Patient with Nodules, Plaques, and Draining Tracts Flashcards
for nodular diseases, what is the first thing to consider/look for
is there one lesion or multiple?
What does a single nodular lesion suggest?
neoplasia, foreign body, or fungus
What do draining tracts suggest for disease?
foreign bodies
deep bacterial/fungal infection
What is the diagnostic approach and tests for nodules, draining tracts and plaues
impression smear for tracts
aspirates if nodules?
cytology if plaques?
what are examples of zoonotic diseases with these types of lesions?
Feline sporotrichosis
yersinia pestis
blasto
What are the major DDx for plaques, nodules and draining tracts
eosinphilic granulma complex
skin tumors
bacterial infections
fungal infections
how to make the specific diagnosis of skin tumors?
Cytology
What skin tumor is monitorable?
histocytoma
What skin tumor needs wide surgical argins?
Mast cell tumors
what is the common lesion for eosinophilic granuloma complex?
skin, mucocutaneous junctions and oral cavity in cats.
3 types of lesions noticed with EGC
indolent ulcer
eosinophilic plaque
eosinohpilic granuloma
characteristics of the indolent rodent ulcer
unilateral on upper lip
not painful or itchy
Characteristics of the eosinophilic plaque
ventral abdomen and inner thigh. usually ulcerated and pruritic
characteristics of the eosinophilic granuloma
linear nodules on caudal thigh, lower lips, chin
not itchy
cause of the EGC
pevious hypersensitivity to whatever it may be
some heritability
Dx og EGC
Histopathology
AM tx then biospies
cytology to look at the secondaries
Tx of EGC
try to manage the underlying hypersensitivity - flea/parasite control, diet trial,
ID or Serum allergy testing
or if atopy is the underlying cause, do immunotherapy
When cause unknown,
oral glucs, Ahist, EFAs, AM for secondary, Cyclosporine
what is commonly cultures for bacterial infections causing these signs? causes?
pasteruella, staph, strep, anaerobes, mycobacterium**
Nocardia and Actinomyces - tracts esp
trauma or biting
Interdigial deep pyoderma in dogs can cause it too
Where are mycobac granulomas often found in cats?
caudal abd
inguinal region
Dx of mycobacterial granulomas in cas
acid-fast from smear, aspirate, and biopsy
what if the bacterial draining tracts do not resovle?
go in with surgery to find out why. maybe awn or something
What is a characteristic fungal lesion often found in dogs?
a fungal kerion – severely inflammatory, rapidly enlarging dermal nodule
Different from the usual erythema and alopecia
what is a good way to dx sq mycoses
FNA and biopsies and request special staina
Maybe fungal culture
Wear gloves
Blasto is found where
Mississippi and missouri
river valley areas
Blast usually hits
young, active, large breeds
Skin lesions of blasto include
firm papules, nodules, ulcers, abscesses
on the face, clawbeds, and nasal planum
If we see lesions that could be blasto what is the worst thing to do?
treat as if it is IM disease.
Clinical signs of cryptocooccus in cats
URT signs,
cutaneous, CNS, and ocular signs
a mass swelling in the nostril over the bridge of the nose
Dx of fungal infections
cytology** alone can get it
Antigen testing for crypto and blasto (onl active infection)
Other causes of nodules
papillomas
Cuterebra flies (late summer/fall)
Sterile panniculitis, granuloma/pyogranuloma, cutaneous histiocytosis, and calcinosus cutis
In summary, what are the best methods to Dx nodules, plaques and draining tracts
Cytology and Histopath
maybe cultures
