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Diseases of the Epidermis Flashcards

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Dermatology Board Prep flashcards
1
Q

What are common pustular diseases of the epidermis?

A
  • suppurative/pustular/ exudative/ neutrophilic - Bacterial or due to autoimmune
  • pyoderma
  • impetigo
  • intertrigo
  • hot spot
  • exudative epidermitis
  • dermatophilosis
  • pemphigus foliaceous
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2
Q

Define Pyoderma

A
  • ‘Pus in the skin’, usually bacterial
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3
Q

Superficial pyoderma

A
  • affects epidermis & hair follicles

Examples:
* Canine superficial spreading pyoderma/Bacterial folliculitis
* Impetigo (superficial pustular dermatitis)
* Greasy Pig dz
* dermatophilosis

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4
Q

Examples of Deep Dermis Pyoderma

A
  • Bacterial furunculosis
  • Abscesses
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5
Q

Portals of entry for pyoderma

A
  • follicular openings
  • haematogenous spread
  • direct entry thru damaged skin
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6
Q

Predisposing factors to pyoderma?

A
  • disorders of keratinisation (seborrhoea)
  • endocrine dz
  • chronic dermatitis - allergy, parasites, etc.
  • immunodeficiency
  • anatomic predisposition
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7
Q

Why is pyoderma common in dogs?

A
  • stratum corneum has a lack of lipid seal of hair follicles & an increase in skin pH
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8
Q

What is impetigo?

A
  • bacterial skin dz causing superficial non-follicular pustules
  • Due to: Staphylococcus intermedius - exfoliative toxins that cause intraepidermal splitting
  • Common in: prepubescent & pubescent dogs
  • poor environmental hygiene or poor nutrition
  • If present in adults: look for underlying suppression
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9
Q

What pustular skin dz is present in this image?

A

pyoderma

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10
Q

What is this skin condition?

A

Impetigo

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11
Q

Intertrigo

A
  • skin fold pyoderma
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12
Q

What skin condition is present?

A

Intertrigo

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13
Q

What is the pathogenesis of intertrigo?

A
  • closely apposed skin surfaces –> frictional trauma –> moisture –> opportunistic bacterial infections +/- Malassezia
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14
Q

Pyotraumatic dermatitis is also known as

A
  • hot spots
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15
Q

What is the pathogenesis of Pyotraumatic dermatitis?

A
  • self trauma –> bacterial infection
  • underlying pruritic skin, esp FAD
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16
Q

What does pyotraumatic dermatitis look like grossly?

A
  • moist, alopecic, slightly raised, red, well-circumscribed lesions leading to ulceration/crusting
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17
Q

What is this?

A

Hot spot
Pyotraumatic dermatitis

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18
Q

What is exudative epidermitis also known as?

A
  • Greasy pig dz
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19
Q

What characteristics are common to exudative epidermitis?

A
  • small papules & pustules
  • malodorous ‘greasy’ exudate
  • starts on head, can be generalised w/i 24-48 hrs
  • non-pruritic
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20
Q

Describe the histopathology of exudative epidermitis

A
  • subcorneal pustules
  • neutrophilic exocytosis
  • spongiosis
  • intracellular oedema
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21
Q

Greasy pig dz can be fatal to…

A
  • neonatal pigs
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22
Q

What does exudative epidermitis appear grossly?

A
  • erythema –> pustules –> brownish ‘greasy’ exudates/crusts
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23
Q

What are predisposing factors to exudative epidermitis?

A
  • other skin lesions
  • poor nutrition/husbandry
  • lacerations
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24
Q

What disease is present here?

A

Exudative epidermitis (Greasy pig dz)

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25
Q

What organism commonly leads to exudative epidermitis

A
  • Staphylococcus hyicus
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26
Q

Dermatophilosis characteristics?

A
  • lesions on back or distal extremities
  • stimulates neutrophilic exocytosis: pustules –> exudate –> matting of hair/wool –> alopecia
  • multiple layers of infected epidermis form a laminar structure
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27
Q

What are predisposing factors for dermatophilosis?

A
  • wet weather in humid climates (“rain rot”)
  • prolonged wetting of skin/hair/wool allows penetration of epidermis by “zoospores”
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28
Q

What organism leads to dermatophilosis?

A
  • Dermatophilus congolensis (Gram + filamentous bacteria)
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29
Q

Where would you find the organism that causes dermatophilosis?

A
  • Dx in the crust
  • Coccoid bodies germinate to form long filaments that undergo longitudinal & transverse septation ‘Tram track’ appearance
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30
Q

What condition is present?

A

Dermatophilosis

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31
Q

What condition is present?

A

Dermatophilosis

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32
Q

What is pemphigus?

A
  • autoimmune dz’s involving antibody-mediated rxn against cell adhesion proteins (desmosomes)
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33
Q

Pemphigus foliaceous is the most common and mildest form of pemphigus in what species?

A

horses, dogs, cats, goats

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34
Q

Pemphigus foliaceous can be due to:

A
  • spontaneous
  • drug-induced
  • assoc’d w/ allergic skin dz
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35
Q

Where is pemphigus foliaceous most commonly found on the body?

A
  • face
  • ears
  • footpads
  • clawbeds
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36
Q

What dermatological signs are present in pemphigus foliaceous?

A
  • vesicles
  • pustules
  • crusts
  • ulcers
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37
Q

What condition is this?

A

Pemphigus foliaceous

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38
Q

What bullous diseases are common in the epidermis?

A
  • pemphigus vulgaris
  • bullous pemphigoid
  • epidermolysis bullosa
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39
Q

What causes pemphigus vulgaris

A
  • autoimune dz (dog/cat)
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40
Q

What dermatological features are present in pemphigus vulgaris?

A
  • severe vesicobullous & ulcerative lesions due to demoglein 3 affecting desmosomes (suprabasilar keratinocytes)
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41
Q

What condition is present?

A

Pemphigus vulgaris

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42
Q

How common is pemphigus vulgaris?

A

Very rare

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43
Q

What is bullous pemphigoid?

A
  • fluid-filled spaces within the epidermis or at the dermoepidermal junction
  • Due to an antibody against a transmembrane glycoprotein of basal keratinocytes
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44
Q

What condition is present?

A

Bullous pemphigoid

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45
Q

Pemphigus foliaceous

Parts of body affected, symptoms, commonality

A

Affects: top layer of skin, over whole body
Symptoms: shallow skin blisters; itchy skin, redness, crust
Type: most common

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46
Q

Pemphigus vulgaris

Affects, symptoms, type

A

Affects: deep layers of skin whole body (incl mouth) & in particular trauma areas - claw folds, underarms, groins
Symptoms: deep ulcers; itchy skin & pain, fever, lethargy, depression, anorexia from mouth ulcers
Type: most serious - critical & life-threatening; devleops into bacterial infections which are common & fatal

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47
Q

What is epidermolysis bullosa?

A
  • Mechanobullous dz
  • common in dogs, cats, cattle, people
  • can be hereditary or acquired
  • leads to structural defects in basal cell layer (basement membrane)
  • loss of epithelial integrity, blister formation
  • acquired antibody to same structures
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48
Q

What disease is present?

A

Epidermolysis bullosa

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49
Q

whenever you see ulcers, you should look for…

A

vesicles

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50
Q

Vesicular diseases of cattle that have vesicles of out FMD, Vesicular stomatitis, swine vesicular dz, and vesicular exanthema

A
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51
Q

Vesicular diseases of pigs that have vesicles of out FMD, Vesicular stomatitis, swine vesicular dz, and vesicular exanthema

A
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52
Q

Vesicular diseases of horses that have vesicles of out FMD, Vesicular stomatitis, swine vesicular dz, and vesicular exanthema

A
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53
Q

Explain vesicle formation of Foot & Mouth Dz

A
  • ingestion or aerosol exposure –> initial viral replication in pharynx & lungs –> targets lymphoid cells, macrophages, dendritic cells –> leukocyte trafficking to regional LNs –> replication phase in LNs –> systemic spread –> lysis of epithelial cells in the stratum spinosum of stratified squamous epithelium
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54
Q

What are necrotizing diseases of the epidermis?

A
  • erythema multiforme
  • toxic epidermal necrolysis
  • superficial necrolytic dermatitis
  • photosensitisation
  • herpesvirus
  • cowpox virus
  • burns
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55
Q

Explain erythema multiforme & toxic epidermal necrolysis (TEN)

A
  • Type IV hypersensitivity towards antigens on keratinocyte surface inducing apoptosis
  • antigenic mimicry following drug admin, underlying infection, neoplasia, dyes/preservatives in pet food
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56
Q

Explain the gross appearance of erythema multiforme & Toxic epidermal necrolysis (TEN)

A
  • widespread coalescing erythematous macules (target lesions) –> vesicles & ulcers (trunk, axilla, groin)
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57
Q

What condition is this? What is the characteristic sign?

A
  • keratinocyte death (apoptosis) occurs w/ lymphocyte satellitosis
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58
Q

What condition is this? What are its characteristics?

A
  • TEN (toxic epidermal necrolysis)
  • very rare, severe, life-threatening syndrome
  • Generalised dz (erythema multiforme) & >30% epithelial detachment
59
Q

Superficial Necrolytic Dermatitis

A
  • Hepatocutaneous syndrome
  • Necrotising skin disorder (dogs > cats)
  • Metabolic hepatic dz
  • Cats = neoplasia
60
Q

What condition is presented here?

A

Superficial necrolytic dermatitis

61
Q

What is photosensistisation?

A

UV light absorbed by photodynamic chemicals in skin –> free radical damage –> epidermal necrosis of lightly pigmented or sparsely haired skin

62
Q

Type 1 photosensitisation

Due to, Examples of causes

A
  • Due to ingestion of a photodynamic substances OR plants w/ photoreactive pigments OR mycotoxins, moulds, chemicals, drugs
  • Ex: St. John’s Wort, Lucerne, Perennial ryegrass, quinolones, griseofulvin
63
Q

Type II photosensitisation (Intrinsic, tertiary)

A
  • due to endogenous pigment accumulation OR defective porphyrin metabolism
  • Ex: erythropoietic porphyria
64
Q

Type III photosensitisation (secondary, hepatogenous)

A
  • Due to abnormal build-up of phylloerythrin due to liver dz or biliary obstruction
  • Ex: hepatogenous, secondary
65
Q

Type IV photosensitisation

A

Idiopathic

66
Q

Macroscopic changes of photosensitisation

A
  • Present in unprotected, unpigmented skin
  • erythema
  • oedema
  • pruritus
  • extensive necrosis
  • marked exudation
  • Mainly in herbivores (chlorophyll)
67
Q

Histopathology of photosensitisation

A

coagultive necrosis of epidermis, dermal oedema, fibrinoid degen of vessel walls & thrombosis

68
Q

Bovine herpesvirus 2 causes what conditions in cattle? What parts of the body are affected?

A
  • Bovine ulcerative mammilitis
  • Pseudolumpy skin dz
  • Affects: cutaneous
69
Q

Bovine herpes virus 4 causes what conditions in cattle? What parts of the body are affected?

A
  • Bovine herpes mammary pustular dermatitis
  • Affects: cutaneous
70
Q

Feline herpes virus 1 causes what condition in cats? What part of the body is affected?

A
  • Feline facial dermatits & stomatitis
  • Affects: cutaneous, oral, ocular, upper respiratory
71
Q

Ovine herpes virus 2 causes what condition? In what species? What part of the body is affected? Where is this dz found?

A

Malignant Catarrhal fever
Cattle
cutaneous, oral, systemic
USA

72
Q

What does the histology of herpesvirus look like?

A
  • Severe necrosis & ulceration of the epidermis & dermis
  • Massive exudation to form large superficial crusts
  • Mixed dermal inflammation w/ numerous eosinophils
  • Large amphophilic intranuclear inclusion bodies in the epithelium
73
Q

What condition does this histology depict?

A

Herpesvirus

74
Q

Pseudo-Lumpy Skin Dz (PLSD) causes…

A
  • ulcerative mammilitis (self-limiting) on the udder & teats
  • Generalised superficial cutaneous nodules w/ central depressions
75
Q

What condition is modeled here?

A

Pseudo-lumpy skin dz (PLSD)

76
Q

What condition is modeled here?

A

Pseudo-lumpy skin dz (PLSD)

77
Q

Feline herpesvirus 1 is also known as

A

Feline herpesvirus ulcerative dermatitis

78
Q

Feline herpesvirus 1 causes

A
  • Upper resp tract dz: rhinotracheitis, conjunctivitis
  • erosion & ulceration of the face (muzzle, periorbital regions, planum nasale)
79
Q

What allows for resurgence of feline herpesvirus 1

A

stress & immunosuppression

80
Q

Ovine herpesvirus 2 causes what condition?

A

Malignant Catarrhal Fever (MCF)

81
Q

What are signs of ovine herpesvirus 2?

A
  • Fever
  • Depression
  • Ocular & nasal d/c
  • lesions of the buccal cavity & muzzle
  • swelling of LN’s
  • Opacity of the corneas
  • inappetance
  • diarrhoea
  • some have neurologic signs: ataxia, nystagmus, head pressing

Remember: this is in CATTLE

82
Q

What condition is present here?

A

Malignant Catarrhal Fever

83
Q

Feline Cowpox virus is caused by what virus?

A
  • cowpoxvirus (orthopoxvirus)
84
Q

Where is feline cowpox virus most common?

A

UK/IE

85
Q

What does feline cowpox virus look like grossly?

A
  • ulcerting, erythematous, crusted macule on head, neck, forelegs
86
Q

What does feline cowpox virus look like on histology?

A
  • severe ulceration
  • serocellular crusting
  • ballooning degeneration of keratinocytes (epidermis & hair follicles)
  • Numrous, large intracytoplasmic, brightly eosinophilic inclusions
87
Q

What condition is presented here?

A

Feline cowpox virus

88
Q

Acute solar injury (‘sunburn’) is due to…

A
  • acute severe UV light exposure –> sunburn
89
Q

What does acute solar injury look like grossly?

A

erythema –> blistering/vesicles –> sloughing of necrotic skin

90
Q

What is the pathogenesis of acute solar injury?

A
  • direct cellular injury by ionizing radiation
  • endothelial damage & cytokine production causes erythema
  • years of UV exposure leads to solar/actinic keratosis
  • Ventral abd/thx –> non-pigmented & sparsely haired skin is erythematous, has comedones, crusts, thickened
  • Increases risk for neoplasia due to DNA injury/mutations
91
Q

What condition is presented here?

A

Acute solar injury

92
Q

What condition is presented here? What is the pathogenesis?

A

Solar keratosis –> neoplastic transformation –> squamous cell carcinoma (SCC)
Due to acute solar injury

93
Q

What causes thermal burns?

A
  • exposure to excessive heat (hot liquids, flames, friction, electricity, heating pads, blow dryers, drying cages, lightning
94
Q

What signs are present in a 1st degree thermal burn?

A
  • reddened/darkened necrotic epidermis
  • complete healing
95
Q

What signs are present in a second degree thermal burn?

A
  • vesicle formation in the epidermis & dermis
  • some adnexa preserved allowing epidermal regeneration & some scarring
96
Q

What signs are present in third degree thermal burns?

A
  • sloughing of necrotic tissue followed by granulation tissue
  • scarring
  • can be life-threatening (fluid/protein loss & protal for sepsis)
  • Affects: full thickness epidermis & dermis +/- subcutis
97
Q

What are some hyperplastic diseases of the epidermis?

A
  • acral lick dermatitis
  • malassezia dermatitis
  • hyperplastic dermatosis of WHWT
  • Actinic keratosis (solar)
  • Pox virus/parapox virus
98
Q

What causes acral lick dermatitis?

A
  • self-trauma to a focal area, usually a dorsal distal extremity
  • strong psychogenic component, but must also rule out allergy, bacterial, fungal dz, demodicosis, previous trauma, underlying joint dz
99
Q

What does acral lick dermatitis look like grossly?

A

alopecic, firm, oval plaque

100
Q

What does acral lick dermatitis look like histologically?

A
  • compact hyperkeratosis
  • severe irregular acanthosis +/- erosion or focal to extensive ulceration w/ exudation
  • inflammatory cells perivascular, perifollicular, or diffuse
  • perihidradenitis +/- deep folliculitis & furunculosis
101
Q

What condition is present here?

A

acral lick dermatitis
(lick granuloma)

102
Q

Malassezia dermatitis is very common in what species? Rare in what species?

A

Common in dogs
Rare in felines

103
Q

Malassezia dermatitis is caused by what organism?

A

Yeast (Malassezia pachydermatis)

104
Q

What signs are present with malassezia dermatitis?

A
  • Excessive sebum production
  • moisture accumulation
  • disruption of normal barrier fxn
  • hypersensitivity
  • secondary to predisposing triggers
105
Q

What does malassezia dermatitis look like grossly?

A
  • focal/multifocal/generalised
  • ventral neck, ventral abd, axilla, face, pinnae, feet, forelegs, skin folds
  • Erythema
  • greasy or waxy adherent scales & crusts
  • hair loss
  • hyperpigmentation
  • lichenification
  • ‘musty’ odour
106
Q

What condition is presented here?

A

Malassezia dermatitis

107
Q

Hyperplastic Dermatosis of WHWT (Westies) is also known as…

A

Armadillo Westie Syndrome

108
Q

What are signs of Hyperplastic dermatosis of WHWT?

A
  • severe, chronic hyperplastic skin dz
  • hyperproliferative rxn pattern initiated by various inflammatory stimuli & infectious agents (usually Malassezia)
109
Q

What does hyperplastic dermatosis of WHWT look like grossly?

A
  • generalised erythema w/ lichenification
  • hyperpigmentation
  • alopecia
  • malodorous brownish-grey, greasy exfoliative debris
  • +/- pruritis Malassezia dermatitis & surface bacterial overgrowth or superficial pyoderma
110
Q

What is the sequence of lesions in pox viruses?

A

macule –> papule –> vesicle –> umbilicated pustule –> crust –> scar

111
Q

Parapox viruses cause what conditions?

A

Bovine papular stomatits, orf, parapox of red deer, pseudocowpox, sealpox

112
Q

Orf affects what stages of life?

A

Lambs & weaners
Ewes at lambing

113
Q

Where would lesions of Orf be found?

A

mouth, feet, teats

114
Q

What does orf look like grossly?

A
  • epidermal hyperplasia
  • ballooning degeneration
  • vessicles
  • neutrophil accumulation in vesicle
  • intracytoplasmic inclusions
115
Q

What condition is present here?

A

Orf

116
Q

What are diseases that produce abnormal cornification?

A
  • seborrhea
  • sebaceous adenitis
  • nasodigital hyperkeratosis
  • ichthyosis
  • callus
  • Zn-responsive dermatitis
117
Q

What is seborrhea?

A

non-specific name for excessive scaling, crusing, & greasiness

118
Q

What is primary idiopathic seborrhoea?

A

inherited faulty keratinisation present in animals <18-24 mos
Breeds: WHWT, Cocker spaniels, Labs

119
Q

What causes secondary seborrhoea?

A

underlying endocrinopathies, allergies

120
Q

Secondary seborrhea is often assoc’d w/

A

superficial pyoderma
Malassezia infection
Alopecia

121
Q

What is the pathogenesis of primary idiopathic seborrhoea?

A
  • invovles hyperproliferation of the epidermis, hair follicle infundibulum, and sebaceous glands
122
Q

Describe the histopath of primary idiopathic seborrhoea

A

marked epidermal & follicular hyperkeratois + comedones

123
Q

What condition is this?

A

primary idiopathic seborrhoea

124
Q

What condition is this?

A

Canine ear margin seborrhoea

125
Q

What are the features of canine ear margin seborrhoea?

A
  • Seborrhoea on the margins of the pinnae - adherent keratinous deposits on the lateral & medial margins of the pinna
  • Dachshunds predisposed
  • Due to hypothyroidism
126
Q

Sebaceous adenitis occurs in…

A
  • dogs (rare in cats)
  • Std poodle, Akita
127
Q

What does sebaceous adenitis look like grossly?

A
  • adherent scaling forming follicular casts or fronds
  • coat qlty diminishes as dz progresses –> dull, dry, brittle, broken hairs
128
Q

What does sebaceous adenitis look like histologically?

A
  • infalmmation of sebaceous glands or absence of sebaceous glands w/ acanthosis
  • hyperkeratosis
129
Q

What is nasodigital hyperkeratosis?

A
  • idiopathic disorder of cornification affecting the planum nasale & pawpads
  • common to older dogs (rare in cats)
130
Q

What does nasodigital hyperkeratosis look like grossly?

A
  • Frondlike keratinous proliferations OR verrucous, ridged proliferations w/ feather-like splitting
  • inflammation NOT present
  • proliferative debris predominantly at pad margins
131
Q

Nasodigital hyperkeratosis is similar to what other condition in what specific species/age of dog?

A

Nasal parakeratosis of labs <1 yr of age

132
Q

What condition is this?

A

Nasodigital hyperkeratosis

133
Q

What is ichthyosis?

A
  • inherited skin disorder characterised by thickening & marked scaling of skin which can crack into plates & resemble fish scales
  • Assoc’d w/ defects in epidermal barrier (intracellular lipid layers, cornified envelope, keratin proteins) resulting in increased production of stratum corneum (scaling)
134
Q

What condition is this?

A

Ichthyosis

135
Q

What is a callus?

A
  • pressure point granuloma
  • aka thickened plaque on bony prominences or pressure points due to repeated pressure or frictional trauma
  • common in large/giant breeds
  • Epidermal hyperplasia, hyperkeratosis, cystic hair follicles, furunculosis
136
Q

What’s this?

A

Callus/pressure point granuloma

137
Q

What causes Zn responsive dermatosis?

A

Diet deficient in Zn, high in Ca/Fe/phytates or other Zn-chelating organisms

138
Q

What are the signs of Zn responsive dermatosis in pigs?

A
  • 2-4 mos old
  • anorexia
  • reduced growth rate
139
Q

What are the two syndromes of Zn responsive dermatosis in dogs?

A
  • Syndrome 1: Siberian huskies, Alaskan malamutes < 1 yr old
  • Syndrome 2: Puppies of any breed
140
Q

What does Zn responsive dermatosis look like in ruminants?

A
  • Several in herd affected
  • decreased appetite
  • weight loss
  • decreased milk production
  • depression
  • diarrhoea
141
Q

What does Zn responsive dermatosis look like grossly?

A

scaling & crusting skin lesions mainly around the eyes, lips, nose, pressure points, foot pads

142
Q

What does Zn responsiver dermatosis look like histologically?

A
  • severe acanthosis, follicular parakeratosis
143
Q

What breeds/species can get Zn responsive dermatosis as an autosomal recessive condition?

A

Cattle: Friesians, US Shorthorns
Dogs: Bull terriers

PK Derm (5 decks)

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