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Integumentary (SP23, Exam2) > Module 3 MiniModule 1: Pruritus - Infections > Flashcards

Module 3 MiniModule 1: Pruritus - Infections Flashcards

1
Q

Canine Pyoderma:
Pyodermas should be considered a ___________ clinical manifestation

A

Secondary
- Of a primary problem

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2
Q

General considerations: Canine Pyoderma
Part of the stratum corneum, they have antibacterial properties

A

Epidermal Lipids

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3
Q

General considerations: Canine Pyoderma
Alterations cause dysbiosis allowing for proliferation of pathogenic bacteria

A

Sebum

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4
Q

General considerations: Canine Pyoderma
Maintaining a normal microbiome discourages the growth of pathogenic bacteria

A

Normal non-pathogenic flora

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5
Q

List Predisposing conditions of Canine Pyoderma:

A
  • Allergic dermatitis
  • Endocrinopathies
  • Immunologic incompetence
  • Long term glucocorticoid therapy
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6
Q

Definition:
Bacteria infection within the skin

A

Pyoderma

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7
Q

Canine Pyoderma:
What is the most commonly involved pathogen, particularly in superficial pyoderma?

A

Staphylococcus pseudintermedius

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8
Q

Canine Pyoderma:
What spp. are found as secondary invaders, especially in cases of deep pyoderma?

A

Proteus spp., Corynebacterium spp., Bacillus spp., E. coli and Pseudomonas

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9
Q

Canine Pyoderma: Agents
- Produce beta-lactamase (destroys penicillin, amoxicillin and ampicillin)
- Is usually resistant to streptomycin and tetracycline
- DO NOT empirically use these antibiotics!

A

S. pseudintermedius

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10
Q

Canine Pyoderma: Common Clinical Presentations
- Small circumscribed elevations of the epidermis that is filled with pus (bacteria/inflammatory cells)
- Very superficial, below stratum corneum, rupture easily

A

Pustules (primary lesions)

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11
Q

Canine Pyoderma: Common Clinical Presentations
- Small solid, palpable elevation of the skin

A

Papules (primary lesions)
- “Infection is under”

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12
Q

Canine Pyoderma: Common Clinical Presentations
- Dried exudate, serum, pus, blood, cells, scales, or medication adhere to the skin surface

A

Crusts (Secondary lesions)

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13
Q

Canine Pyoderma: Common Clinical Presentations
- Remnants of the roof of a pustule or papule

A

Epidermal Collarettes (secondary lesions)

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14
Q

Canine Pyoderma: Less common Clinical Presentation
- In short coated breed - small groups of hair tufting together

A

Moth eaten alopecia

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15
Q

Canine Pyoderma: Less common Clinical Presentation
- Superficial spreading pyoderma is a rapidly expanding, and often erythematous and pruritic large (several centimeters) epidermal collarette

A

“Spreading” pyoderma

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16
Q

Canine Pyoderma: Less common Clinical Presentation
- Large Pustules with a ring of erythema
- Puppies or immunosuppressed adult dogs
- Seen with spontaneous or iatrogenic hyperadrenocorticism or other immunosuppressive disease

A

Bullous impetigo

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17
Q

Canine Pyoderma:
(T/F) Most pyodermas are secondary to underlying skin or systemic disease

A

True

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18
Q

Definition:
Infection confined to the interfollicular epidermis

A

Surface pyoderma

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19
Q

Definition:
The most frequent type of pyoderma in dogs

A

Superficial pyoderma
- invasion of the epidermis and folicular ostium by bacteria
- “bacterial folliculitis”

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20
Q

Definition:
- Expansion into the dermis and proximity to blood vessels
- Furunculosis = rupture of the hair follicle is present
- The infection affects tissue deeper than the hair follicle

A

Deep pyoderma

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21
Q

Bullous impetigo can be seen in:

A
  • Young and immunosuppressed dogs
  • Dogs receiving immunosuppressive therapy
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22
Q

What are not good choices for empirical therapy for superficial pyoderma?

A
  • Penicillin
  • Amoxicilin
  • Streptomycin
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23
Q

** Filler Card **

A

Canine Surface Pyoderma

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24
Q

Surface pyoderma:
- Common
- More common in dogs with long, thick hair coat
- Golden retrievers, St. Bernards
- Most common in hot humid weather
- Rapid onset

A

Acute moist dermatitis - “hot spot”
- Etiology: self-inflicted
- Underlying problem causes licking, chewing, scratching -> scratching -> trauma -> secondary infections

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25
Q

List the Clinical Signs of Surface pyoderma:

A
  • Erythema
  • Edema
  • Sero-purulent exudate - yellowish crust
  • Pain
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26
Q

Treatment for Surface pyoderma:

A
  • Mild: topical steroid cream or lotion
  • Severe: oral prednisone
  • Oral antibiotic if multiple lesions or associated with generalized pyoderma
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27
Q

(T/F) Hot spots are self-induced and always look for an underlying condition

A

True

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28
Q

Intertrigo or Skin Fold Pyoderma:
Exudative, odoriferous, and erythematous lesions within skin folds

A

Intertrigo

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29
Q

Intertrigo or Skin Fold Pyoderma:
Anatomic defects in some breeds predispose to maceration of the stratum corneum and bacterial growth

A

Skin Fold Pyoderma

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30
Q
  • Affect most commonly lower lips
  • Client main complain is usually halitosis
A

Lip Fold Pyoderma

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31
Q

Definition:
an oral health problem where the main symptom is bad-smelling breath

A

Halitosis

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32
Q
  • More common in brachycephalic breeds
  • Concurrent traumatic corneal abrasions or ulcerations are common
A

Facial Fold Pyoderma

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33
Q
  • More common in obese animals and animals with infantile vulva
  • Client complaints include frequent licking at the vulva, foul odor, and painful urination
  • Secondary ascending UTI may occur
A

Vulvar fold pyoderma

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34
Q
  • Most common in corkscrew tails
A

Tail fold pyoderma

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35
Q

List skin folds pyoderma treatments:

A

Palliative therapy
- Gentle daily cleaning
- Treat infection and inflammation
- may need topical steroids or systemic antibiotics
Surgical ablation of the anatomic defect offers the potential for a permanent cure

36
Q

List the topical therapies for fold pyoderma:

A
  • Antiseptic solution
  • Medicated wipes
  • Antiseptic ointment/lotion
37
Q
  • Bacterial infection that involves the epidermis and follicular epithelium
    • Impetigo or puppy pyoderma
      • dogs less than 1 year
      • subcorneal pustuled that affects sparsely-haired skin
      • Self-limiting (don’t need to implement therapy)
      • usually requires only topical therapy
      • look and control any underlying condition
    • Bacterial folliculitis
      • bacterial infection involving the hair follicle and adjacent epidermis, but NOT beyond the hair follicle
      • Secondary to an underlying cause
      • Very common and often under-diagnosed
      • Short haired
    • Mucocutaneous pyoderma
A

Superficial pyoderma

38
Q
  • Pruritus may be non-existent to intense
  • Can be a recurrent problem if the underlying primary condition is not controlled
  • Rarely affects only face
A

Bacterial Folliculitis

39
Q

List differential diagnosis for bacterial folliculitis:

A
  • Demodicosis
  • Dermatophytosis
  • Pemphigus foliaceus
40
Q

If it looks like ringworm, it is probably ______________

A

bacterial folliculitis

41
Q
  • A relapsing dermatosis of unknown etiology
  • Lips, perioral skin, nasal planum, and nares can be affected
  • German shepherds and their crosses are at increased risk of developing it
A

Mucocutaneous pyoderma

42
Q

Definition:
Is a general term used to describe any skin defect or lesion on the skin

A

Dermatosis

43
Q

Erythema and swelling that progress to crusting, fissuring, erosion, ulceration, and focal depigmentation
These are the Clinical signs of:

A

Mucocutaneous pyoderma

44
Q

How long do we treat superficial pyoderma?

A

At least 1-week past the resolution of all skin lesions
- recheck is important

45
Q

** FILLER CARD **

A

Canine Deep Pyoderma

46
Q

Deep Pyoderma (2) :
- Chin acne
- Chin and Lips
- Papules (draining tracts)
- Nodules (draining tracts)
- Pustules
- Interdigital furuculosis
- inflammatory, multifactorial disease
- complex to diagnose and treat
- short-coated dogs
- Deep hot spot

A

Localized deep pyoderma

47
Q

Deep Pyoderma (2) :
- Post grooming furunculosis

A

Generalized deep pyoderma

48
Q

Canine Deep Pyoderma:
- Folliculitis and furunculosis
- More common in short-coated breeds
- Usually seen in young (<12 months) dogs but it may persist throughout adulthood

A

Canine Acne

49
Q

Definition:
A parasitic skin disease with medical and veterinary importance caused by the Demodex mites

A

Demodicosis
- deep pyoderma: important to rule out demodicosis

50
Q

Pain and pruritus are variable
- lameness
These are the Clinical signs of:

A

Interdigital furuculosis
- papules
- nodules
- bullae
- ulcers
- draining tracts

51
Q

List the differential diagnosis for Interdigital furuculosis:

A
  • Parasitic
    • Demodicosis
    • Pelodera
    • Hookworms
  • Fungal
    • Blastomycosis
    • Mycetomas (subcutaneous fungal mass)
52
Q

(T/F) For Interdigital furunculosis topical therapy is sufficient

A

False, deep lesions are not reached and systemic antibiotic (8-12 weeks) therapy is needed

53
Q
  • Commonly seen in Golden retrievers
  • Looks like a hot spot but the skin is thicker and if you squeeze the skin, draining tracts will noticed
  • Rule out true hot spot
  • Rule out deep fungal infections
  • Identify and control underlying problem
A

Deep Hot Spots

54
Q

Treatment for deep hot spots

A
  • Systemic antibiotic => Based on culture and susceptibility
  • Oral prednisone for pruritus
55
Q

** FILLER CARD **

A

Generalized Deep Pyoderma

56
Q
  • Uncommon form of deep pyoderma
  • Commonly affects dogs with thick hair coats
  • Unique and severe clinical presentation
  • Acute: 24 to 48 hours after bathing, hand stripping, or traumatic brushing e.g. using Furminator
A

Post Grooming Furunculosis
- Bacterial contamination of shampoo or cream rinse
- Presence of Pseudomonas (Rod-shaped bacteria)

57
Q

List the clinical signs for Post Grooming Furunculosis:

A
  • The dorsal trunk is most commonly affected
  • Lesions
    • pustules, hemorrhagic bullae, and draining tracts
  • The affected skin is painful
  • Systematic signs of illness and fever often precede the onset of skin lesions
58
Q

List the treatment for Post Grooming Furunculosis:

A
  • Systemic therapy with an antibiotic targeting gram-negative bacteria while culture/susceptibility is available
    • fluoroquinolones
  • 6-8 weeks
    • rechecks
    • document resolution before discontinuing therapy
59
Q

Generalized Deep Pyoderma:
Areas more commonly affected are …

A
  • Rump
  • Lateral thighs
  • Chest
  • Legs
    (German shepherd commonly affected)
60
Q

What are the steps for diagnosing Generalized Deep Pyoderma?

A
  • Deep scrapings to r/o demodicosis
  • Skin cytology
  • Bacterial culture and susceptibility
    • Biopsy
  • Fungal cultures
61
Q

What is the treatment for Generalized Deep Pyoderma?

A
  • Appropriate antibiotic therapy based on culture and susceptibility results
  • Adjunctive therapy
    • Antibacterial baths
    • Topical antibacterial leave-ons
      • Mupirocin ointment
      • chlorhexidine spray/mousse
      • diluted bleach spray
62
Q

Generalized Deep Pyoderma
List the possible underlying disease that must be ruled out:

A
  • Allergies
  • Endocrinopathies
  • Immunodeficiencies
  • Parasitic skin diseases
63
Q

** FILLER CARD **

A

Management Pyoderma

64
Q

(T/F) For pyoderma there is no “gold standard” method of treatment

A

True, treatment must be tailored to each patient

65
Q

Bacteria that cause superficial pyoderma
List the less commonly identified causes of superficial pyoderma:

A
  • S. schleiferi
  • S. aureus
  • Streptococcus spp.
66
Q

Bacteria that cause superficial pyoderma:
(T/F) Gram-negative bacteria such as Pseudomonas aeruginosa and Corynebacterium spp are rarely identified

A

True

67
Q

What are the most important factors leading to the emergence of antimicrobial resistance?

A

Use and misuse of antimicrobial therapy
- Inappropriate duration

68
Q

Staphylococcus species resistant to:

A
  • all beta-lactam antimicrobials
    • cephalosporins
    • penicillins (including potentiated amoxicillin)
  • carbapenem antimicrobials
69
Q

Definition:
Bacteria that demonstrate in vitro resistance to at least 3 antimicrobial classes

A

Multidrug-resistant (MDR) bacteria

70
Q

List the reasons to do culture and susceptibility:

A
  • Recurrent superficial pyoderma
  • Deep pyoderma
  • When cytology reveals mixed infection
  • Any case with poor response to empirical treatment
71
Q

Immune modulatory therapy:
- Contain cellular products of Staphylococcus
- Staphage Lysate
- Effective in about 77% of recurrent cases of pyoderma
- Improvement is determined by a decrease in frequency or severity

A

Bacterins

72
Q

** FILLER CARD **

A

Malassezia Infections

73
Q
  • Causative agent of Malassezia dermatitis and otitis
  • Is lipophilic, nonmycelial, saprophytic, thick-walled, ovoid to ellipsoid, unipolar budding yeast
  • Skin lesions are not specific
A

Malassezia pachydermatis

74
Q

(T/F) Malassezia pachydermitis can be part of the normal cutaneous microflora of dogs and cats

A

True
- Facultative pathogen when predisposing factors are present

75
Q

Definition:
Nail inflammation that may result from trauma, irritation, or infection

A

Paronychia

76
Q

Malassezia dermatitis in cats can also be localized:

A
  • Paronychia
  • Chin acne
  • Otitis externa
77
Q

Malassezia infection in Cats:
when generalized, often associated with an underlying condition such as:

A
  • FIV, FeLV
  • Neoplasia
  • Diabetes
  • Allergies
78
Q

What technique identifies yeast more frequently than the other cytologic techniques?

A

The Acetate Tape Impression

79
Q

List Treatment options for Malassezia:

A
  • 2% miconazole/2% chlorhexidine shampoo
  • oral ketoconazole or oral itraconazole for 3 weeks
    • Itraconazole might be preferred to ketoconazole because it is better tolerated
  • Alone or in combination with systemic antifungals
80
Q

Topical Therapy for Malassezia:
- Keratolytic $ keratoplastic
- Mild follicular flushing
- Not a good degreaser

A

Sulphur

81
Q

Topical Therapy for Malassezia:
- Keratolytic
- Act synergistically
- Usually, come together with Sulphur
- eg. GentleSeb

A

Salicylic acid

82
Q

Topical Therapy for Malassezia:
- Keratolytic
- Follicular flushing (Demodex)
- Degreasing - “seborrhea oleosa”
- good for oily skin
- Can bleach hair, cloth, furniture
- eg. DermaBenSs, Oxiderm PS

A

Benzoyl peroxide 2.5 - 3%

83
Q

Topical Therapy for Malassezia:
- Keratolytic & keratoplastic
- Very degreasing
- Mild antifungal effect
- No veterinary products
- MAY BE TOXIC IN CATS

A

Selenium sulfide

84
Q

(T/F) Allylamines - Terbinafine has also shown to be effective in cases of Malassezia dermatitis

A

True

85
Q

(T/F) Malassezia pachydermatis is not considered a potential zoonotic agent

A

False, it is considered a potential zoonotic agent, especially in immunocompetent or immuno- compromised individuals

86
Q

Pulse dosing (2 days/week) with ___(1)____ or _____(2)____has been shown to be effective for Malassezia dermatitis in dogs

A
  1. Itraconazole
  2. Terbinafine

Integumentary (SP23, Exam2) (5 decks)

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