Final Exam Inflammation & Repair Deck 2 Flashcards
What are the pathological cardinal signs of inflammation?
Erythema
Edema
Exudate
Heat
Pain/Itching
T/F
If there are pustules or crust, that means there is an inflammatory component to the lesion
TRUE
T/F
Immune mediated inflammatory lesions can cause depigmentation
TRUE
T/F
The difference between inflammatory infiltration and neoplasia is that in inflammatory infiltration, you will see papules, plaques, and nodules, but in neoplasia, you won’t.
FALSE
You can see these symptoms in BOTH inflammatory infiltration AND neoplasia
T/F
The only kind of pigmentation you will see with Dermatitis is hyperpigmentation
FALSE
you can see BOTH hyperpigmentation OR hypopigmentation
Pyoderma is indicative of this type of infection of the skin
bacterial infection will produce pus
Another name for
Superficial Pustular Dermatitis
Impetigo
Greasy Pig Disease is an example of ________ pyoderma
superficial
T/F
Dermatophilosis is pyoderma of the deep dermis
FALSE
it is pyoderma of the superficial EPIDERMIS and hair follicles
Bacterial furunculosis and abcesses are examples of pyoderma found in the ______ _______
deep dermis
Infections of the skin often involve this bacteria, which produces exfoliative toxins that cause intraepidermal splitting.
What is the exception?
Staphylococcus
EXCEPT for dermatophilosis
What is intertrigo?
Skin fold pyoderma
Do not get confused with Impetigo, which is superficial pustular dermatitis
What is the MDx for Intertrigo?
MDX: Neutrophilic dermatitis
Always think Staphylococcus if you get this MDx
T/F
You should always start treatment with antibiotics before taking a biopsy
FALSE!!!
ALWAYS biopsy BEFORE antibiotics!!
The more common term for Pyotraumatic Dermatitis
HOT SPOT
You see hairless, slightly raised, well circumscribed lesions and ulcerations with crust on the skin of your dog.
What is this called?
HOT SPOT (Pyotraumatic Dermatitis)
You see hairless, slightly raised, well circumscribed lesions and ulcerations with crust on the skin of your dog.
What kind of infection is this?
Bacterial infection
You see hairless, slightly raised, well circumscribed lesions and ulcerations with crust on the skin of your dog.
What is the underlying cause?
FLEA Allergy Dermatitis
This disease, that can be fatal for neonatal pigs, is also called “Exudative Epidermitis”
Greasy Pig Disease
What is the bacterial cause of Greasy Pig Disease or Exudative Epidermitis?
Staphylococcus hyicus
T/F
Pyoderma is a pathological term
FALSE
it is a clinical term, caused by an infection
What is Dermatophilosis caused by?
Dermatophilus congolensis
What condition is associated with “train tracks” morphology?
Dermatophilosis
What are the predisposing factors for Dermatophilosis?
Wet weather in humid climates- “Rain Rot”
Prolonged wetting of skin/wool/hair allows penetration of epidermis by zoospores
In sheeps, another name for Dermatophilosis caused by
Dermatophilus congolensis
LUMPY WOOL
the exudate dries and pulls wool together, then in sloughs off
How do you confirm dermatophytes is the pathogen?
Use a wood’s lamp to light it up
or take a fungal culture and make a smear on a slide
T/F
Canine Superficial Spreading Pyoderma is a secondary condition
TRUE
If you see Dermatitis AND folliculitis, what is on your DDx?
Bacterial pathogen like Staph
or a fungal pathogen like ringworm (dermatophytes)
it could also be demodicosis (mites)
Rule out dermatophytes using a Wood’s lamp
and Mites by doing a smear slide
What is it called when follicular inflammation leads to rupture?
Furunculosis
What are two conditions grossly indistinguishable from
Canine Superficial Pyoderma?
Clinical signs include folliculitis, erythematous macules, alopecia, scaling
MDx: Neutrophilic Dermatitis and Folliculitis
Demodicosis (Demodex spp. mites)
Dermatophytosis (Epidermophyton, Microsporum, Trichophyton)
Which species are you most likely to see Demodicosis in?
Dog (young)
If you see an adult dog with Demodicosis, what should you be worried about?
A systemic disease like Neoplasia or
- Endocrinopathy *or
- Immunosuppressive therapy*
What is the site of colonization of *Epidermophyton, Microsporum, *and Trichophyton,
agents that cause Dermatophytosis?
Keratin!!
Immunosuppressed animals are predisposed
T/F
*Demodicosis *is zoonotic
FALSE
*Dermatophytosis *IS zoonotic, not Demodicosis
What are predisposing factors for Dermatophytosis?
Young animals
Immunosuppressed animals
Hot/humid environments
What stains are used histologically for fungus?
GMS stains
Dermatophytes may have a granulomatous response
A 5-year-old dog has acutely developed some nasty skin lesions
You see crusting and ulcerations around the eyes and nose
and erythema with pustules and more crusting around the paw pads.
What is your MDx?
MDx:
Exudative Dermatitis
or
Pustular Dermatitis
A 5-year-old dog has acutely developed some nasty skin lesions
You see crusting and ulcerations around the eyes and nose
and erythema with pustules and more crusting around the paw pads.
What is your suspected EDx? How do you confirm?
EDx suspected:
Bacterial Dermatitis
Do a cytology on pustules and crust. Biopsy during the acute phases, not months later
A 5-year-old dog has acutely developed some nasty skin lesions
- You see crusting and ulcerations around the eyes and nose*
- and erythema with pustules and more crusting around the paw pads.*
After histology, the following results are given:
There is leukocyte infiltration of the epidermis
No mites or fungus is seen on skin scraping
No fluorescence seen with Wood’s Lamp
No fungal growth seen in culture
The pustules have eosinophils and some bacteria, but NOT in the cytoplasm of leukocytes
There are few neutrophils
Keratinocytes have lost connection to eachother
WHAT IS YOUR DIAGNOSIS?
Pemphigus folliaceous
A group of autoimmune diseases involving type II hypersensitivity against cell adhesion proteins (desmosomes)
Pemphigus
The most common and milder form of pemphigus reported in horses, dogs, cats, and goats
and often involves
face, ears, footpads and clawbeds
with **vesicles, pustules, crusts, **and ulcers
Pemphigus folliaceous
*Pemphigus folliaceous *can be
spontaneous, drug-induced, or associated with ________
skin disease
allergic
Cross reaction with the _______ that are holding the skin together is the most common immune-mediated response of dermatological *Pemphigus Folliaceous *skin disease in dogs
desmosomes
In inflammation and repair:
If you see suppurative/pustular/exudative/neutrophilic
lesions
What is your best guess at the pathological process?
Bacterial or Autoimmunity
In inflammation and repair:
If you see proliferative lesions
What is your best guess at the pathological process?
Viral pathogen
In inflammation and repair:
If you see vesicular lesions
What is your best guess at the pathological process?
Viral or Autoimmunity
In inflammation and repair:
If you see granulomatous lesions
What is your best guess at the pathological process?
“Higher” bacteria
Mycobacteria
Fungus
or
Foreign substance
In inflammation and repair:
If you see eosinophilic lesions
What is your best guess at the pathological process?
Allergy
or
Parasite
In inflammation and repair:
If you see interface
What is your best guess at the pathological process?
Autoimmunity
Piglets in a zoo display come down with skin lesions.
You see a raised, slightly encysted area with multiple papules.
What is your MDx?
Papular dermatitis
Piglets in a zoo display come down with skin lesions.
You see a raised, slightly encysted area with multiple papules.
But something is being “added” to the epidermis, so this is most likely a disturbance of growth, or inflammatory.
What is your DDx?
Not mineral deposit, because it is not white.
Grossly, it looks like a papule
So you gotta think Viral pathogen
Piglets in a zoo display come down with skin lesions.
You see a raised, slightly encysted area with multiple papules.
No mites or fungus seen on skin scraping
Cytology reports a few lymphocytes and some keratin
Culture of the crust shows *Staph *spp.
Histopathology shows Proliferative Dermatitis with “ballooning degeneration” and intracytoplasmic inclusion bodies. The cytoplasm compartment is clear
What is your diagnosis?!
SWINE-POX is the cause!!
The following is pathognomic for a virus in pigs. Which virus is it?
Proliferative dermatitis with “ballooning degeneration”
and
intracytoplasmic inclusion bodies
Swine-Pox Virus
What do pox virus lesions look like?
Papules with necrotic or depressed centers
“umbilicated depressed center”
What is the sequence of lesions for a poxvirus infection?
Macule→Papule→Vesicle→Umbilicated pustule→Crust→Scar
Poxviruses have a gene that is similar to epidermal growth factor
which causes ________ _________
epidermal hyperplasia
In a lamb, you see vesicles and papules early on, and then later see crusts and scabs on the mouth.
Your MDx is Papular vesicular dermatitis/chelitis
and epidermal hyperplasia (acanthosis), ballooning degeneration, and vesicles with neutrophilic infiltration which results in pustules.
What is your diagnosis?
Contagious ecthyma
caused by a
poxvirus
T/F:
Contagious ecthyma is zoonotic
TRUE
see painful, umbilicated papules on hands mostly in humans
You are seeing some
*lameness, ptyalism, *and anorexia in some backyard livestock
When you open the mouth of your sheep, you see hard vesicles
In between the toes, you see vesicles, but mostly ulcers
What is your MDx?
Vesicular Ulcerative Dermatitis and Stomatitis
and
Pododermatitis on the feet
You are seeing some
lameness, ptyalism, and anorexia in some backyard livestock
When you open the mouth of your cow, you see hard vesicles
In between the toes, you see vesicles, but mostly ulcers
Histopathology shows something damaging keratinocytes
so know the process is degeneration/necrosis or inflammatory
What is your diagnosis?
**Vesicular Stomatitis Virus (VSV) **in cows
NEVER FORGET ________ when you see Vesicles
VIRUSES!
Vesicular dermatitis is caused by _______ virus
HERPESvirus
T/F:
Herpesvirus can cause cutaneous vesicles
TRUE
What viruses can cause vesicles?
- Herpes*
- Poxvirus*
- Foot and Mouth Disease*
- Vesicular Stomatitis Virus*
- Swine Vesicular Disease*
- Vesicular Exanthema of Swine*
FMD, VSV, SVD, VES, H, P
Feline Herpesvirus 1 causes
this MDx
which occurs around their eyes, lips, and nose
MDx: Pustular vesicular dermatitis/chelitis/rhinitis
What are clinical signs seen with
Bovine Herpesvirus 2
Ulcerative mammilitis
and
Pseudo-lumpy skin disease (vesiculo-ulcerative dermatitis)
What is the predilection site for *BHV-2 (Bovine herpesvirus 2) *?
TEATS!
Causing vesicles and ulcerations
If something is being added to the epidermis, the pathological process is likely due to what?
Disturbance of growth
or
Inflammation
What is the LEAST likely cause of
papules, nodules, and plaques
Mineral deposition
It’s not an abcess if it’s not filled with ____
pus
What is it called when macrophages have uncontrolled growth and division in Idiopathic Sterile Granuloma and Pyogranuloma Syndrome, a rare disease in dogs?
Neoplasia
Fungal dermatitis is an infectious granulomatous disease
caused by Pythium and *Lagenidium *spp.
It is also known as this.
Swamp Cancer
Swamp Cancer, or Fungal Dermatitis resembles this pathogenic process clinically, because of its invasive lesions and involvement of regional lymph nodes
Neoplasia
What is the MDx for fungal dermatitis, or “Swamp Cancer”?
MDx: Granulomatous dermatitis
an infectious granulomatous disease
What kind of cells will be seen in lesions of
Granulomatous Dermatitis, caused by Pythium and *Lagenidium *spp. ?
Macrophages and a rim of lymphocytes
Fungal hyphae seen in necrotic regions
In Actinomycete Mycetomas,
*Nocardia *or *Actinomyces *spp. of bacteria
is introduced via
traumatic injury
Large clumps seen in Actinomycete Mycetomas
are grossly evident as ________ ________
sulfur granules
These bacteria cause persistent lesions that can eat away at underlying bone, and are introduced into the host via traumatic injury
Nocardia or *Actinomyces *spp.
which cause pyogranulomatous dermatitis (MDx)
Feline Leprosy is also known as
Mycobacterial Dermatitis
Feline Leprosy, or Mycobacterial Dermatitis is caused by
this bacteria, an obligate intracellular organism
Mycobacterium lepraemurium
What are the predisposing factors for a cat with Mycobacterial Dermatitis (Feline Leprosy)?
Cats in cold, wet areas
FIV or other underlying viral infections
Debilitation
How is the MDx for Actinomycete Mycetomas different from the MDX for Mycobacterial Dermatitis?
Actinomycete Mycetomas: MDx- pyogranulomatous dermatitis
Mycobacterial Dermatitis: MDx: granulomatous dermatitis
Another name for Mycobacterial Dermatitis (Feline Leprosy) is
Opportunistic Mycobacteriosis
Mycobacterial Dermatitis of dogs, especially boxers, is also known as this.
Canine Leproid Granuloma
A boxer with cute floppy ears presents with nodules involving
the dorsal pinna. This is difficult to culture and
ZN stain is needed to see the
acid fast bacilli within macrophages
What is your number 1 DDx?
Leproid Granuloma
MDx: Granulomatous Dermatitis
Another name for Juvenile Sterile Granulomatous Dermatitis is
Puppy Strangles
A puppy that is 3 months old presents with pustules and enlarged lymph nodes. After about a week and a half, the same dog has
*alopecia, edema, crusting, *and its lymph nodes are even larger. It’s face and ears along with mucocutaneous junctions are all very swollen.
What is your diagnosis?
Puppy Strangles
(Juvenile Sterile Granulomatous Dermatitis)
What is the pathogenesis of Puppy Strangles (Juvenile Sterile Granulomatous Dermatitis)?
Pustules–> Pyogranulomas–> Granulomas –> Lymphadenitis (swollen lymph nodes)
Will also have “pyelosteopathy”
What is your MDx for Puppy Strangles?
MDx: Pyogranulomatous dermatitis and panniculitis +/- lymphadenitis
(Fever and joint pain often accompany this)
What is your MDx for “Lick Granuloma”, also called “Acral Lick Dermatitis”?
This is NOT actually a Granuloma
MDx: Dermal fibrosis and epidermal hyperplasia
A dog presents with his front paws having circumscribed lesions, with hair loss in those areas and some ulceration. Upon Histology, epidermal hyperplasia, granulation tissue, and fibrosis
are seen. What is your diagnosis?
Acral Lick Dermatitis
aka
“Lick Granuloma”
which is NOT actually a granuloma, only called this because grossly looks raised
A 3 years old mixed breed dog is brought in because his constant itching is driving everyone in the family crazy, especially at night.
The dog presents with erythema, alopecia, and scaling and the areas are warm to the touch.
The pathological process is most likely….
Inflammatory!
ALLERGY is at the top of the list because of the itching, but you must distinguish this clinically.
A 3 years old mixed breed dog is brought in because his constant itching is driving everyone in the family crazy, especially at night.
The dog presents with erythema, alopecia, and scaling and the areas are warm to the touch.
**A skin scraping shows no mites or fungus, and bacterial culture just shows *Staph *spp. **
Histopathology shows *Eosinophilic dermatitis with epidermal hyperplasia *and perivascular leukocyte infiltrate.
WHAT IS YOUR DIAGNOSIS?
ALLERGIC SKIN DISEASE!!
What is your MDx for Allergic Skin Disease?
MDx: Eosinophilic Dermatitis with Epidermal Hyperplasia
What is the name for areas where the epidermis is thickened?
Acanthosis
What 4 things can cause Allergic Skin Disease?
Atopy
Food Allergy
Contact Hypersensitivity
Insect Bite Hypersensitivity
Type 1 Hypersensitivity to environmental allergens
aka
“inhalant allergy”
Atopy
How is Atopy “inhalant allergy” diagnosed?
Intradermal skin test
A golden retriever has erythema, alopecia, and erosions in the skin around the eye and muzzle. The lesions are caused by self-trauma from rubbing and scratching as a result of pruritis.
What is the cause of these clinical signs?
Atopic Dermatitis
“inhalant allergy”
Looks like demodex because it was around the eyes
Contact dermatitis is Type ___ Hypersensitivity
Type 4 Hypersensitivity
Lesions in allergic skin diseases vary:
Erythema, alopecia, and excoriation are due to
Self-inflicted trauma
Lesions in allergic skin diseases vary:
**Papules, Pustules, **and Crusts
are lesions due to
Secondary Pyoderma
Lesions in allergic skin diseases vary:
**Lichenification, Hyperpigmentation, **and Scaling
are lesions due to
Chronicity
Insect Bite Hypersensitivity is Type __ and/or __ Hypersensitivity reaction
Type 1 and/or 4 Hypersensitivity
What is the most likely cause of Insect Bite Type 1 or 4 Hypersensitivity in a horse and where would you see the clinical signs?
*Culicoides *saliva
Effects seen at **tail base, withers **and head
What is the most likely cause of Insect Bite Type 1 or 4 Hypersensitivity in a dog or cat
and where would you see the clinical signs?
Flea saliva
**Tail base **for dogs
Neck for cats
What is the most likely cause of Insect Bite Type 1 or 4 Hypersensitivity in a cat (not flea)
and where would you see the clinical signs?
Mosquito saliva
On the **nose **and face
What is the MDx for Insect Bite Hypersensitivity?
MDx: Papular/Pustular Dermatitis
A dog with flea bite hypersensitivity also commonly has
this secondary self-trauma associated pyoderma
Pyotraumatic dermatitis
MDx: Chronic and Exudative Dermatitis
**Miliary dermatitis **is not a disease, its just a pattern. Describe the pattern
Small erythematous papules
Macropapular dermatitis commonly seen in cats
with allergic skin disease
is also known as
Miliary Dermatitis
T/F
Eosinophilic granuloma complex in cats is a disease that causes ulcers on the upper lips
FALSE
Eosinophilic Granuloma Complex is NOT a disease, it is just a pattern of lesions
What are the 3 ways that Eosinophilic Granuloma Complex in cats can present?
- Indolent Ulcer (upper lip ulcer)
- Eosinophilic plaque (discrete red to ulcerated plaques on abdomen or medial thighs bilaterally symmetrical)
- Eosinophilic granuloma (nodules on thighs, face, mouth)
What is the MDx for Eosinophilic Granuloma Complex?
MDx: Eosinophilic Ulcerative Dermatitis/Chelitis
What 4 things can cause an Eosinophilic Granuloma?
Parasitic reaction
Insect bite hypersensitivity
Foreign body reaction
Underlying mast cell neoplasia
Summer sores in a horse (cutaneous habronemiasis)
cause these lesions via larval migration of
Habronema or *Draschia *spp.
deposited into a wound by house or stable flies
Cutaneous eosinophilic granulomas
What is a very common finding histologically within eosinophilic granulomas?
Degenerate collagen fibers (collagenolysis)
Discoid Lupus Erythematosis is an _________ disease
autoimmune
This 2nd most common autoimmune skin disease is induced and exacerbated by UV light
Discoid Lupus Erythematosis
An Akita presents depigmentation in its nasoplanar area.
Erythema, scaling, erosion, ulceration, and crusting are also seen.
Because the dog has this disease, you will have to
immediately start it on immune suppressive therapy before it
loses its vision!
Discoid Lupus Erythematosis
(autoimmune disease)
What is pigmentary incontinence?
a histopathological lesion in which melanin granules are free
in the dermis and within dermal macrophages;
it is associated with damage to the stratum basale and
basement membrane of theepidermis.
What are melanomacrophages?
The macrophages that break down free melanin and pigment cells caused by pigmentary incontinence
