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Papules, pustules and crusts Flashcards

1
Q

what do papules, pustules and crusts often represent

A

a progression of a lesion

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2
Q

major differentials for papules, pustules and crusts

A 
pyoderma
demodicosis
dermatophytosis
miliary dermatitis (cats)
flea allergy dermatitis
sarcoptic mange
contact dermatitis
pemphigus foliaceus
superficial necrolytic dermatitis
zinc responsive dermatosis
calcinosis cutis
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3
Q

true or false; pyoderma is one of the most common cutaneous conditions of dogs but is uncommon in cats

A

true

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4
Q

characteristics of the staphylococcal organisms typically involved in pyoderma

A

not highly virulent and need an abnormality in the host in order to proliferate excessively

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5
Q

examples of host abnormalities that may predispose to pyoderma

A

impaired barrier function of skin and impaired immune function

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6
Q

examples of impaired barrier function of skin

A

atopic dermatitis, dry skin, swimming, poor nutrition

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7
Q

example of impaired immune function

A

hyperadrenocorticism

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8
Q

which bacteria is common in a majority of canine bacterial skin infections

A

staphylococcus pseudintermedius

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9
Q

what other bacteria is currently being recognized as a cause of canine bacterial skin infection that is inherently more resistant

A

staphylococcus schleiferi

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10
Q

what are the different subtypes of staphylococcus schleiferi

A

staph schleiferi schleiferi (coag neg) and staph schleiferi coagulans (coag positive)

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11
Q

is pyoderma contagious

A

transmission is not common

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12
Q

what two things must you consider with a patient with a resistant staph in your clinic

A

hygiene and environmental cleaning

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13
Q

what do we do differently now with more resistant staph infections

A

rely more on bacterial cultures for antimicrobial choices and use topical treatments rather than systemic

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14
Q

which gram negative can be involved in skin infections

A

pseudomonas

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15
Q

3 classifications of pyoderma

A

surface, superficial and deep

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16
Q

distribution of superficial bacterial folliculitis

A

most common on trunk but can be anywhere on body

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17
Q

clinical signs of superficial bacterial folliculitis

A

elevated hair shafts or patchy alopecia; pustules or papules on the ventral abdomen

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18
Q

where does the saying “in dogs, if it looks like ringworm it’s probably pyoderma” result from

A

superficial bacterial folliculitis commonly has lesions that are considered classic for ringworm in dogs

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19
Q

definition of furunculosis

A

rupture of hair follicles

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20
Q

factors of deep pyoderma

A

deep folliculitis, furunculosis and cellulitis

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21
Q

which bacteria are commonly involved in deep skin infections

A

E. coli, proteus or pseudomonas

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22
Q

where do you commonly see deep pyoderma in german shepherd dogs

A

trunk

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23
Q

where do you commonly see deep pyoderma affect in boxers and pit bull terriers

A

interdigital skin

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24
Q

what should always be considered as a possible underlying cause of deep pyoderma

A

demodicosis

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25
what causes deep pyoderma associated with grooming or bathing (post-grooming furunculosis)
shampoos contaminated with bacteria (pseudomonas)
26
what can also be a name for pyotraumatic dermatitis
hot spots
27
cause of pyotraumatic dermatitis
self-trauma (scratching or biting)
28
lesions seen with pyotraumatic dermatitis
circular alopecia or matted erythematous, moist, exudative area of skin
29
which types of dogs is pyotraumatic dermatitis most common in
thick-coated dogs -- golden retrievers
30
description of fold pyoderma (intertrigo)
surface infection with bacteria, yeast or both seen in a body fold
31
what is an indication to check the folds of a dog
bad odor
32
which breed and at what location does mucocutaneous pyoderma affect
german shepherd in the haired skin near the lower lips
33
definition of bacterial overgrowth syndrome
surface bacterial proliferation without any pyoderma lesions
34
presentation of bacterial overgrowth syndrome
pruritic and malodorous dogs
35
definition of impetigo
superficial infection not involving hair follicles
36
what body location is impetigo seen in
inguinal and axillary regions of young dogs
37
what is your best diagnostic tool for pyoderma
cutaneous cytology
38
what are the best lesions to sample with pyoderma
pustules (next would be edge of an epidermal collarette, draining lesion or from greasy or moist skin)
39
what is observed with classification 0
no bacteria or inflammatory cells
40
what is observed with class 1+
occasional bacteria or inflammatory cells but slide must be scanned carefully for detection
41
what is observed with classification 2+
bacteria or inflammatory cells present in low numbers but detectable rapidly without difficulties
42
what is observed with classification 3+
bacteria or inflammatory cells present in large numbers and detectable rapidly without any difficulties
43
what is observed with classification 4+
massive amounts of bacteria or inflammatory cells present and detectable rapidly without difficulties
44
when are bacterial cultures useful
when rods are present on cytology, with deep or severe pyoderma, when infection doesn't respond to first line therapy or relapses frequently
45
what is the minimum treatment length for superficial pyoderma
3-4 weeks
46
what is a major cause of recurrences of pyoderma
inadequate length of therapy
47
3 other causes of recurrence of pyoderma
inappropriate drug selection, inadequate dosing and poor compliance
48
first choice antibiotic for pyoderma
cephalexin or clavamox
49
what antibiotic can be a good choice for pyoderma in cases with extensive scarring
clindamycin
50
example of topical therapy that can be used with pyodermas in addition to antimicrobials
shampoos containing chlorhexidine and benzoyl peroxide
51
what are 3 things that can be useful in pyotraumatic dermatitis
clipping, topical astringents such as aluminum acetate (burrow's solution) and short courses of corticosteroids in select cases
52
two examples of topical antibiotics
mupirocin or fusidic acid
53
cause of demodicosis
demodex canis -- normal resident of dog skin
54
where do demodex mites reside and what do they feed on
reside in hair follicles and feed on skin cells, sebum and epidermal debris
55
when does demodicosis occur
when host-mite balance is tipped in favor of the parasite
56
forms of demodicosis
localized or generalized; juvenile onset or adult onset;
57
localized demodicosis
one or several areas only, 6 or less lesions, does not progress to generalized
58
generalized demodicosis
large areas of body, entire body region, 2 or more feet, 12 or more lesions
59
juvenile onset demodicosis
less than 12 months old in small dogs, less than 18 months in large breeds, less than 2 years in giant breeds
60
adult onset demodicosis
above the cut-offs for juvenile onset
61
true or false: dogs with generalized demodicosis are okay to be bred
false: there is a genetic predisposition
62
what should dogs with adult-onset demodicosis be screened for
immunosuppressive conditions: cushing's disease, steroid or other immunosuppressive drug therapy, hypothydroidism and neoplasia
63
clinical appearance of demodicosis
highly variable: alopecia, erythema, scaly, hyperpigmented areas
64
clinical appearance of demodicosis when complicated by secondary pyoderma
comedones, papules, pustules follicular casts, crusts and deep folliculitis
65
diagnosis of demodicosis
deep skin scrapings -- 3 or more collected while squeezing the skin and draw capillary blood; can also use trichogram in sensitive or painful areas
66
when can skin biopsies be useful to diagnose demodicosis
in chronic cases when there is extensive scarring
67
what should be done in addition to skin scrapings when suspecting demodicosis
cutaneous cytology for secondary pyoderma
68
treatment of localized demodicosis
benign neglect -- usually have spontaneous resolution within 6-8 weeks as puppy immune system matures; can do mild topical therapy (benzoyl peroxide) but not necessary
69
duration of treatment of generalized demodicosis
need to be treated, likely will last several months, skin scrapings every 2-4 weeks; treat for one month past two consecutive skin scrapings
70
when is a patient considered cured of generalized demodicosis
when there has been no relapse for 12 months after treatment has stopped
71
treatments of generalized demodicosis
oral isoxazolines, oral or topical macrocyclic lactones and topical amitraz
72
example of an oral isoxazoline
fluralaner (bravecto)
73
benefit of using fluralaner to treat demodicosis
safe in ABCB1 deletion dogs and excellent efficacy
74
common adverse effects seen with macrocyclic lactones
neuro side effects: early signs are mydriasis, salivation and ataxia
75
which drug should not be used in patients with demodicosis
corticosteroids
76
dermatophytosis
fungal infection affecting keratinized tissues of the body -- superficial skin layers, hair and claws
77
causes of dermatophytosis
microsporum canis, trichophyton mentagrophytes and microsporum gypseum
78
most common cause of dermatophytosis
microsporum canis
79
what can predispose an animal to a dermatophyte infection
mechanical disruption of the stratum corneum
80
which breeds are predisposed to dermatophytosis
persian and himalayan cats; yorkshire terriers, dalmatians, and jack russell terriers
81
major differential diagnosis for scaling, crusting and alopecia in the cat
dermatophytosis
82
appearance of lesions of dermatophytosis in the cat
one or more roughly circular areas of alopecia with or without scaling and erythema
83
why is a definitive diagnosis of ringworm/dermatophytosis crucial
it is contagious and zoonotic
84
diagnosis of dermatophytosis
wood's light; trichograph; fungal culture
85
what is the most reliable diagnostic test for dermatophytosis
fungal culture of affected hair and scales
86
how long can M. canis spored remain infective in the environment
18 months
87
why are antifungal dips more effective than shampoos in treating dermatophytosis
dips have a longer residual activity
88
how long should pets be treated for dermatophytosis
systemic antifungal treatment until 2 to 3 consecutive fungal cultures are negative -- may be up to 4-20 weeks
89
two examples of dips that can be used to treat dermatophytosis
lime sulfur and enilconazole
90
systemic treatment of dermatophytosis
ketoconazole
91
what is miliary dermatitis
a reaction pattern in cats referring to the way the lesions feel on palpation -- multiple etiologies
92
lesions of miliary dermatitis
fine papules and crusts often scattered over the dorsal trunk
93
what is miliary dermatitis often associated with
underlying hypersensitivity dermatitis
94
examples of causes of miliary dermatitis
feline nonflea-induced hypersensitivity dermatitis, fleabite hypersensitivity, cheyletiella, pemphigus foliaceous

Dermatology (10 decks)

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