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Dermatology > Papules, pustules and crusts > Flashcards

Papules, pustules and crusts Flashcards

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Dermatology Board Prep 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
Q

what causes deep pyoderma associated with grooming or bathing (post-grooming furunculosis)

A

shampoos contaminated with bacteria (pseudomonas)

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26
Q

what can also be a name for pyotraumatic dermatitis

A

hot spots

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27
Q

cause of pyotraumatic dermatitis

A

self-trauma (scratching or biting)

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28
Q

lesions seen with pyotraumatic dermatitis

A

circular alopecia or matted erythematous, moist, exudative area of skin

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29
Q

which types of dogs is pyotraumatic dermatitis most common in

A

thick-coated dogs – golden retrievers

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30
Q

description of fold pyoderma (intertrigo)

A

surface infection with bacteria, yeast or both seen in a body fold

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31
Q

what is an indication to check the folds of a dog

A

bad odor

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32
Q

which breed and at what location does mucocutaneous pyoderma affect

A

german shepherd in the haired skin near the lower lips

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33
Q

definition of bacterial overgrowth syndrome

A

surface bacterial proliferation without any pyoderma lesions

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34
Q

presentation of bacterial overgrowth syndrome

A

pruritic and malodorous dogs

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35
Q

definition of impetigo

A

superficial infection not involving hair follicles

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36
Q

what body location is impetigo seen in

A

inguinal and axillary regions of young dogs

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37
Q

what is your best diagnostic tool for pyoderma

A

cutaneous cytology

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38
Q

what are the best lesions to sample with pyoderma

A

pustules (next would be edge of an epidermal collarette, draining lesion or from greasy or moist skin)

39
Q

what is observed with classification 0

A

no bacteria or inflammatory cells

40
Q

what is observed with class 1+

A

occasional bacteria or inflammatory cells but slide must be scanned carefully for detection

41
Q

what is observed with classification 2+

A

bacteria or inflammatory cells present in low numbers but detectable rapidly without difficulties

42
Q

what is observed with classification 3+

A

bacteria or inflammatory cells present in large numbers and detectable rapidly without any difficulties

43
Q

what is observed with classification 4+

A

massive amounts of bacteria or inflammatory cells present and detectable rapidly without difficulties

44
Q

when are bacterial cultures useful

A

when rods are present on cytology, with deep or severe pyoderma, when infection doesn’t respond to first line therapy or relapses frequently

45
Q

what is the minimum treatment length for superficial pyoderma

A

3-4 weeks

46
Q

what is a major cause of recurrences of pyoderma

A

inadequate length of therapy

47
Q

3 other causes of recurrence of pyoderma

A

inappropriate drug selection, inadequate dosing and poor compliance

48
Q

first choice antibiotic for pyoderma

A

cephalexin or clavamox

49
Q

what antibiotic can be a good choice for pyoderma in cases with extensive scarring

A

clindamycin

50
Q

example of topical therapy that can be used with pyodermas in addition to antimicrobials

A

shampoos containing chlorhexidine and benzoyl peroxide

51
Q

what are 3 things that can be useful in pyotraumatic dermatitis

A

clipping, topical astringents such as aluminum acetate (burrow’s solution) and short courses of corticosteroids in select cases

52
Q

two examples of topical antibiotics

A

mupirocin or fusidic acid

53
Q

cause of demodicosis

A

demodex canis – normal resident of dog skin

54
Q

where do demodex mites reside and what do they feed on

A

reside in hair follicles and feed on skin cells, sebum and epidermal debris

55
Q

when does demodicosis occur

A

when host-mite balance is tipped in favor of the parasite

56
Q

forms of demodicosis

A

localized or generalized; juvenile onset or adult onset;

57
Q

localized demodicosis

A

one or several areas only, 6 or less lesions, does not progress to generalized

58
Q

generalized demodicosis

A

large areas of body, entire body region, 2 or more feet, 12 or more lesions

59
Q

juvenile onset demodicosis

A

less than 12 months old in small dogs, less than 18 months in large breeds, less than 2 years in giant breeds

60
Q

adult onset demodicosis

A

above the cut-offs for juvenile onset

61
Q

true or false: dogs with generalized demodicosis are okay to be bred

A

false: there is a genetic predisposition

62
Q

what should dogs with adult-onset demodicosis be screened for

A

immunosuppressive conditions: cushing’s disease, steroid or other immunosuppressive drug therapy, hypothydroidism and neoplasia

63
Q

clinical appearance of demodicosis

A

highly variable: alopecia, erythema, scaly, hyperpigmented areas

64
Q

clinical appearance of demodicosis when complicated by secondary pyoderma

A

comedones, papules, pustules follicular casts, crusts and deep folliculitis

65
Q

diagnosis of demodicosis

A

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
Q

when can skin biopsies be useful to diagnose demodicosis

A

in chronic cases when there is extensive scarring

67
Q

what should be done in addition to skin scrapings when suspecting demodicosis

A

cutaneous cytology for secondary pyoderma

68
Q

treatment of localized demodicosis

A

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
Q

duration of treatment of generalized demodicosis

A

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
Q

when is a patient considered cured of generalized demodicosis

A

when there has been no relapse for 12 months after treatment has stopped

71
Q

treatments of generalized demodicosis

A

oral isoxazolines, oral or topical macrocyclic lactones and topical amitraz

72
Q

example of an oral isoxazoline

A

fluralaner (bravecto)

73
Q

benefit of using fluralaner to treat demodicosis

A

safe in ABCB1 deletion dogs and excellent efficacy

74
Q

common adverse effects seen with macrocyclic lactones

A

neuro side effects: early signs are mydriasis, salivation and ataxia

75
Q

which drug should not be used in patients with demodicosis

A

corticosteroids

76
Q

dermatophytosis

A

fungal infection affecting keratinized tissues of the body – superficial skin layers, hair and claws

77
Q

causes of dermatophytosis

A

microsporum canis, trichophyton mentagrophytes and microsporum gypseum

78
Q

most common cause of dermatophytosis

A

microsporum canis

79
Q

what can predispose an animal to a dermatophyte infection

A

mechanical disruption of the stratum corneum

80
Q

which breeds are predisposed to dermatophytosis

A

persian and himalayan cats; yorkshire terriers, dalmatians, and jack russell terriers

81
Q

major differential diagnosis for scaling, crusting and alopecia in the cat

A

dermatophytosis

82
Q

appearance of lesions of dermatophytosis in the cat

A

one or more roughly circular areas of alopecia with or without scaling and erythema

83
Q

why is a definitive diagnosis of ringworm/dermatophytosis crucial

A

it is contagious and zoonotic

84
Q

diagnosis of dermatophytosis

A

wood’s light;
trichograph;
fungal culture

85
Q

what is the most reliable diagnostic test for dermatophytosis

A

fungal culture of affected hair and scales

86
Q

how long can M. canis spored remain infective in the environment

A

18 months

87
Q

why are antifungal dips more effective than shampoos in treating dermatophytosis

A

dips have a longer residual activity

88
Q

how long should pets be treated for dermatophytosis

A

systemic antifungal treatment until 2 to 3 consecutive fungal cultures are negative – may be up to 4-20 weeks

89
Q

two examples of dips that can be used to treat dermatophytosis

A

lime sulfur and enilconazole

90
Q

systemic treatment of dermatophytosis

A

ketoconazole

91
Q

what is miliary dermatitis

A

a reaction pattern in cats referring to the way the lesions feel on palpation – multiple etiologies

92
Q

lesions of miliary dermatitis

A

fine papules and crusts often scattered over the dorsal trunk

93
Q

what is miliary dermatitis often associated with

A

underlying hypersensitivity dermatitis

94
Q

examples of causes of miliary dermatitis

A

feline nonflea-induced hypersensitivity dermatitis, fleabite hypersensitivity, cheyletiella, pemphigus foliaceous

Dermatology (10 decks)

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