PQ Dermatology Flashcards
What is one of the techniques used for collecting samples for skin cytology?
Impression smear or Fine Needle Aspiration (FNA)
Which diagnostic method is used in detection of skin parasitic infestations
Skin scraping
What is not a predilection site of atopy?
Dorsal part of the body
What is the predilection site of atopy?
- Interdigital areas
- Tarsal and carpal region
- Axillar region
distribution of the pruritus and lesions typically involves the face, around eyes, lateral ear plot (concave ear), the ventral aspects of abdomen, the perianal areas, interdigital areas, and lateral symmetry is common
Which parasitic cause of otitis is associated with dry, granular coffee ground exudate?
Otodectes cynotis
Hereditary dermatoses in breeds with black hair, which is manifested by their alopecia, defect in pigmentation and follicle atrophy is
- Color-dilution alopecia
- Black - hair follicular dysplasia
What are the typical clinical signs of acute moist dermatitis in dogs?
- Bordered round or oval lesion
- Inflammation of the serious or purulent discharge
- Alopecias by automutilation
What is the burrowing type of skin mite?
Sarcoptes scabiei var. canis
What is the most common ectoparasite for cats and dogs?
Ctenocephalides felis
Mark the clinical signs associated with Malassezia pachydermatis
- Greasy exudate
- “Rancid fat smell”
- Pruritus
Mark neurological sign seen in associated with diseases of the middle and inner ears
Nystagmus
What does not belong to eosinophilic complex in cats?
Eosinophilic rhinitis
Write a congenital dermatological disease with skin keratinzation disorder that begins at puppy age
Canine primary seborrhoea
Describe a hereditary dermatitis disease epsodic follicular dysfunction and with seasonal nature of lesions where we can suggest the influence of photoperiod?
Recurrent flank alopecia
Most common bacterial organism isolated in canine pyoderma
Staphylococcus pseudointermedius
Which agent is the most common cause of otitis in allergic dogs?
Malassezia
Name as many secondary effloresensens as you know
Squama
Sinus
Crust
Comedo
Cicatrix
Eschara
Erosion
Ragada
Fissura
Ulcer
What is included in the eosinophilic granuloma complex?
- Eosinophilic plaque (bold patches with raised areas of reddened skin, often on hindlegs and stomach)
- Eosinophilic granuloma (in mouth, around lips and other parts of the body)
- Indolent ulcer
Often seen in cats
Dermal signs of endocrine disorders
- Alopecia - bilaterally symmetrical
- Dry, lusterless coat
- Hyperpigmentation of alopetic skin
- Seborrhea
- Pyoderma
- Secondary infections of bacteria and yeasts
Name 4 acquired traumatic alopecia (?)
4 reasons for development of traumatic alopecia?
- Pruritic dermatoses
- Sarcoptic mange
2: Malassezia pachydermatis - Recurrent otitis externa
- Pyotraumatic dermatitis (hot-spot)
- Sarcoptic mange
- Physical and chemical assault
5 hereditary alopetic skin diseases
Divided into two classes
1. Dystrophy or absence of hair follicles
a) Hereditary hypotrichosis
b) Canine primary seborrhea
2. Abnormalities in the hair shaft structure
a) Follicular dysplasia
b) Color dilution alopecia
c) Black hair follicular dysplasia
d) Pattern alopecia
e) Recurrent flank alopecia
Name 6 parasitic skin infections in DOGS + agent
a. Flea infestation - Ctenocephalides felis, C. canins, Ceratophyllus erinacei, C. gallinae, Pulex irritans
b. Scabies - Sarcoptes scabiei var canis
c. Cheyletiellosis - Cheyletiella yasguri
d. Otodectic mange - Otodectes cynotis
e. Demodicosis - Demodex canis
f. Trombiculosis - Neotrombicula autumnalis, Eutrombicula alfreddugesi
Most common ectoparasite of dogs and cats?
Fleas - Ctenocephalides felis ( + C. canis, Ceratophyllus erinacei, C galinae, Pulex irritans)
Name 6 parasitic skin infestations in CATS + agents
a. Flea infestation – Ctenocephalides felis, C. canis, Ceratophyllus erinacei, C. galinae, Pulex irritans
b. Notoedric mange - Notoedres cati
c. Cheyletiellosis – Cheyletiella blakei
d. Otodectic mange – Otodectes cynotis
e. Demodicosis – Demodex cati
f. Tromiculosis – Neotrombicula autumnalis, Eutrombicula alfreddugesi
What are clinical signs of Malassezia pachydermatitis
a. Alopecia, excoriation
b. Pruritus
c. Lichenification, hyperpigmentation
d. Unpleasant body odor
Cats – waxy otitis externa, chin acne, alopecia, erythema, seborrhea
What methods are used for parasitic diagnosis?
Direct visualization, (deep) skin scrapings, acetate tape preparations, flea combing
What are the types of pyoderma?
- Surface pyoderma = Infection of interfollicular epidermal layers of skin
- Pyotraumatic dermatitis (hot spot) – acute moist, dermatitis
- Intertigo (skin fold pyoderma) – retain skin secretions and cells, promoting bacterial and yeast growth. Red, smelly skin. Typically due to excessive skin folds
- Superficial pyoderma = limited to the epidermis and hair follicles
- Impetigo (non-follicular pustules)
- Superficial folliculitis (follicular pustules)
- Pododermatitis – superficial spreading pyoderma (intra-corneal splitting)
- Deep pyoderma = involves dermis, deep dermis and cause furunculosis
* Deep folliculitis and furunculosis – pyoderma that extends into hair follicles and surrounding dermis. Characterized by papules, pustules, exudation, ulceration, crusts and pain. Risk for bacteremia.
* Canine acne
* Nasal or muzzle pyoderma
* Callus pyoderma
* Interdigital pyoderma
* Cellulitis
Hotspot (acute moist lesions) appearance?
- Allopoietic moist, thickend erythematous areas lesions, with exudate covering surface of the lesion.
- Often single but may be multiple
Which sites are predisposed for atopy?
Similar to sarcoptic mange infestation.
Face: around eyes or lips, lateral ear plot (concave ear), axillary, ventral abdomen, tarsal and carpal region (interdigital region), perianal regions.
Name different techniques used for detection of skin cytology
a. Direct techniques - Swabs, impression smear, scraping
b. Tape technique
What are minimun days for ATB therapy in pyoderma?
Superficial pyoderma - Minumum 3 weeks, at least one week after clinical signs are gone
Deep pyoderma - Minimum 6 weeks, at least 2 weeks after clinical signs are gone
What are etiological agent of deep pyoderma
Staphylococcus pseudointermedius
- Only common primary cutaneous canine bacterial pathogen
Staphylococcus schleiferi
- Uncommon, can be methicillin and fluoroquinolone resistant.
- Occasionally secondary colonization by transient Proteus, Pseudomonas, E. coli, other coliforms
- Mixed infections – gram negative organisms colonize areas already invaded by S. pseudointermedius
Symmetrical, bilateral, non-pruritic alopecia can be which disease?
a. Hyperadrenocorticism, hypothyroidism, hyperestrogenism, alopecia X, pituitary dwarfism
b. Generally, endocrinopathies
Location of anal sacs?
Ventrolaterally from the middle of anus (clock 4 and 8 )
5 functions of the skin
a. Homeostasis of the body
b. Integrity of the body
c. Thermoregulation
d. Immunological function
e. Neurosensorical receptors
f. Metabolic function
Steps for checking ears of otitis externa
- A complete medical history
- A complete physical exam including a thorough exam for the entire skin
- Exam of ear with an otoscope - size of ear canal, odor, presence of exudate, hair, color, sensitivity - bilateral. If ear drum is intact, to find out if also middle ear is infected
- Look for foreign bodies or mites in the ear canal, changes in health of ear canal due to chronic disease
- Cytological test of ear swab - yeast, bacteria and mites
- Cultivation to find type of bacteria
- In case of chronic or recurrent ear problems - check other underlying causes (biopsy, x-ray)
Possible for:
a) Biopsy – abnormal masses, tumors
b) Myringotomy – edema and discoloration of drum – sample of aspirate
c) X-rays – ventrodorsal, lateral – with open mouth
1. Tumors, effusions
d) CT evaluation can be essential if the infection is in the deeper structures.
In cases of chronic or recurrent ear problems, other diagnostic tests to determine the underlying cause of the symptoms may be needed
Most common parasite associated with otitis in cats
Otodectes cynotis
Microorganisms that may induce severe form of otitis externa
Microorganisms found in otitis externa
Bacteria – Staphylocoocus pseudointermedius, Proteus mirabilis, Pseudomonas aeruginosa, Streptococcus
Yeasts – Malassezia pachydermatis
Describe Hornerov’s /Horner’s syndrome
Common neurological disorder of the eye and facial muscles, which occurs suddenly.
- Usually unilateral, but can be bilateral.
- There are many causes, among them are otitis media or interna.
Clinical signs: ipsilateral miosis (constricted pupil), ptosis (drooping of upper eyelid), enophthalmos
Name as many primary skin efflorescense you know
Macula
Papula
Plaque
Nodule
Tuber
Vesicula
Pustula
Urticaria
What is atopy and it’s clinical signs?
Atopy is a hypersensitivity I reaction.
* Breed and age predilection important!
- Onset of problem from 6 months to 3 years (but should not be ruled out cause of age)
- Breeds: Labrador and Golden retriver, Bulldogs, Pitbull, Yorkshire, Boxer, Beagle, Cocker Spaniel, Dalmatian etc…
- Genetic predisposition to IgE Ab production to environmental specific allergens with an extrinsic form (production of IgE) and intrinsic form (no production of IgE)
3 specific signs for Atopy
1. Atopic dermatitis - most common
2. Atopic rhinits (not in cat )
3. Atopic conjunctivits
Clinical signs: causing skin inflammation and pruritus!
- Erythematous macules, very small papules (1mm) and difficult for owner to detect.
- Non-specific changes are excoriation, lesions, hyperpigmentation and alopecia
- Typical with lateral symmetricity of lesions
- Affected areas: feet, around eyes, lateral ears, axillary, interdigital areas ventral abdomen
- Secondary skin and ear infections with Staphylococcus pseudointermedius and Malassezia spp. are common.
Clinical signs in cat differ:
- Facial / ear pruritus
- Miliary dermatitis (dorsal part of tail root, neck and dorsal head region)
- Eosinophilic granuloma complex (ulcer, plaque and granuloma)
- Symmetrical alopecia
- General alopecia
Bacteria most commonly causing pyoderma in dogs?
Staphylococcus pseudointermedius
Staphylococcus schleiferi - uncommon, can be methicillin and fluoroquinolone resistant
Write a dermatological disease with acquired, non-traumatic alopecia and occurence of thinning of hairs on the lateral and caudal aspects of the thighs which often extends to the ventral abdomen
Idiopathic bald thigh syndrome
Which agent is the most common cause of otitis in allergic dogs?
Malassezia pachydermatis a. Atopy is a hypersensitivity reaction.
b. Age of onset – 6 months to 3 years
c. Clinical signs: seasonal, nonseasonal.
i. Pruritus!
ii. Mostly secondary lesions due to self-trauma: alopecia, erythema, scaling, hemorrhagic crusts, excoriations, lichenification, hyperpigmentation
d. Affected areas: feet, face, ears, flexural surfaces of the front legs, axillae, abdomen
e. Secondary skin and ear infections with Staphylococcus and Malassezia are common.
What are the characteristic clinical signs of otitis externa?
Ear pruritus
Name 4 skin efflorescence
Papule, Macule, Pustule, Vescule
Bacteria most common cause of pyoderma in dogs
Staphylococcus pseudointermedius
6 Primary factors which induce otitis externa? (open)
- Hypersensitivites - atopic dermatitis and cutaneous adverse food reactions (most common triggers of recurrent otitis in dogs)
- Ectoparasites - Otodectes cynotis (+ Notoedres cati, Sarcoptes scabiei)
- Foreign bodies - grass
- Disorders of keratinization
- Autoimmune conditions
- Contact reactions to ear cleaners and medications
- Endocrinopathies - hypothyroidism and hyperadrenocortism
Name 3 predisposing factors for developing of otitis externa
- Long floppy ears
- hair / water in ears
- allergies
- Otic neoplasia which can obstruct ear canal
- Errors in management of an ear disease
- Environment temperature and humidity (dogs with long floppy ears where ear is not coming in, water in ears from swimming etc)
Predisposing factors for developing otitis externa
Predisposing factors are factors that alter the local ear canal environment and increases risk for otitis externa
a) Excessive hair in ears
b) Stenotic ears
c) Increased cerumen production in the canal
d) Otic masses
e) Frequent ear cleaning
f) Changes in external environmental temperature and humidity
Microorganisms that may induce severe form of otitis externa?
Pseudomonas aeruginosa
Typical symptoms of yeast infection
Alopecia, excoriation, pruritus, lichenification, hyperpigmentation, unpleasant body odour.
In cats - waxy otitis externa, chin acne, alopecias, erythema and seborrhea
Name the Pemphigus complexes
Pemphigus is an autoimmune skin disease, in which the body’s immune system attacks the connections between its own skin cells.
- Pemphigus Foliaceus
- Pemphigus Erythematosus
- Pemphigus vulgaris
Hornerov’s syndrome
a. Otitis externa
b. Otitis media
c. Otitis interna
b. Otitis media
Therapy of eosinophilic complex in cat
- Find a remove primary cause - hypersensitivity, ectoparasites, bacterial infectiom genetic predisposed.
- Give glucocorticouds
[glucocorticoids – Prednisolone; cyclosporine; ATB-(amoxicillin-clavulanate, fluoroquinolones); radiotherapy, cryosurgery, laser, surgical excisions]
Symmetrical, bilateral alopecia without pruritus is due to
a. Hypothyroidism
b. scabies
c. fleas
d. food allergies
e. atopy
Hypothroidism
Non-cutaneous signs of hyperadrenocorticism in cats or dogs:
a. Hypertrichosis
b. Calcinosis cutis,
c. Symmetric alopecia
Symmetric alopecia
Indication for skin scraping?
- Demodicosis – deep skin scraping: btw healthy and infected skin (live in hair follicles)
- Sarcoptic mange (canine scabies - burrowing mites) – extensive superficial scrapings of the
ears, elbows, and hocks. Choose non-excoriated areas. - Trombiculosis –skin scrape
- Cheyletiellosis (walking dandruff) – tape, superficial skin scrapings.
Tapeworms can be spread by fleas and lice in young dogs, name the species
Dipylidium caninum - Spread by flea Ctenocephalides canis
The optimal treatment for cat with eosinophilic ulcers is
Glucocorticoids
Describe Pemphigus foliaceus and its characteristics
- Most common of the pemphigus complex
- Not specific lesions - (superficial) papules and rare pustules, erythema, crusts, scales, alopecia, erosions
- Pain/pruritus – variable (not usually as itchy as allergy)
- Systemic signs are uncommon
- Secondary pyoderma may be present
What are clinical signs to otitis interna?
Holding of head to one side, circling, nystagmus (eye spasms), vomitus, deafness if bilateral affection, ataxy
What are clinical signs of otitis media?
Head shaking, rubbing or scratching the affected ear, and tilting or rotating the head toward the affected side. Salivation, absent of palpebral reflex, facial paralysis, Horner syndrome (ipsilateral miosis, ptosis, enophthalmos) on the same side as the affected ear. Keratitis sicca.
What are clinical signs of otitis externa?
Headshaking, scratching or rubbing ears (pruritus), odour, pain on manipulation of the ear, exudate, redness and edema of external ear canal. Can also be calcification of the aural cartilages and narrowing of the external ear canals. wax/exudate production, differs in colour and consistency
What are typical distribution of lesions / clinical signs in pemphigus foliaceus?
- Nasal planum – mucocutaneous junctions +/-
- Ear pinnae – Not otitis externa but rather on the pinnae itself
- Foot pads (hyperkeratotic) – Very typical and may be only clinical sign
- Total body – general distribution
