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skin class > Final studying > Flashcards

Final studying Flashcards

1
Q

what are the 4 reaction patterns in feline atopic skin syndrome?

A
  • miliary dermatitis (MD)
  • self-inflicted alopecia/hypotrichosis (SIAH)
  • head and neck pruritis (HNP)
  • eosinophilic granuloma complex
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1
Q

describe miliary dermatitis in cats

A

small, crusted, erythematous papules
often assoc with pruritis and secondary cutaneous lesions

may occur anywhere but are common on trunk and neck

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2
Q

describe self-inflicted alopecia/hypotrichosis in cats

A

secondary to fur pulling/biting/chewing/licking

caudoventral truncal regions, flank, lumbar region, limbs

underlying skin often normal and pruritis assoc with this alopecia is often mistaken by owners as normal grooming

cants often demonstrate pruritic behaviours when alone so owners mistake this for hair falling out

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3
Q

describe head and neck pruritis in cats

A

excoriations, erosions, alopecia, erythema (can be quite dramatic)
self-trauma to face and pinnae

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4
Q

describe eosinophilic granuloma complex in cats

A

eosinophilic granulomas, eosinophilic plaques (pictured), indolent ulcers

EG: nodules, plaques, masses that can affect the head, oral cavity, chin, and paw/paw pad. erosion/ulceration may be present, pruritis is variable
- linear granuloma on rear limbs

EP: erythematous, usually pruritic, often eroded plaques and masses usually on caudoventral abdomen and medial thighs (but can appear anywhere)

IU: upper lips, near midline, often thickened and fibrotic

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5
Q

What is this?

A

head and neck pruritis (HNP) in a cat with feline atopic skin syndrome (FASS)

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6
Q

What is this?

A

head and neck pruritis (HNP) in a cat with feline atopic skin syndrome (FASS)

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7
Q

What is this?

A

self-inflicted alopecia/hypotrichosis (SIAH) in a cat with feline atopic skin syndrome (FASS)

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8
Q

What is this?

A

self-inflicted alopecia/hypotrichosis (SIAH) in a cat with feline atopic skin syndrome (FASS)

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9
Q

What is this?

A

miliary dermatitis (MD) in a cat with feline atopic skin syndrome (FASS)

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10
Q

What is this?

A

miliary dermatitis (MD) in a cat with feline atopic skin syndrome (FASS)

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11
Q

What is this?

A

eosinophilic granuloma complex – eosinophilic granuloma (linear)

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12
Q

What is this?

A

eosinophilic granuloma complex – eosinophilic plaques

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13
Q

What is this?

A

eosinophilic granuloma complex – indolent ulcers

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14
Q

What is this?

A

eosinophilic granuloma complex – eosinophilic granulomas (roof of mouth) with an indolent ulcer (upper lip)

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15
Q

You have a cat showing some of the feline hypersensitivity reactions. List reasons why these could be present. (list ddx)

A
  • feline atopic skin syndrome*
  • food allergy*
  • flea allergy*
  • dermatophytosis
  • other parasitic dermatoses (Demodex gatoi, pediculosis, Cheyletiellosis, Notoedres cati)
  • infection
  • psychogenic
  • consider immune-mediated (pemphigus foliaceus), endocrine, or neoplastic if systemically ill or C/S elicit suspicion
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16
Q

Which feline hypersensitivity reactions respond to antibiotics?

A

indolent ulcers and eosinophilic plaques

not eosinophilic granulomas!

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17
Q

You have a pruritic cat presenting with signs of feline hypersensitivity reactions. Describe a general approach to this case, and cases like it.

A
  1. Isoxazoline (ectoparasite control) (all in contact animals)
  2. strict diet trial
  3. tx secondary infections
  4. perform dermatophyte testing
  5. consider UTI in cats with SIAH affecting skin overlying bladder
  6. consider phychogenic behaviour when SIAH or HNP is present, esp if other abnormal behaviours exist.
  7. Oclacitinib/apoquel or glucocorticoids (prurits)
  8. recheck in 8 weeks and if signs persist, then likely FASS
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18
Q

What is the distribution of lesions of atopic dermatitis?

A

periocular, muzzle, paws, ventral metacarpal and metatarsal regions, perianal, inguinal, axillary, cubital fold

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19
Q

List primary causes of otitis externa

A
  • hypersensitivity disorders (atopic dermatitis, food-induced atopic dermatitis) [most common]
  • endocrine (esp hypothyroid)
  • parasites (Otodectes, Demodex, Sarcoptes)
  • immune-mediated diseases (pemphigus)
  • masses
  • foreign bodies
  • glandular disorders (ex. sebaceous adenines, seborrheic disorders)

incite inflammation directly

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20
Q

List secondary causes of otitis externa

A
  • Malassezia
  • bacterial (staph, pseudomonas)
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21
Q

List predisposing factors of otitis externa

A
  • large and pendulous pinnae (cocker spaniel, springer spaniel
  • narrow ear canal (shar pei)
  • excessive hair in ear canal (poodle)
  • excessive moisture (swimming, bathing)
  • obstructive lesions (neoplasia, polyps)
  • systemic disease (immunosuppression, ex hypothyroid)

may not directly cause otitis externa, but increase the risk of development

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22
Q

List perpetuating factors of otitis externa

A
  • bacteria
  • yeast (Malassezia)
  • otitis media
  • glandular hyperplasia
  • stenosis
  • thickening and edema
  • calcification
  • tympanic membrane changes
  • hyperkeratosis with debris exfoliated into canal
  • fold development in ear canal
  • biofilms
  • interruption in epithelial migration

not responsible for initiation of otitis, but do cause the disease to continue once established

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23
Q

Which drugs cause ototoxicity?

A
  • aminoglycosides
  • chlorhexidine (high concentration chlorhex is MOST CONCERN)
  • cerumenolytics (although squalene is not ototoxic and most effective)
  • many carrier agents
  • long acting agents
  • more concern in cats
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24
Q

What are the signs of otitis media?

A
  • otitis externa (most commonly!)
  • increased pain, increased head shaking
  • lethargy, inappetence
  • pain opening mouth
  • facial nerve paresis/paralysis
  • Horner’s syndrome
  • parasympathetic damage –> nasal planum is dry and crusty + hyperkeratotic (xeromycteria), KCS
  • tympanic membrane abnormalities
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25
Q

what are the signs of otitis interna?

A
  • peripheral vestibular signs (head tilt, horizontal/rotary nystagmus, circling, falling toward side of lesion)
  • otogenic meningitis
  • facial nerve paralysis
  • usually an extension of otitis media
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26
Q

what is the difference between a primary and secondary lesion?

A

primary: direct manifestation of a disease process

secondary: lesions that evolve from a primary lesion

some lesions can be both primary and secondary

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27
Q

what is a macule? is it primary or secondary?

A

flat area of colour change <1cm diameter

primary

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28
Q

what is a papule? is it primary or secondary?

A

circumscribed elevated lesion <1cm diameter

primary

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29
Q

what is a patch? is it primary or secondary?

A

flat area of colour change >1cm diameter

primary

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30
Q

what is a pustule? is it primary or secondary?

A

circumscribed elevated lesion filled with pus

primary

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31
Q

what is a plaque? is it primary or secondary?

A

flat-topped, raised skin lesion >1cm diameter

idk it actually doesn’t say in the notes

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32
Q

what is a vesicle? is it primary or secondary?

A

thin-walled fluid filled lesion <1cm diameter

primary

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33
Q

what is a bulla? is it primary or secondary?

A

thin walled fluid filled lesion >1cm diameter

primary

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34
Q

what is a nodule? is it primary or secondary?

A

solid mass >1cm diameter

primary

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35
Q

what is a wheal? is it primary or secondary?

A

flat, firm, raised, emematous lesion; larger and coalescing wheals create angioedema (basically, they’re hives)

primary

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36
Q

what is a cyst? is it primary or secondary?

A

epithelial lined cavity containing fluid, cellular, follicular, or sebaceous debris

primary

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37
Q

what is alopecia? is it primary or secondary?

A

aka hypotrichosis

decreased amount of hair/fur

can be both primary or secondary

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38
Q

what is a scale? is it primary or secondary?

A

fragments of surface epithelium

can be both primary or secondary

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39
Q

what is a crust? is it primary or secondary?

A

accumulation of cellular debris (pus, blood, keratinocytes)

can be primary or secondary

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40
Q

what is a follicular cast? is it primary or secondary?

A

keratinous debris adhered to proximal hair shaft

can be primary or secondary

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41
Q

what is a comedone? is it primary or secondary?

A

dilated and plugged hair follicles

can be primary or secondary

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42
Q

what is hypopigmentation? is it primary or secondary?

A

decreased epidermal melanin

can be primary or secondary

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43
Q

what is hyperpigmentation? is it primary or secondary?

A

increased epidermal melanin

can be primary or secondary

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44
Q

what is leukoderma? is it primary or secondary?

A

white skin

can be primary or secondary

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45
Q

what is leukotrichia? is it primary or secondary?

A

white fur

can be primary or secondary

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46
Q

what is melanoderma? is it primary or secondary?

A

dark skin

can be primary or secondary

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47
Q

what is melanotrichia? is it primary or secondary?

A

dark fur

can be primary or secondary

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48
Q

what is an epidermal collarette? is it primary or secondary?

A

circular alopecic lesion with peripheral scale and develops from ruptured pustule or bulla

secondary

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49
Q

what is a scar? is it primary or secondary?

A

fibrous tissue that has taken the place of dermis and subcutis

secondary

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50
Q

what is excoriation? is it primary or secondary?

A

erosion or ulcerations from self-trauma

secondary

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51
Q

what is erosion? is it primary or secondary?

A

partial thickness epidermal defect (not to level of dermis)

secondary

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52
Q

what is an ulcer? is it primary or secondary?

A

full thickness epidermal defect (to level of dermis)

secondary

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53
Q

what is lichenification? is it primary or secondary?

A

thickened, elephant-like skin, usually also hyper pigmented

secondary

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54
Q

what is a callus? is it primary or secondary?

A

hyperplastic, thickened, alopecic lesions typically on pressure points

secondary

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55
Q

list the ddx: erythema

A

allergic inflammation, malassezia, bacterial overgrowth

anything that can cause inflammation can cause erythema

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56
Q

list the ddx: hypopigmentation

A

lupus (nasal planum), cutaneous lymphoma (periocular and perioral), senile (top ones)

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57
Q

list the ddx: hyperpigmentation

A

healed bacterial pyoderma (post-inflammatory), melanoma, viral plaques, endocrine dz, senile

58
Q

list the ddx: leukotrichia

A

vitiligo, alopecia arrieta (immune system attacks hair follicle or shaft and grows back white)

59
Q

list the ddx: papule

A

allergic dermatitis, bacterial folliculitis, demodicosis, dermatophytosis, parasitic, actinic disease, drug reaction, pemphigus early in disease

60
Q

list the ddx: pustule

A

bacterial pyoderma, ectoparasites, pemphigus foliaceus, pustular dermatophytosis, drug reaction

61
Q

list the ddx: plaque

A

infection dermatoses (pyoderma, dermatophytosis), eosinophilic plaques, viral plaques, neoplasia, sterile panniculitis, sterile granuloma/pyogranuloma syndrome

62
Q

list the ddx: macule

A

erythema multiforme

63
Q

list the ddx: vesicle/bullae

A

bullus pemphigoid, systemic lupus, vesicular cutaneous lupus, drug reaction, contact dermatitis, mucous membrane pemphigoid, mucinosis

64
Q

list the ddx: cyst

A

hair follicle cyst

65
Q

list the ddx: wheal

A

acute allergic reaction

66
Q

list the ddx: crusts

A

pyoderma, pruritis (any pruritic disease), demodicosis, scabies, pemphigus foliaceus, seborrhoea

67
Q

list the ddx: scale

A

anything causing skin inflammation (seborrhoea, ichthyosis, scabies, cutaneous lymphoma)

if crust in elbow = scabies

68
Q

list the ddx: comedones

A

chin acne, demodicosis, ringworm, endocrine dz, Sphinx cats, hairless dogs

69
Q

list the ddx: lichenification

A

atopic dermatitis, self trauma

70
Q

list the ddx: follicular casting

A

sebaceous adenitis, Vit A responsive dermatitis, seborrhoea, demodicosis, dermatophytosis

71
Q

list the ddx: excoriation

A

self-induced lesions secondary to pruritis: consider all pruritic conditions

72
Q

which diseases are zoonotic?

A
  • scabies (mild)
  • dermatophytosis (M. canis; M. gypseum and T. mentagrophytes less so)
  • Cheyletiellosis
  • staph aureus
73
Q

what is the pattern distribution of scabies?

A

ear margins, elbow, hock, periocular region, inguinal/ventral

becomes generalized if untreated

74
Q

what is the pattern distribution of flea allergy?

A

caudal dorsum/tail base, neck, inguinal

75
Q

what is the pattern distribution of demodex?

A

paws, head/face, but can be haphazard

76
Q

what is the pattern distribution of pediculosis and Cheyletiella?

A

dorsum

77
Q

what is the pattern distribution of yeast dermatitis?

A

paws, face, inguinal, axillary, ventral neck

78
Q

what are the diseases that have a pattern distribution that mimic allergies in dogs?

A

scabies, fleas, demodex, yeast, lice/cheyletiellosis, CAD/food allergy

79
Q

Why do we perform allergy testing in animals?

A

ID environmental allergens for immunotherapy or avoidance

NOT FOR DIAGNOSIS

80
Q

what is the distribution of lesions for pemphigus foliaceus?

A
  • face
  • nasal bridge and planum (symmetrical crusting)
  • pinnae
  • paw pads (crust, pustular discharge) (dog)
  • nailbed (cat)
  • nipple (cat)
81
Q

what are the differences b/t how dogs and cats present with pemphigus foliaceus?

A

dog:
- paw pads have crusting and fissures that appear like hyperkeratosis

cats:
- nail folds and nipples affected
- severe caseous, purulent, or crusty exudate from nail folds specifically

82
Q

what are our goals for treating auto-immune diseases?

A

minimize side effects of treatment and give them the highest quality of life possible

not to give them normal skin!

83
Q

what are the C/S of pemphigus foliaceus?

A

papules, pustules, crusts, epidermal collarettes with erosion and secondary alopecia

crusts usually yellow to tan

(site predilection in another flashcard)

lethargy, inappetent, febrile in mod-severe cases

84
Q

Who is he? what caused him?

A

acantholytic keratinocytes (and neutrophils)

caused by pemphigus complex (PF most commonly)

85
Q

what are the main ddx for pemphigus foliaceus?

A

dermatophytosis, pyoderma, demodex

86
Q

how do you diagnose pemphigus foliaceus?

A
  • cytology –> acantholytic keratinocytes!!
  • skin scrape to rule out demodex
  • biopsy for definitive diagnosis
87
Q

how do you treat pemphigus foliaceous?

A

pred ± atopica

88
Q

what is the site predilection for discoid lupus erythematosus?

A

confined to skin, usually just the face

may also involve ears, perianal areas, occasional non-facial regions

89
Q

what are the C/S of discoid lupus erythematosus?

A
  • depigmentation of nasal planum
  • loss of cobblestone appearance
  • erosion/ulceration
  • scaling/crusting
  • (site predilections in another flashcard)
90
Q

how do you treat discoid lupus erythematosus?

A

Vit E, essential fatty acids, topical tacrolimus if just confined to nasal planum, steroids if necessary, avoid sun at peak hours or put on sunscreen

91
Q

Which diseases affect the nasal planum?

A
  • discoid lupus erythematosus (most common)
  • pemphigus foliaceus
  • pemphigus erythematosus
  • mucocutaneous pyoderma
  • uveodermatologic syndrome
  • vitiligo
  • cutaneous lymphoma
  • squamous cell carcinoma (cats esp)
  • idiopathic nasodigital hyperkeratosis
  • parasympathetic nose
92
Q

When should you perform a biopsy?

A
  • suspect immune-mediated or auto-immune disorder
  • severe skin disease
  • suspect systemic disease
  • suspect neoplasia
  • unusual or unrecognized lesions
  • nodular or deep skin lesions
  • lack of response to therapy
93
Q

What lesions do you want to biopsy?

A

Primary lesions!!!!&raquo_space;» secondary

  • avoid scarring and ulcers
  • alopecia: centre
  • hypopigmentation: early lesion
  • multiple samples, variety of lesions
94
Q

what are the lesions of superficial pyoderma?

A

pustules, papules, crusts, epidermal collarettes

95
Q

what are the lesions of deep pyoderma?

A

follicle ruptures –> furunculosis
nodules, draining tracts, erosions, ulcers

96
Q

what are the lesions of CAD?

A

primary: erythema, papules
secondary: excoriation, alopecia, lichenification, moist dermatitis, infection

97
Q

how do you diagnose CAD?

A

no clinical test

  1. rule out other diseases
    - skin scrapes
    - cytology
    - food trial
    - tx/rule out ectoparasites
    - ID and tx infections
  2. detailed analysis of hx and C/S –> Favrot’s criteria (need 5/8)
    - age of onset <3 yrs
    - mostly indoor
    - corticosteroid responsive pruritis
    - chronic or recurrent yeast infections
    - affected front feet
    - affected ear pinna
    - non-affected ear margins (if yes, then scabies!)
    - non-affected dorso-lumbar area (if yes, then fleas!)
  3. demonstration of IgE and ID allergens (intradermal skin test, serum IgE)
98
Q

why do flare ups occur in allergy pets?

A
  • infection (most common!) [Staph, yeast]
  • seasonal or increased exposure to allergen
  • food allergy/other allergy development
  • fleas or other ectoparasites
  • change in meds
99
Q

how do you treat a flare up in an allergy pet?

A

fast acting relief –> oclacitinib, lokivetmab, corticosteroids

NOT CYCLOSPORINE

100
Q

what is the generic name for apoquel?

A

oclacitinib

101
Q

what is the generic name for cytopoint?

A

Lokivetmab

102
Q

what is the MOA for apoquel? any considerations with it?

A

JAK1 inhibitor –> binds to cytokine receptors and inhibits activity of many cytokines involved in CAD

fast-acting (useful for acute flares)

label age >12 mo

103
Q

what is the MOA for cytopoint? any considerations with it?

A

caninized monoclonal antibody –> targets, binds, inactivates IL-31

fast-acting (useful for acute flares)

DOES NOT WORK ON CATS

lasts 4-8 weeks

104
Q

what is the MOA of cyclosporine? any considerations with it?

A

calcineurin inhibitor –> calcineurin activates IL-2, and IL-2 activates lymphocytes, so cyclosporine stops that whole train

slow acting (not good for flares!)

adverse effects: GI signs, gingival hyperplasia, hypertrichosis, immune-suppression (secondary infection)

label age >6mo

more anti-inflammatory than the others – not really used as first line tx

105
Q

why can’t you use cytopoint on a cat?

A

it’s a CANINIZED antibody! made just for doggies

if given to a cat, it will induce an antibody response and make things worse

106
Q

why do we do bacterial cultures in pyoderma cases?

A

ID causative organism from lesions and to select appropriate abx

NOT TO DIAGNOSE!

107
Q

when should you perform a bacterial culture?

A

pyoderma dx (already made the dx)

  • rods seen on cytology (atypical bacteria)
  • deep/severe pyoderma present
  • infection doesn’t respond to first-line therapy or relapses frequently
  • patients with a hx of resistant infection or recent use of Abx
  • suspect anaerobic culture
  • ear culture: non-responsive otitis externa or media/interna
108
Q

how do you treat pyoderma?

A

topical therapy always!!!
- chlorhexidine shampoos/wipes/sprays
- topical Abx

systemic therapy
- cephalexin, clindamycin, cefpodoxime –> first-line empirical treatments (for treatment-naive S. pseudintermedius)
- do C&S if indicated

topical for superficial, systemic + topical for deep

always assess for underlying causes, like CAD

109
Q

What organism is this?

A

Microsporum canis (dermatophyte)

fluffy, white, raised, cottony

110
Q

What organism is this?

A

Microsporum gypseum (dermatophyte)

flat, cream to tan, granular

111
Q

What organism is this?

A

Trichophyton mentagrophytes (dermatophyte)

white to cream, powdery or cottony

112
Q

What organism is this?

A

Microsporum canis (dermatophyte) macroconidia

abundant, pindle shaped, knobbed, thick cells, more than 6 cells ± microconidia

113
Q

What organism is this?

A

Microsporum gypseum (dermatophyte) macroconidia

spindle, thin walls, rounded ends, less than 6 cells ± microconidia

114
Q

What organism is this?

A

Trichophyton mentagrophytes (dermatophyte)

hardest to find, cigar shaped, thin walled, narrow attachment to hyphae, spiral hyphae, globose clusters of microconidia

115
Q

What organism is this?

A

yeast

116
Q

What organism is this?

A

not well stained yeast lmao

117
Q

What organism is this?

A

cocci

if on skin, most often will be Staph pseudintermedius

118
Q

What organism is this?

A

rods

if rods, then culture

119
Q

What organism is this?

A

dermatophytosis

120
Q

What organism is this?

A

environmental mold spores

121
Q

what is this?

A

eosinophilic plaque

eosinophils have arrows, macrophages have arroewheads

122
Q

what is this?

A

mast cells

intense granulation!

123
Q

what is this?

A

soft tissue sarcoma

124
Q

what is this?

A

pemphigus foliaceus

“fried egg cells” = pathognomonic (aka acantholytic keratinocytes)

125
Q

what is this?

A

cutaneous lymphoma

126
Q

what is this?

A

sebocytes

127
Q

What organism is this?

A

Demodex canis (mite)

only in dogs!

128
Q

What organism is this?

A

Demodex injai

only in dogs!

129
Q

What organism is this?

A

Demodex gatoi

only in cats!

130
Q

What species is this? What disease does it cause?

A

Sarcoptes scabei var canis

causes scabies / sarcoptic mange

131
Q

what are these?

A

Sarcoptes scabei var canis eggs

132
Q

you get this organism from a skin scraping from a dog. what is it?

A

Demodex canis

133
Q

how do you treat ectoparasites generally?

A

isoxazolines (afoxolaner/NexGard, sarolaner/Simparica/Revolution Plus, fluralaner/Bravecto)

134
Q

Who is this man?

A

Otodectes cynotis (ear mite)

135
Q

Who is this man?

A

Cheyletiella (there are 3 species, but I don’t wanna remember them lmao)

136
Q

who is this man?

A

Notoedres cati

they have a dorsal anus, compared to Sarcoptes mites having a terminal anus

137
Q

What is this cytology slide of?

A

pyoderma case

can see inflammatory cells and bacteria

138
Q

what species of lil guy fluoresces under a Wood’s Lamp?

A

Microsporum canis (ringworm)

dermatophytosis (only the 1 species above)

139
Q

Who are they?

A

Malassezia

140
Q

Who are they?

A

Malassezia

141
Q

What is this?

A

fungal elements from a slide impression in a dog with dermatophytosis

142
Q

What is a soft steroid? What are their names?

A

topical steroid that is very potent in the skin but metabolized to a very weak steroid once it gets into circulation

  • Mometasone
  • Hydrocortizone aceponate
143
Q

What is the generic name for Atopica?

A

Cyclosporine

skin class (4 decks)

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