Patient with Greasy or Scaling Skin Flashcards
Ddx for scaling or greasy skin
malassezia sebaceous adenitis keratinization disorders including primary idiopathic seborrhea pyoderma/bacterial overgrowth demodicosis dermatophytosis Vitamin-A responsive dermatosis endocrine skin disease Cheyletiella ichthyosis cutaneous lymphoma paraneoplasic disorders
what are the classifications of seborrhea?
seborrhea sicca
seborria oleosa
seborrheic dermatitis
what will often accompany oily and flaky hair
pruritus
odor
The most important diagnostic tests for greasy and scaly skin
skin scrapings
cytology
The three ddx for crusting that can cause scaling and greasy skin
pyoderma
demodicosis
dermatophytosis
etiology of malassezia
malassezia pachydermatitis
malassezia is symbiotic with …
staph
what is malass results due to?
overproliferation of yeast on the skin –> just on the skin –> causes inflamm, hypersen rxn –> atopic signs
Malass thrives when
high humidity
skin folds
greasy skin
staph overgrowth areas
breeds predisposed to malass
shih tzus, lhasa apsos, basset hounds, devon rex cats
Underlying disease that predisposes to malass
AD, pyo
seborrheic diseases
endocrine diseases
clinical features of malass
can be gen or localized
pruritus
locations of malass
feet, lip folds, nailbeds, ventral neck, and other folds
Malass can often cause
otitis externa
additional clinical features of generalized malass
erythematous
greasy
scaly
crusty
this is the corn chips one
Dx of malass
cytology tape technique 1 or more organisms there significant NOT fungal cultures biopsies are not sensitive, not specific
Tx of malass
anti-fungal shampoos systemic and topical is good. Ketoconazole for 7 days after cure itraconazole fluconazole terbinfafine
Warning when treating for malass
if lethargy or inappetance, stop therapy immediately
Some people will do pre-treatment tests
Drugs that ketoconazole interacts with
ivermectin
cyclosporine
GSA (granulomatous Sebaceous Adenitis) cause and effect
idiopathic and heritable
progressive destruction of the sebaceous glands and loss of sebum production –> derm findings
Breeds targeted by GSA
Standard poodle
saoyed
akita
autosomal recessive thing
CLinical signs of GSA
progressive areas of hair loss, poor hair coat, dry hair, excessive scaling, follicular plugging, casts
Mild Pruritus
pyoderam as a secondary
DDx for GSA
endocrine disease like hypothyroidism
Dx of GSA
characteristics inflammatory pattern
absence of sebaceous glands
skin biopsies
Tx of GSA
aim for restore oil to the skin FA supplementation bath oil to wet skin 30 min before shampooing once per week AD doses of cyclosporine NOT steroids
Keratinization disorders are called
primary seborrhea
Keratinization dosirder of cocker spanial
primary idiopathic seborhhea - because of the 8 day renewal time, not 21
Clinical signs of primary seborrhea
dull coat excessive flaking greasy malodorous skin otitis externa digital hyperkeratosis brittle claws Secondary malass and pyoderma sometimes
Dx of primary seborrhea
not curable
shampoos and conditioners
Omega-3,6 FA
Synthetic retinoids - do the Schirmer tests when on this though
Vitamin A-responsive dermatosis is characterized by…
marked follicular plugging
hyperkeratotic plaques
Dx of Vit A responsive dermatosis
histopathology
response to vitamin A
