Nodules, Plaques and Draining Tracts

Question 1

3 general differentials for nodules, plaques and draining tracts

Answer 1

sterile inflammatory lesions, neoplasia or various infections

Question 2

what 2 features of nodules can guide your differential list

Answer 2

multiple or single nodule;

if draining tracts are present or not

Question 3

what is more common with a single nodule

Answer 3

neoplasia, foreign body or fungal kerion

Question 4

what is more common if draining tracts are present with nodule

Answer 4

foreign body or deep bacterial/fungal infection

Question 5

what diagnostic approach do you use with a cat or dog with nodules

Answer 5

cytologic exam of the contents – impression smear or FNA

Question 6

what is necessary for a definitive diagnosis of a nodule

Answer 6

biopsy

Question 7

if inflammation is seen with a nodule, what other tests should you do

Answer 7

bacterial (aerobic and anaerobic) culture and fungal culture

Question 8

what is a potential human concern regarding nodules, especially ones with draining tracts

Answer 8

zoonosis – feline sporotrichosis and plague

Question 9

major differential diagnosis for nodules, plaques and draining tracts

Answer 9

eosinophilic granuloma complex
skin tumors
bacterial infections
fungal infections

Question 10

what is eosinophilic granuloma complex

Answer 10

a group of unique lesions affecting the skin, mucocutaneous junctions or oral cavity of cats (REACTION PATTERN)

Question 11

what 3 types of lesions are noted in eosinophilic granuloma complex

Answer 11

indolent ulcer, eosinophilic plaque and eosinophilic granuloma

Question 12

indolent ulcer description

Answer 12

presents unilaterally on upper lip, can occur in oral cavity

Question 13

are indolent ulcers painful or pruritic

Answer 13

not usually

Question 14

location of an eosinophilic plaque

Answer 14

ventral abdomen and inner thigh

Question 15

are eosinophilic plaques painful or pruritic

Answer 15

yes, usually ulcerated and pruritic

Question 16

lesions and location of eosinophilic granuloma

Answer 16

“linear” nodule on caudal thighs;

can also occur in oral cavity, lower lips and chin

Question 17

are eosinophilic granulomas pruritic

Answer 17

no

Question 18

what type of underlying disorder do most cats with eosinophilic granuloma complex also have

Answer 18

hypersensitivity disorder;

but some can be heritable

Question 19

diagnosis of eosinophilic granuloma complex

Answer 19

histopathology

– collect biopsy after antimicrobial therapy

Question 20

what two things should be part of your general work up with eosinophilic granuloma complex

Answer 20

strict flea and ectoparasite control;
elimination diet trial

((then can look for atopy))

Question 21

treatments for patients with idiopathic eosinophilic granuloma complex

Answer 21

glucocorticoids, antihistamines, EFA, antibiotics for secondary infection

Question 22

true or false: the skin is the most common site of occurrence for neoplasms in the dog and cat

Answer 22

true for the dog;

false for the cat – second most common

Question 23

true or false: dogs have 2X more malignant skin neoplasms than benign

Answer 23

false: 2X more benign than malignant

Question 24

true or false: cats have 3X higher incidence of malignant skin tumors than benign

Answer 24

true

Question 25

Diagnosis of skin neoplasm

Answer 25

cytologic exam of aspirates

Question 26

what type of skin tumor would you only monitor

Answer 26

histiocytoma

Question 27

what type of skin tumor do you want wide surgical margins

Answer 27

mast cell tumor

Question 28

what is the most frequent isolate from subcutaneous abscesses in cats

Answer 28

pasteurella multocida

Question 29

treatment of SQ abscesses in cats

Answer 29

surgical drainage and thorough flushing of the abscess + systemic antibiotics (clavamox)

Question 30

which type of dog is predisposed to interdigital deep pyoderma causing nodules

Answer 30

short coated

Question 31

where are opportunistic mycobacterial granulomas most commonly seen in the cat

Answer 31

caudal abdominal or inguinal region

Question 32

diagnosis of mycobacterial granulomas

Answer 32

demonstration of acid-fast organisms

Question 33

what two organisms can cause chronic draining tracts in dogs and cats

Answer 33

nocardia and actinomyces

Question 34

what is a fungal kerion

Answer 34

a severely inflammatory, rapidly enlarging dermal nodule in dogs caused by dermatophytes

Question 35

diagnosis of fungal kerion

Answer 35

FNA, biopsy and fungal culture

Question 36

treatment of fungal kerion

Answer 36

self limiting

Question 37

causative agent of sporotrichosis

Answer 37

sporothrix schenkii

Question 38

where is blastomyces dermatitidis found in canda

Answer 38

northwestern ontario -- can be seen in manitoba and saskatchewan

Question 39

what types of dogs are affected by blastomyces

Answer 39

young, active large breed dogs

Question 40

what body systems does blastomyces affect

Answer 40

lung, bone, ocular and/or skin

Question 41

what skin lesions are seen with blastomyces

Answer 41

firm papules, nodules, ulcers, abscesses; | especially face, clawbeds and nasal planum

Question 42

what fungi is commonly found on vancouver island

Answer 42

cryptococcus neoformans

Question 43

what signs are seen in a cat infected systemically with cryptococcus

Answer 43

upper respiratory, cutaneous, CNS and ocular signs can be seen; may be able to observe a mass in nostril or swelling over bridge of nose

Question 44

diagnosis of fungal infections

Answer 44

can be made on cytology alone

Question 45

what does cuterebra larvae cause in cats and dogs

Answer 45

abberant migration leading to a swelling and fistula;