable pruritus
  • contagious (cat-cat)
  • alopecia from self-trauma or overgrooming
49
Q

D. cati (diagnosis)

A
  • superficial skin scrapings

- incidental finding on biopsy

50
Q

D. gatoi (diagnosis)

A
  • superficial skin scrapings
  • acetate tape method
  • fecal float
  • empirical treatment and response
51
Q

Feline demodicosis (treatment)

A
  • lime sulfur dips q1-2 times weekly
  • moxidectin (advantage multi)
  • ivermectin
  • fluralaner
    D. cati can resolve spontaneously if underlying disease is addressed
52
Q

T/F: skin disease in less common in cats than dogs

A

T

53
Q

T/F: prednisolone is the preferred corticosteroid in cats

A

T

54
Q

Feline Miliary Dermatitis

A
  • reaction pattern - multiple etiologies, most are hypersensitivities
  • -> flea allergies, food allergy, AD, ectoparasites
  • crusted papules +/- pruritus and self-trauma, alopecia
55
Q

Feline Miliary Dermatitis (Rx)

A
  • treat underlying cause

- flea control

56
Q

Feline Eosinophilic Reaction Patterns

A
  • eosinophilic reaction patterns are not specific diseases
  • -> eosinophilic plaque
  • -> eosinophilic granuloma
  • -> indolent lip ulcer
57
Q

Eosinophilic Plaque

A
  • most common on abdomen, medial thighs
  • pruritic
  • often associated w/ FelineAD
58
Q

Eosinophilic Granuloma

A
  • caudal thighs, oral cavity, chin, foot pads

- may have genetic basis in some cats and not associated with allergy

59
Q

Feline Lip Ulcer

A
  • bad other names: rodent ulcer, indolent ulcer
  • upper lip
  • symmetrical lesions on either side of philtrum
60
Q

Mosquito Bite hypersensitiviity

A
  • dorsal muzzle, pinna, footpad
  • crusts, papules, ulcers, swelling
  • Rx: corticosteroids and keeping cat indoors
61
Q

herpes Virus (FHV-1) Ulcerative Dermatitis)

A
  • often dorsal muzzle lesion
  • Biopsy: often eosinophili inflammation w/ visible inclusions
  • PCR skin biopsy: sensitive and specific test
62
Q

Diagnostic Approach to Eosinophilic Lesions

A
  • impression cytology: eosinophils
  • Therapeutic trials to evaluate for underlying hypersensitivity
  • possible infectious etiologies = biopsy
63
Q

Clinical Presentations of the Pruritic Cat

A
  • head and neck pruritus/ excoriations
  • self-induced alopecia
  • miliary dermatitis
  • eosinophilic lesions
64
Q

Why are pruritic cats challenging to treat?

A
  • overlapping clinical presentations require a systematic approach
  • may take time to determine etiology
65
Q

Feline Dermatophytosis

A
  • ubiquitous infectious skin disease

- Diagnosis - fungal culture, PCR, wood’s lamp, trichogram, biopsy

66
Q

Feline Dermatophytosis (treatment)

A

Systemic: Itraconazole, fluconazole, terbinafine
Topical: lime-sulfuer
Environment: bleach

67
Q

Feline Degenerative Mucinotic Mural Folliculitis

A
  • presumptive immunologic disease
  • generalized alopecia and exfoliation
  • facial skin is thickened, shiny, w/ narrowing of eyelid margins
  • Prognosis: poor
68
Q

Feline Paraneoplastic Alopecia

A
  • older cat, often unwell
  • marked ventral alopecia w/ very shiny appearance
  • foot pad lesions
  • abd u/s = pancreatic or hepatic mass
  • skin biopsy: marked atrophy of follicles and epidermal hyperplasia
69
Q

Feline Thymoma-Ass. Exfoliative Dermatitis

A
  • rare, cutaneous marker for underlying thymoma
  • erythema, dramatic exfoliation, alopecia, sheets of scale, begins head and neck
  • Systemic - coughing, dyspnea, lethargy anorexia
70
Q

Plasma Cell Pododermatitis

A
  • distinctive foodpad lesions

- Dx: confirm w/ biopsy

71
Q

Feline Acne

A
  • comedones present on chin and mandibular lip region
72
Q

Common Pruritic Parasites for Rabbit, Guinea Pig, Rats and Hamsters

A

Rabbit: Psoroptes cuniculi
Guinea Pig: Trixacarus caviae
Rats and Hamster: Notoedris muris

73
Q

Lice as Vectors for Disease

A

Polyplax serrata (mice) and Polyplax spinulosa (rats):

  • -> mycoplasma muris
  • -> encephalitozoon cuniculi
  • -> eperythrozoon coccoides
74
Q

Mites and Lice Treatment

A
  • Selamectin
  • Isoxazolines
  • Ivermectin
  • Do not use fipronil (frontline) for rabbits or hamsters
75
Q

Causes of Alopecia w/out pruritus in small mammals

A
  • dermatophytes
  • barbering/ shedding
  • demodicosis (most common in hamsters)
  • endocrine
76
Q

Small Mammal Dermatophytes

A
  • Trichophyton menoagrophytes
  • microsporum canis
  • M gypseum
77
Q

Chinchilla

A
  • fur slip –> frightened or stress causes shedding of tufts of hair
  • ear trauma including frostbite
  • avoid aminoglycosides
78
Q

Demodicosis in Hamsters

A
  • demodex aurati (long, follicular)

- demodex criceti (short, stratum corneum)

79
Q

Endocrine Diseases in small mammals

A
  • hyperadrenocorticism (hamsters)
  • cystic ovaries (guinea pigs)
  • dx of both probably done most easily w/ ultrasound
80
Q

Treponema paraluiscuniculi

A
  • crusts, erythema, edema, vesicles, ulcers, proliferative lesions; face and perineum
  • painful, not pruritic
  • metritis, abortion, and neonatal death
  • rabbit syphilis is not zoonotic
81
Q

Treponema paraluiscuniculi (Rx)

A
  • Penicillin G
  • monitor for signs of abx-ass. enterotoxaemia
  • Choramphenicol
  • Azithromycin
82
Q

Causes of scaling and crusting in small mammals

A
  • sebaceous adenitis
  • cutaneous lymphoma (hamsters, rabbits, guinea pigs and mice)
  • thymoma
83
Q

Chelitis in Guinea Pigs

A
  • rough forage and/or acidic fruit
  • hypovitaminosis C
  • pox virus (myxoma virus)
84
Q

Myxomatosis

A
  • arthropod transmission
  • morbidity and mortality high in pet rabbits, approaching 100%
  • edema of head, ears, eyelids, and genitalia
  • firm, non-pruritic, erythematous nodules
85
Q

Abcsesses in Rabbits

A
  • pasteurella multocida
  • rabbit heterophils are myeloperoxidsase-deficient: abscesses are more inspisated
  • better results in abscess removed surgically
86
Q

Mouse pox

A
  • infectious ectromelia, orthopoxvirus
  • usually in colony situations
  • transferred from infected serum
  • EM, IHC, animal inoculations, serologic testing, virus isolation, PCR
87
Q

Otitis Externa (Signalment)

A
  • Dogs: 5-8 years old, allergic dermatitis most common

- Cats: 1-2 years old, ear mites most common

88
Q

Otitis Externa ( Clinical Signs)

A
  • head shaking
  • scratching
  • pain
  • erythema, excoriations, alopecia
  • exudate, odor
89
Q

Otitis Externa (Causes)

A
  • most cases have mutlifactorial etiology

- Predisposing Factors, Primary Factors, Perpetuating Factors

90
Q

Otitis Externa (predisposing factors)

A
  • Breed conformation ( hairs w/in ear canal, narrow canal conformation, large number of apocrine glands)
  • Humidity in the ear (leads to maceration of tissue)
  • Inappropriate therapy
  • Contact Rxn (non-haired pinna and canal, rxn to drugs)
91
Q

Otitis Externa (Primary Factors)

A
  1. Atopic Dermatitis
  2. Cutaneous Adverse Food Rxn
  3. Parasites
  4. Foreign Bodies
  5. Cornification disturbances
  6. Neoplasia
  7. Immune-mediated dz (pinnae > ear canal)
92
Q

Common Otitis Externa parasites

A
  • Otodectes Cynotis
  • demodex canis
  • otobius megnani
93
Q

Otitis Externa (Perpetuating Factors)

A
  • bacterial organisms
  • Yeast/ fungal organisms
  • Otitis media
  • chronic pathological changes
94
Q

Otitis Externa (bacterial perpetuating factors)

A
  • Staph pseudintermedius (most common)
  • pseudomonas (causes ulceration)
  • strep
95
Q

Otitis Externa (Otitis Media)

A
  • not ruled out by intact TMb
  • Tx w/ systemic abx +/- myringotomy and flush of middle ear
  • 1* Secretory Otitis Media (PSOM) = middle ear effusion only, rarely ext. ear canal dz
96
Q

Otitis Externa ( Diagnosis)

A
  • History and PE
  • Otoscopic inf
  • myringotomy
  • cytology
  • imaging studies
  • biopsy
  • culture and sensitivity (sens only for serum, not topical)
97
Q

Otitis Externa (treatment)

A
  • use ear cleaner prior to treating w/ appropriate topical +/- systemic therpaies
  • Ear Cleaners: antimicrobial and ceruminolytic (always flush after use)
  • Glucocorticoids: use as sole agent (topical) in allergy or ceruminous OE; otherwise used in combination
  • Systemic therapy: Abx, glucocorticoids, anti-fungal
98
Q

Otitis Externa (Keys to successful management)

A
  • always do cytology
  • id all predisposing, primary, perpetuating factors
  • appropriate medical management –> removal of all etiological factors
99
Q

Surgical Management of Skin Fold Pyoderma

A

Episioplasty:

  • dog placed in perineal stand
  • estimate the amount of skin to be removed
  • resect an elliptical portion of skin around vulva
  • resolution of UTIs in 84-100%
100
Q

Indications for total ear canal ablation

A
  • end-stage otitis externa
  • ear canal neoplasia (ceruminous gland carcinoma)
  • cholesteatoma
101
Q

TECA-BO Surgery

A
  • total ear canal ablation - bullus osteotomy
  • want to stick to the cartilage all the way down the ear canal to minimize damage to surrounding tissues
  • highly effective but complications commons
102
Q

TECA-BO Complications

A
  • Facial Nerve Paralysis (cats > dogs) (treatment w/ corneal protectants necessary d/t loss of ability to blink)
  • Horner’s Syndrome (mainly cats) (ptosis, miosis, enophthalmus)
  • Vestibular syndrome (occurs in 3-8% of dogs) (less common but high impact on QOL)
  • Post-op Fistula Formation (incomplete removal of secretory epithelium)
103
Q

Outcomes of Traction-Avulsion for treatment of nasopharyngeal polyps in cats

A
  • 50% success rate
  • when treated w/ pred post traction – recurrence after traction only: 11% for nasopharyngeal, 50% of aural
  • ventral bulla osteotomy may reduce recurrence rate
104
Q

T/F: the treatment of choice for any primary ear canal neoplasia is a total ear canal ablation.

A

T

VET 433a - Small Animal Stream 1 (10 decks)

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