Patent wth Localized or Generalized Alopecia

Question 1

definition of alopecia

Answer 1

hair loss from areas of the body where it is normally present

Question 2

Categories of hair loss

Answer 2

decreased hair numbers, hair maturation, hair breakage
Local or generalized
inflamm or non-inflamm

Question 3

the 3 major causes of localized alopecia

Answer 3

3 major causes of folliculitis which are…

Question 4

diagnostics that are important with focal or MF hair loss…. Others for maybe more generalized can be

Answer 4

Skin scrapings, cytology, fungal culture, trichography

general CBC, UA, chem
Endocrine testing

Question 5

How to know if the hair is lost by self-trauma or follicular dysplasia?

Answer 5

tips broken (self)
tips tapered (dysplasia)

Question 6

What is the trichography sensitive to

Answer 6

can detect self-trauma vs. foll dysplasia
can pick up demodex
dermatophytosis
the stage of hair growth

Question 7

Major differentials for Alopecia (13)

Answer 7

1. Folliculitis (bacteria, Demodex, dermatophytes)
2. Vaccine-associated ischemic dermatopathy
3. familial canine dermatomyositis
4. Hyperadrenocort
5. hypothyroid
   6, Alopecia X
6. Cyclic Flank Alopecia
7. Pattern Baldness
8. Color dilution alopecia - other dysplasia
9. sertoli cell tumor
10. anagen defluxation
11. telogen defluxation
12. feline asymmetrical alopecia

Question 8

3 common types of localized folliculitis alopecia. What are others that are always on the differential list?

Answer 8

bacterial (dogs0
demodex (dogs)
dermatophytosis (Cats)

PF
cut lyphoma

Question 9

Any localized alopecia can…

Answer 9

become generalized

Question 10

Vx associ. ischemic demratopathy happens in

Answer 10

recently vx (rabies) 
small breed
white fluffies
Poodles
Bichon Friese

Question 11

Dx of Vx associ. ischemic demratopathy

Answer 11

FNA
Biopsies
C/S, Hx
R/O demodex

Question 12

Tx of Vx associ. ischemic demratopathy

Answer 12

Pentoxifylline

Question 13

Familial Canine Dermatomyositis causes what in whom?

Answer 13

shetlands, collies
hereditary, inflammatory condition of skin and muscles
Autosomal dominant with variable expressivity

Question 14

When do animals present with Familial Canine Dermatomyositis

Answer 14

6-12 months

Question 15

Clinical signs of Familial Canine Dermatomyositis

Answer 15

lesions - alopecia, erythema, scaling, mild crusting
marked atrophy of skin**
myositis after skin lesions

high-stepping gait
food in the bowl
atrophy of mast muscles

Question 16

Dx of Familial Canine Dermatomyositis

Answer 16

C/S and skin biopsies

But do skin scrapings first to r/o demodex

Question 17

Prognosis of Familial Canine Dermatomyositis

Answer 17

good with only skin

Question 18

Tx of Familial Canine Dermatomyositis

Answer 18

pentoxifylline
Vitamine E
Cyclosporine
topical tacrolimus

Question 19

HyperAC Clinical signs

Answer 19

hypotonic skin
symmetrical alopecia
easy bruising
delayed wound healing
seborrhea sicca
PUPDPG
panting
pot-bellied
muscle wasting

Question 20

HyperAC Predisposes to…

Answer 20

bacterial infections
calcinosus cutis
demodex
Comedones
coat color lightening

Question 21

HyperAV Dx

Answer 21

biopsy
urine cort:cr
ACTH stim
LDDST

Question 22

HyperAC Tx

Answer 22

Reduce steroid dose
switch to cyclo, tacrol
mitotane, trilostane (for adrenal tumors)
DMSO

Question 23

Hypothyroidism clinical signs

Answer 23

epidermal atrophy
abnormal keratinization
dry, scaly skin
hyperpigmented from myxedema
no hair growth - stops in anagen phase
lightening of the hair 
rat-tail looking appearance
secondary pyoderma

but most will not have cutaneous signs and just have lethargy and weight gain

Question 24

You will only see pruritis with Hypothyroid if…

Answer 24

pyoderma or bacterial infection is present

Question 25

Age and breed predilctions to Hypothyroid

Answer 25

6-10 yrs

large or giant breeds

Question 26

Dx of hypothyroidism

Answer 26

C/S and TH levels
Low TH, T4
High TSH
non-regenerative normo/normo anemia
hypercholesterolemia
liver enzyme elevations

Question 27

Why is the wrong dx and actual euthyroid sick a problem?

Answer 27

give thyroxine which will stimulate hair growth and you will think you got the dx right.

Question 28

What is the Dx approach to hypothyroid?

Answer 28

recheck TH levels in 2 months
look for improvement of signs
Only keep giving TH when you think the signs are reducing

Question 29

What do biopsies and histo tell us about hypothyroid?

Answer 29

it will point to endocrine disease but not much further.

Question 30

Prognosis of hypothyroid

Answer 30

requires lifetime treatment but is really good.

need to ensure levels are high enough

Question 31

What to watch for as contra-indications in thryoid hormone supplementation?

Answer 31

safe, but watch in dogs with heart disease - see signs in 2 weeks

Question 32

What to warn owners of with hypothyroid treatments

Answer 32

the alopecia will get worse before it gets better.

Question 33

Alopecia X/Hair cycle Arrest typically happens in…and wheny

Answer 33

pomeranians, siberian huskies, malamutes, poodles,

before 3 years old

Question 34

CLinical signs of Alopecia X/Hair cycle Arrest

Answer 34

dull, dry hair coat
loss of primary hairs
looks like a puppy coat
then it turns into alopecia of the trunk, caudal thighs, neck and tail
the alopecic skin can become hyperpigmented, especially in sites of sunburn or trauma
NO pruritus

Question 35

Dx of Alopecia X/Hair cycle Arrest

Answer 35

r/o cushings and hypothyroid
SKin biopsies**
adrenal sex hormone panel but not useful

Question 36

Tx of Alopecia X/Hair cycle Arrest

Answer 36

benign neglect
oral melatonin
mitotane and trilostane

but these are considered a little bit harsh for the cosmetic problem.

Question 37

Color dilution alopecia typically hits

Answer 37

dobermans

Question 38

Characteristics of the Color dilution alopecia

Answer 38

brittleness and broken hairs by about 6 months of age

Question 39

Cause of color dilution alopecia

Answer 39

abnormal melatonin deposition into irregulat macromelanosomes –> disrupts the integrity of the hair shafts. this is progressive

This will predispose to bacterial infection

Question 40

Dx of Color dilution alopecia

Answer 40

r/o the other causes
skin scrapings
trichograms - clumping of melatonin and dysplastic hair shafts

Question 41

Tx for Color dilution alopecia

Answer 41

avoid mechanical rauma and treat secondary infections

Question 42

Prognosis of Color dilution alopecia

Answer 42

poor

Question 43

Feline symmetrical alopecia clinical signs

Answer 43

massive pruritus manifested by excessive grooming which removes hairs

Question 44

Feline symmetrical alopecia dx

Answer 44

bloodwork/UA to r/o hyperthyroidism and FLUTD
trichogram
Skin scrapings, fungal culture and ectoparasite Tx trials are important

Question 45

Feline symmetrical alopecia closely resembles but is differentiated by…

Answer 45

looks a lot like endocrine disease but there is the stubble of broken off hairs

Question 46

DDx for Feline symmetrical alopecia

Answer 46

flea hypersens
AD
Adverse food reaction
dermatophytosis
cheyletiella
Maybe truly psychogenic

Question 47

What is anagen and telogen defluxion?

Answer 47

an insult that causes hair shafts to break off suddenly.

Question 48

How long after does anagen and telogen take after insult/

Answer 48

anagen - days

telogen - 1-3 months

Question 49

prognosis of defluxion

Answer 49

very good

Question 50

Canine flank alopecia is characterized by…

Answer 50

seasonal dermatosis
bilaterally symmetrical hair loss
hyperpigmentation
Lesions have scalloped edges

Question 51

Who gets canine flank alopecia and where

Answer 51

boxers, bulldogs, and airedale terriers

in northern latitudes from the changes in day length

Question 52

Dx of canine flank alopecia

Answer 52

skin biopsies to find dysplastic keratin filled follicles.

Question 53

Tx of canine flank alopecia

Answer 53

nothing

some people try melatonin but meh