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SS - Exam 4 > Erosions/ulcers 1 > Flashcards

Erosions/ulcers 1 Flashcards

1
Q

erosions

A

Partial loss of epidermis
Does not penetrate the basement membrane
Heals without scarring

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2
Q

Ulcers

A

Full loss of epidermis
Penetrate & extend beyond basement membrane
Heals with scarring

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3
Q

Trauma classification of lesion

A

Pyotraumatic dermatitis*
Intertrigo (skin fold pyoderma)

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4
Q

Ischemia classification of lesion

A

Vasculitis*

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5
Q

Metabolic classification of lesion

A

Necrolytic migratory erythema

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6
Q

Neoplasia classification of lesion

A

Squamous cell carcinoma*
Cutaneous lymphoma*

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7
Q

Pyotraumatic dermatitis

A

Very common in dogs - thick coated breeds
“Hot spot” or acute moist dermatitis - condition can develop quickly

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8
Q

Clinical features of PTD

A

Acute onset**
Usually localized
Self inflicted trauma due to an underlying pruritic skin condition

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9
Q

Underlying causes of PTD

A

Allergic skin disease
Otitis externa
Ectoparasites
Matted hair
Itching can cause excessive biting, licking, scratching
Secondary bacterial infection is often a sequelae (super/deep)

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10
Q

Treating PTD

A

Clip affected areas
Clean w non irritating antibacterial solution - chlorhexidine
Topical/systemic glucocorticoids 5-14d depending on severity
Topical antiseptic or antibiotic for superficial lesion
Systemic antibiotic for deep lesion
PREVENT further trauma

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11
Q

Intertrigo
Skin fold pyoderma

A

Common in dogs
Name is based off location of lesion

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12
Q

names of Intertrigo & breeds

A

Lip fold pyoderma - spaniel breeds
Facial fold pyoderma - Brachycephalic breeds
Tail fold pyoderma - screw tails breeds
Volume fold pyoderma - obese animals

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13
Q

Pathogenesis of Intertrigo

A
  1. Two skin surfaces being rubbed together leading to trauma
  2. Poor ventilation
  3. Accumulation of moisture (tears, saliva, urine, sebum)
  4. Over colonization of microorganism such as yeast & bacterial exacerbate the inflammation
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14
Q

Treating skin fold pyoderma

A

Condition is an anatomical problems = no fix w med TX
Tx is often long term, surgery can be considered
1. Clean non-irritant antibacterial solution - chlorhexidine
2. Topical antiseptic/biotic therapy based on cytology
3. Weight loss for obese animals

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15
Q

Erosion/ulcers of ischemia

A

Inflammation of blood vessels which can lead to
1. Leaky BV wall & OR
2. Occlusion of BV lumen (thrombosis)

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16
Q

Distribution of vasculitis

A

Common in extremities initially but can be generalized
1. Paws/pads
2. Tail
3. Ear tips/margin
4. Nose

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17
Q

Skin lesion of vasculitis progression

A

Superficial - slow progression to alopecia
Deep & rapid progression to alopecia, erosion, ulceration, crusting and scars

18
Q

Pathogen of vasculitis

A

Leak blood vessel wall —> extravasation of RBC into dermis —> petechia (pin point) hemorrhage
Early lesion, skin can appear red
Older lesions, skin turns purplish

19
Q

Determining red discoloration of skin rash vs erythema (congestion) vs vasculitis (petechial hemorrhage)

A

Diascopy - pressing skin
Vasodilation - erythema, skin would blanche
Vasculitis - pressure will not cause coloration to disappear

20
Q

Vasculitis is not…

A

A disease !!
Look for underlying disease factors
Infectious: RMSF, ehrlichiosis, bacterial sepsis
ADR: drugs/vax
Autoimmune: systemic lupus, cold agglutinin disease

21
Q

DX for vasculitis

A

Skin biopsies from affected areas
Avoid collecting from ulcerated skin
Take multiple biopsies bc the changes in skin can be subtle
Inform pathologist that you are suspicious of possible vasculitis/vasculopathy

22
Q

TX of vasculitis

A
  1. Treat underlying cause
  2. Drugs can be used to treat immune mediated vasculitis
    - Pentoxifylline
    - glucocorticoids
    - cyclosporine
23
Q

Metabolic erosions/ulcers

A

Necrolytic migratory erythema ALSO
Hepatocuatnous syndrome*
Superficial Necrolytic dermatitis
Metabolic epidermal necrosis

24
Q

NME pathogenesis

A

Common in older dogs
Underlying conditions
- chronic hepatic disease (80%)
- phenobarbital associated hepatitis
- pancreatic glucagonma
- atrophic enteritis
Poorly understood - associated w low serum amino acids

25
Q

Non-derm signs of NME

A

Lethargy /weakness
Lameness (due to lesions in foot pads)
Inappetance
PU/PD - where there is concurrent diabetes mellitus or hepatic dysfunction

26
Q

Skin lesions of NME

A
  1. Footpads**
  2. Mucocutaneous junctions
  3. Pressure points on limbs
  4. Areas of friction
    2-4 = erosions & crusts
27
Q

Appearance of footpads

A

Hyperkertotic, crusting, fissuring, ulcerations. Interdigital secondary infections w Malassezia or candida is common

28
Q

DX of NME

A

Skin biopsy of inflamed lesions
NEVER biopsy entirely eroded or ulcerated lesion
Abdominal ultrasound : honeycomb/Swiss cheese pattern of liver MAY be seen

29
Q

TX of NME

A

Therapy is usually supportive/palliative & depends on underlying cause
Prognosis is poor (6-12m survival)

30
Q

Effective TX of NME

A

Intravenous amino acids**
High quality protein diet
Zinc supplementation
Essential fatty acids
Treat secondary infections

31
Q

Mechanism of erosion/ulcer in types of neoplasia

A

Tumors require nutrients to grow = secrete angiogenic factors which form a unique blood supply to the tumor
This can lead to tumor hypoxia = rapid growth demands more blood which can’t keep up = ischemic necrosis = erosion /ulceration

32
Q

Cytotoxicity

A

Cells getting toxic = death
Can cause epidermis to necrotize

33
Q

SCC erosions and ulceration

A

Most common epithelial cancer of dogs and cats
In cats - caused by chronic exposure to UV light
White cat = more prone to develop
Can occur from certain strains of papilloma virus

34
Q

Progression of SCC

A

Localized proliferative tumors that tend to ulcerate = tissue destruction
Rarely metastasizes or spreads hemo or lymph

35
Q

DX of SCC

A

Skin biopsy

36
Q

Tx of SCC

A

Surgical excision - most successful
Radiation therapy - best when combined w surgery
Cryosurgery /electrosurgery
Intralesional chemo
Tropical imiquimod

37
Q

Cutaneous lymphoma

A

Rare in cats/dogs
Dogs - presentation is highly variable and mimics other dermatoses
Also called cutaneous epitheliotrophic T cell lymphoma, cutaneous lymphosarcoma

38
Q

Skin lesion of cutaneous lymphoma

A

Erythema
Plaques
Erosion/ulcer
Mucosal lesion

39
Q

DX of cutaneous lymphoma

A

SKIN BIOPSY
Which lesions??
- depigmented lesions
- lesions w loss of architecture
- erythematous and scaly lesions
- plaques or nodules
NEVER biopsy entirely ulcerated lesions

40
Q

TX of cutaneous lymphoma

A

GRAVE prognosis
6-9m
Treatment is only palliative
REFER for recommended treatment

SS - Exam 4 (28 decks)

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