Papules, Pustules, & Crusts Flashcards

1
Q

Papule (3)

A

1) small solid elevation
2) up to 1 cm
3) due to infiltration of inflammatory cells & edema

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2
Q

Flea bite hypersensitivity*** clinical signs (6)

A

1) pruritus
2) erythema
3) excoriation
4) self induced alopecia
5) crusted papules
6) dorsal lumbar region most affected

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3
Q

Sarcoptic mange (scabies)** clinical signs (7)

A

1) INTENSE pruritus
2) excoriation
3) crusts
4) self induced alopecia
5) papules
6) lateral surfaces of the skin (hock, elbows, ventral abdomen)
7) alopecia and crusting of the margin of the pinna

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4
Q

Miliary dermatitis (crusted papular dermatitis) ** (1)

A

1) not a disease but a cutaneous reaction pattern associated with hypersensitivity in cats (allergies)

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5
Q

Pustules &/or Crust classification (3)

A

1) Infectious: bacterial superficial pyoderma***
2) Autoimmune: pemphigus foliaceus *
3) sterile

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6
Q

Superficial pyoderma (2)

A

1) common in dogs
2) staphylococcus pseudintermedius & staphylococcus schleiferi

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7
Q

Bacterial folliculitis*** (5)

A

1) extremely common in dogs, rare in cats
2) superficial pyoderma that affects the follicles
3) regions effected: abdomen, groin, medial thighs, axilla
4) pruritus variable
5) crusts are small

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8
Q

Bacterial folliculitis*** of short coated breeds (5)

A

1)extremely common in dogs, rare in cats
2) spontaneous alopecia
3) multifocal do not tent to expand & coalesce
4) affected areas; trunk, extremities (lateral & medial aspects
5) commonly mistaken as dermatophytosis

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9
Q

Bacterial impetigo (4)

A

1) puppy pyoderma
2) causes by certain strains of staphylococci that produce exfoliative toxins
3) affected region: abdomen
4) flaccid pustule that leads to epidermal collarettes that don’t coalesce/expand

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10
Q

Exfoliative superficial pyoderma *** (4)

A

1) lesions: large rapidly expanding epidermal collarettes, peripheral erythema, hyperpigmented center in chronic lesion
2) pustules RARELY seen)
3) pruritus variable
4) bacterial exfoliative toxins that separate the stratum corneum

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11
Q

Cytologic diagnosis of bacterial folliculitis (2)

A

1) sampling: intact pustules, beneath the crust
2) cytology: degenerate neutrophils with intracellular bacteria

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12
Q

Cytologic diagnosis of bacterial folliculitis of short coated breeds (1)

A

1) cytology may not yield degenerate neutrophils or bacteria, if it does very scant

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13
Q

Cytologic diagnosis of bacterial impetigo (2)

A

1) Sampling: intact pustules, edge of epidermal collarette
2) cytology: degenerative neutrophils with intracellular cocci, free floating epidermal cells due to separation of the stratum corneum

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14
Q

Cytologic diagnosis of exfoliative superficial pyoderma (2)

A

1) sampling: edge of epidermal collarette
2) cytology: similar to bacterial impetigo but presence of bacteria usually very scant

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15
Q

Treatment of localized superficial pyoderma (7)

A

1) topical antibacterial
2) chlorhexidine
3) benzoyl peroxide
4) dilute bleach (1:100)
5) mupirocin
6) gentamicin
7) erythromycin

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16
Q

Treatment of widespread superficial pyoderma (1)

A

1) oral/systemic antibiotics

17
Q

What antibiotics should we NOT use in treating superficial pyodermas & why? (2)

A

1) Penicillin, amoxicillin & ampicillin
2) S. pseudintermedius & S. aureus produce beta lactamase destroys these drugs

18
Q

How long should we treat using oral antibiotics? (1)

A

1) 3 weeks or 1 week beyond clinical resolution

19
Q

When should fluoroquinolones be used? (1)

A

1) reserved for infections that did not respond to previous antibiotics OR whenever bacterial resistance is demonstrated

20
Q

Pemphigus foliaceus * (2)

A

1) most common autoimmune skin disease in dogs and cats
2) autoantiboidies target desmosomes in the superficial epidermis

21
Q

Pemphigus foliaceus * distribution of skin lesions (4)

A

1) facial: nasal planum, nose bridge, periorbital, pinnae
2) bilateral symmetrical
3) concave and convex pinna
4) footpads

22
Q

Pemphigus foliaceus diagnosis (3)

A

1) superficial pyoderma MUST be ruled out first
2) cytology: nondegenerate neutrophils with acantholytic keratinocytes, no bacteria
3) biopsy: intact pustule or lesion with crust, diagnostic

23
Q

Treatment of pemphigus foliaceus (2)

A

1) oral glucocorticoids- if this fails to control disease in 4-6 weeks proceed to step 2
2) oral glucocorticoids + azathioprine- after 4-6 weeks stop steroid and assess if azathioprine monotherapy then taper azathioprine to lowest possible dose