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Small Animal Medicine > Dermatology - Pyoderma (Bacterial-induced Dermatologic Disorders) > Flashcards

Dermatology - Pyoderma (Bacterial-induced Dermatologic Disorders) Flashcards

1
Q

What are the primary bacterial pathogens of the skin encountered in small animal practice?

A

S. psuedintermedius, S. schleferi, S. aureus (in decreasing order of prevalence)

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2
Q

What does staphylococci produce that may induce host reactions or protect the organism?

A

enzymes (like Beta-lactamase proteases) and toxins (Protein A)

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3
Q

What other bacterial isolates can be found in skin infections?

A

Proteus, pseudomonas, E. coli, and streptococcal organisms

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4
Q

What about bacterial skin infections favors bacterial growth?

A

Inflammation of the skin leads to microenvironmental changes (increased temperature and humidity)

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5
Q

What predisposing factors are associated with bacterial skin infections?

A

signalment, anatomic factors, and environmental factors

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6
Q

What do some breeds have that predispose them to bacterial skin infections?

A

IgA deficiency

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7
Q

What anatomic factors predispose them to bacterial skin infections?

A

skin folds and hair coat type

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8
Q

What environmental factors predispose patients to skin infections?

A

temperature, humidity, frequent swimming by the pet

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9
Q

What is the most common primary underlying cause of bacterial skin infections?

A

allergies - atopy specifically

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10
Q

What is the second most common primary cause of bacterial skin infections?

A

endocrinopathies - hypothyroidism (specifically this one) and hyperadrenocorticism

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11
Q

What other primary factors, aside from the top two, are associated with bacterial skin infections?

A

ectoparasitic infestations, scaling disorders/disorders of cornification, immunodeficiencies, skin trauma or maceration (over hydration)

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12
Q

What lesions are seen in pyoderma?

A

papules, pustules, epidermal collarettes, erythema, scale/crusts, patchy alopecia, and draining (fistulous) tracts

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13
Q

What is the severity of pruritus in bacterial skin infections?

A

mild to moderate

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14
Q

What is the classical lesion for superficial folliculitis?

A

patchy alopecia

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15
Q

What are the differential diagnoses for pustules?

A

pyodermma, autoimmune skin diseases, dermatophytosis, eosinophilic dermatitis, sterile pyogranulomatous dermatitis, and panniculitis

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16
Q

What is the goal of specific diagnostics for bacterial skin infections?

A

they are intended to confirm the presence of a bacterial infection, then define the causative organism, and identify the primary (underlying) condition

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17
Q

What specific diagnostics can be used for diagnosing the type of bacterial skin infection?

A

dermatologic data base, cytology, culture and susceptibility/sensitivity testing, routine hematology, evaluation of the thyroid gland, immunologic evaluations, and skin biopsies

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18
Q

When is a cytology a key diagnostic tool in bacterial skin infections?

A

whenever pustules, papules, or draining tracts are present

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19
Q

What type of samples should be used for cytologies in bacterial skin infection cases?

A

they should be collected from intact lesions, such as a pustule, when possible

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20
Q

When is culture and susceptibility/sensitivity testing indicated?

A

recurring infections, failure of the patient to respond to traditional treatment, when the only bacteria on cytology are rod-shaped organisms, and deep pyoderma cases

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21
Q

What types of topical treatments can be used to treat bacterial skin infections?

A

Gels, creams, ointments, sprays, shampoo therapy, wipes, and astringents

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22
Q

What are the types of gels,creams, ointments, sprays that are used to treat bacterial dermatitis?

A

Benzoyl peroxide, mupriocin, povidine-iodine, chlorhexidine

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23
Q

What is Benzoyl Peroxide available as?

A

a gel and shampoo

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24
Q

What is the best used concentration of benzyl peroxide?

A

2.5% solution - higher can cause severe cutaneous irritation

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25
Q

Is benzoyl peroxide bactericidal or bacteristatic and for how long?

A

bactericidal for up to 48 hours after application

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26
Q

What actions do benzoyl peroxide have?

A

follicular flushing action, keratolytic, astringent, degreasing, a debriding action and promotes wound healing

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27
Q

What bacteria is Mupriocin effective against?

A

staphylococci and gram negative bacteria

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28
Q

Is Povidine-iodine bactericidal or bacteristatic?

A

bactericidal

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29
Q

How is Chlorhexidine available?

A

as sprays and shampoo

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30
Q

What active ingredients in shampoos are effective in bacterial dermatitis?

A

Most to least active - benzoyl peroxide, chlorhexidine, povidone-iodine, triclosan, sulfur/salicylic acid

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31
Q

Can shampoos be used for sole treatment of bacterial dermatitis?

A

yes, for mild or superficial infections, or as adjunctive treatment with antibiotics

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32
Q

What are the keys for using shampoos for bacterial dermatitis?

A

Contact time of 10 minutes, use neutral temperature to slightly cool water, bathe every 2-3 days for sole treatment, every 7-10 days for adjunctive therapy, and every 7-14 days for long term use

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33
Q

If benzyl peroxide is used long-term what should be used in conjunction with it?

A

conditioners because it is a potent degreasing shampoo

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34
Q

What are wipes indicated to treat?

A

focal infection (i.e. fold pyoderma, acute moist dermatitis, etc.)

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35
Q

What wipes have antibacterial activity?

A

Nisin (Preva) and Acetic acid/boric acid (Malcetic wipes)

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36
Q

What are astringents used for in treatment of bacterial dermatitis?

A

topical drying of moist lesions

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37
Q

What are some common astringents used in treatment of bacterial dermatitis?

A

Domboro’s solution (aluminum acetate) and TAN-SAL (tannic acid solution)

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38
Q

What antibiotics are a POOR choice for cutaneous therapy of bacterial skin infections?

A

penicillin, ampicillin (and derivatives), sulfas, tetracycline, and aminoglycosides (cause of toxicity and route of administration)

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39
Q

What antibiotics have INTERMEDIATE value in treatment for cutaneous therapy of bacterial skin infections?

A

linomycin, erythromycin, some fluroquinolones, potentiated sulfonamides, and chloramphenicol

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40
Q

What antibiotics are HIGHLY effective for cutaneous therapy of bacterial skin infections?

A

cephalexin/cefadroxil/cefpodoxime, some flouroquinoones, amoxicillin + clavulinic acid, penicillinase-resistant synthetic penicillins (e.g. cloxacillin)

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41
Q

What is the ideal antibiotic for treatment of cutaneous therapy of bacterial skin infections (not a specific antibiotic, this is a generality)?

A

low cost, bactericidal agents, narrow spectrum of activity (to avoid complications, effective orally, infrequent administration, few adverse effects, penetrates skin well, active in the presence of inflammatory cells, concentrates in macrophages)

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42
Q

What is the suggested time frame for treatment with antibiotics for surface pyoderma?

A

5-21 days

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43
Q

What is the suggested time frame for treatment with antibiotics for superficial pyoderma (e.g. folliculitis)?

A

21-30 days

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44
Q

What is the suggested time frame for treatment with antibiotics for deep pyoderma (e.g. furunculosis)?

A

1-6 months

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45
Q

What types of methods can be used for hydrotherapy?

A

whirlpools, ultrasonic tubs, or active bathing systems

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46
Q

What does hydrotherapy help to do?

A

remove surface debris, alleviate discomfort, increased cutaneous blood flow

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47
Q

What condition is hydrotherapy especially helpful in?

A

deep pyoderma

48
Q

Is immunotherapy used for bacterial dermatitis?

A

not commonly anymore

49
Q

Note—- see other side

A

doses for antibacterial agents is in the ppt, there are too many and I doubt he will ask the specifics

50
Q

What are MRS strains recognized to be resistant to?

A

oxacillin

51
Q

What MRS strains are found in dogs?

A

S. pseudintermedius, S. schleferi, and S. aureus

52
Q

What is the most common source of MRS in dogs?

A

S. pseudintermedius

53
Q

True or False: MRSA and MRS are interchangable terms.

A

FALSE - the term MRSA should not be used for MRS pseudintermedius infections in dogs!!!

54
Q

Does MR (methicillin resistance) increase virulence or pathogenicity of S. pseudintermedius?

A

no

55
Q

If a dog has a MRSA infection, and a human in the household also has one, who gave it to who (typically)?

A

the human to the dog

56
Q

What are the categories of pyoderma?

A

surface pyoderma, superficial pyoderma, deep pyoderma, cellulitis

57
Q

What is acute moist dermatitis commonly known as?

A

hot spots

58
Q

What are the predisposing factors of acute moist dermatitis?

A

breed of dog, type of hair coat, behavior such as frequent swimming, underlying allergic diseases, nutritional status of the pet, high environmental temperature and humidity, etc.

59
Q

What primary or initiating factors are associated with acute moist dermatitis?

A

allergic skin disease, ectoparasites, trauma, or any factor could damage the skin allowing bacterial invasion

60
Q

What is the most commonly isolated organism of acute moist dermatitis?

A

Staphylococcus pseudintermedius

61
Q

What form of pyoderma does acute moist dermatitis start as?

A

surface pyoderma

62
Q

What clinical features are associated with acute moist dermatitis?

A

intense pruritus, focal areas of edema, erythema, alopecia, crusts, ulcers, and matted hair

63
Q

Why is acute moist dermatitis considered a dermatology emergency?

A

the lesions develop very quickly

64
Q

What is the therapy protocol for acute moist dermatitis?

A
  1. Clip the region to allow good exposure to air 2. Gently clean the affected area 3. Astringents to dry the lesion 4. Systemic antibiotics for 7-21 days 5. short-term glucocorticoids (1 injection of short or immediate acting, or 7-10 day dose of oral pred)
65
Q

What dogs are commonly affected by canine acne?

A

immature dogs and are reported more common in shorthaired breeds

66
Q

What factors may predispose a patient to canine acne?

A

undeveloped immune system, nutritional status, or other health issues

67
Q

What lesions are associated with canine acne?

A

they range from a few papular eruptions and pustules to severe, progressive folliculitis and furunculosis

68
Q

Where do papules and pustules typically appear in dogs that have canine acne?

A

they are on the muzzle and the chin

69
Q

What permanent lesion is associated with furunculosis?

A

alopecia and scarring because the hair follicle is damaged

70
Q

Can any cases of canine acne heal themselves?

A

yes, mild cases often regress at sexual maturity

71
Q

What type of therapy may be sufficient for mild cases of canine acne?

A

topical antibacterial therapy (mupirocin or BPO gel)

72
Q

How else do you treat canine acne?

A

daily cleaning of affected area with iodine or chlohexidine shampoos, wiping affected areas with acetic acid/boric acid wipes, and systemic antibiotics

73
Q

What is another name for skin fold pyoderma?

A

intertriginous pyoderma

74
Q

Why are skin folds good for bacterial proliferation?

A

they provide a warm, dark, moist environment

75
Q

What are the predisposing factors for skin fold pyoderma?

A

breed predisposition, conformation, hormonal imbalances, poor husbandry, and allergic skin disease

76
Q

Where is skin fold pyoderma typically located (specific)?

A

lip folds, facial folds, vulvar folds, and corckscrew tails

77
Q

How do areas effected with skin fold pyoderma frequently present?

A

erythematous, odiferous, and ulcerated

78
Q

What behavior may a patient with skin fold pyoderma present with?

A

the animal may rub its face or lick at affected areas

79
Q

What is the recommended therapy for skin fold pyoderma?

A

Topical astringents for drying, topical antibiotics for focal lesions, and systemic antibacterials in severe cases

80
Q

Aside from pharmaceutical management, what else can aid in treatment/prevention of skin fold pyoderma?

A

surgical correction of conformational problems

81
Q

What is impetigo also known as?

A

puppy pyoderma or superficial pustular pyoderma

82
Q

What is impetigo often secondary to?

A

improper sanitation, poor diet, coincidental disease states, parasitism

83
Q

Generally, what bacteria is found in impetigo?

A

staphylococcus or streptococcus

84
Q

What age is impetigo seen in?

A

less than 9 months

85
Q

What lesions are associated with impetigo?

A

subcorneal pustular formation which rupture, forming honey colored crusts

86
Q

How do impetigo lesions progress?

A

from pustules to crusts with collarette formation

87
Q

Where are impetigo lesions located primarily?

A

on the ventrum: abdomen, groin, medial aspects of thighs

88
Q

What is the recommended therapy for impetigo?

A

identify and correct underlying causes, topical antibacterials, and systemic antibiotics

89
Q

What are the three main causes of folliculitis?

A

demodicosis, dermatophytosis, and staphylococcal infections

90
Q

What is the most commonly isolated pathogen in patients that have folliculitis?

A

S. pseudintermedius

91
Q

What organism is most commonly associated with postgrooming furunculosis?

A

Pseudomonas aeruginosa

92
Q

Define folliculitis.

A

inflammatory reaction of the hair follicle

93
Q

What lesion does folliculitis lead to?

A

an accumulation of inflammatory cells, edema in the perifollicular area, resulting in formation of a papule

94
Q

What can folliculitis progress into (after a papule)?

A

furunculosis - deep pyoderma

95
Q

What is the most common predisposing disease to folliculitis?

A

atopy and hypothyroidism

96
Q

What dogs are predisposed to folliculitis?

A

shorthaired dogs

97
Q

Where does foliculitis typically focus at?

A

the trunk, chest, and lateral aspects of extremities

98
Q

What do lesions of superficial folliculitis progress to?

A

from papules, to pustules, to epidermal collarettes

99
Q

How does the hair coat typically present in patients with folliculitis?

A

moth eaten, patchy alopecic hair coat

100
Q

What level of pruritus is associated with folliculitis?

A

mild to moderate

101
Q

What is the recommended therapy for folliculitis?

A

Appropriate antibiotic therapy for a minimum of 30 days, topical antibacterial shampoos (taper method), identify and control predisposing and primary factors of pyoderma, and antiseborrheic shampoos to reduce crusts and pruritus

102
Q

How does furunculosis develop?

A

results from progression of folliculitis caused by bacterial, fungal, or parasitic involvement

103
Q

What happens when follicles rupture in cases of furunculosis?

A

The rupture extends the infection and releases highly irritating keratin into the dermis. Sinus or draining tracts develop to extrude the keratinized debris

104
Q

What are the key lesions to identify furunculosis?

A

progress to formation of nodules, crusted ulcers, and small draining (fistulous) tracts

105
Q

What other lesions are associated with furunculosis?

A

pruritus and alopecia (from ruptured hair follicles)

106
Q

Where does postbathing/grooming furunculosis typically develop?

A

in the thoracolumbar regions

107
Q

What is the recommended therapy for furunculosis?

A

Appropriate antibiotic therapy for 1-6 months, hydrotherapy to clear up lesions and reduce pain, surgical debridement and lancing, and identify and control of the underlying diseases

108
Q

What bacterial agent is typically isolated from interdigital pyoderma?

A

S. pseudintermedius

109
Q

What dogs are predisposed to interdigital pyoderma?

A

English bulldogs, dachshunds, boxers, and large breeds

110
Q

What primary conditions are associated with interdigital pyoderma?

A

immunodeficiency syndromes, hypothyroidism, allergies, and true follicular cysts

111
Q

What may suppurative folliculitis and furunculosis in cases of interdigital pyoderma extend into?

A

cellulitis

112
Q

What are the differential diagnoses for interdigital pyoderma?

A

follicular cysts, sterile pyogranulomatous reactions, and foreign bodies

113
Q

What lesions are associated with interdigital pyoderma?

A

purulent, exudative, draining tracts of the feet with moderate to severe swelling

114
Q

What behavioral signs may be associated with interdigital pyoderma?

A

they may refuse to walk because their feet are so painful

115
Q

How can interdigital pyoderma be diagnosed?

A

dermatology data base and cytology, bacterial culture, evaluation of the thyroid

116
Q

What are the recommended therapies for interdigital pyoderma?

A

long term antibiotic therapy, whirlpools, surgical debridement and removal of fistulous tracts, and identify and manage primary disease

117
Q

What may mucocutaneous pyoderma resemble?

A

autoimmune disease (e.g. pemphigus)

Small Animal Medicine (100 decks)

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