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RUSVM SAM 2 > Pruritus 4- Inections > Flashcards

Pruritus 4- Inections Flashcards

1
Q

What are the surface pyodermas?

A

Pyotraumatic pyoderma (hot spot)
Intertrigo (skin fold rash)
Mucocutaneous pyoderma
Bacterial overgrowth

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2
Q

That are the superficial pyodermas?

A

Impetigo
Superficial bacterial folliculitis
Superficial spreading pyoderma

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3
Q

What are the deep pyodermas?

A 
Folliculitis/furunculosis 
Lick granuloma 
Muzzle pyoderma
Pedal pyoderma 
Cellulitis 
Pyotraumatic syndrome folliculitis/furunculosis
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4
Q

What type of bacteria is usually found in surface vs superficial vs deep pyodermas?

A

Surface - mixed population

Superficial — staphylococcus

Deep — mostly staph but can be mixed

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5
Q

Clinical signs with pyoderma?

A

Pustules
Papules
Crust

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6
Q

When are bacterial cultures for pyodermas mandatory?

A

If <50% improvement within 2wks of treatment

New lesions after 2wks of treatment

Residual lesions at 6wks

Intracellular rods on cytology

Hx of MRSP and MRSA

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7
Q

What lesions are best for culture?

A

Pustules

Under crusts

Epidermal collarettes

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8
Q

What is the purpose of topical therapies for dermatitis?

A

Decrease duration of systemic Ab or may eliminate need for systemic Abs

Prophylactical use for recurrent pyodermas
Little to no side effects

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9
Q

How does Benzyol peroxide compare to chlorhexidine?

A

Benzoyl peroxide

  • 1-5% antimicrobial
  • more drying
  • follicular flushing activity
  • keratolytic
  • degreasing agent

Chlorhexidine

  • <0.5% antimicrobial
  • less drying
  • no follicular flushing activity
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10
Q

How often should you apply topical shampoo for pyoderma?

A

2-3x a week

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11
Q

What is mupirocin and what is it used for?

A

Topical bacterial static at low concentrations and bacteriocidal at high concentrations

Gram positive bacteria including MRSA

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12
Q

What is silver sulfadiazine and what is it used for?

A

Topical antibacterial

Burns, wounds, ear infections
Particularly effective against pseudomonas

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13
Q

What are your first tier antibiotics uses for pyoderma?

A

1st generation cephalosporins (eg cephalexin
Amoxicillin/clavulanic acid
Clindamycin

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14
Q

What 2nd tier antibiotics can you used empirically against pyoderma?

A

Sulfadiazine
Erythromycin
Linomycin
Doxycycline

—> chloramphenicol, rifampin, and amikacin should only be used based on C/S results

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15
Q

What are your LAST resort antibiotics for treating pyoderma?

A 
Fluoroquinolones 
—> batryil = enrofloxacin 
—> zenoquin = marbofloxacin 
—> cipro = ciprofloxacin 
—> orbax = orbifolxacin

3rd gen cephalosporins
—> convenia = cefovecin
—> simplicef = cefpodoximine

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16
Q

How long do you treat a superficial pyoderma?

A

3-4weeks minimum
1 week beyond resolution

Exam every two weeks

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17
Q

How long do you treat a deep pyoderma?

A

3-12weeks

2 weeks beyond clinical resolution

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18
Q

Mucocutaneous swelling, erythema, crusting
Affecting lips symmetrically, commisures affected
Painful pruritic, fissures, depigmented

Dx?

A

Mucocutaneous pyoderma

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19
Q

Treatment of mucocutaneous pyoderma?

A

Clip ad clean area
Mupirocin

Systemic ABs?

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20
Q

What is the pathogenesis of pyotraumatic dermatitis?

A

Induced by the patient —> self trauma

Secondary to underlying dermatitis (eg flea allergy)
Intense trauma in short time

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21
Q

Red, most, exudative, crusting
Denuded due to self trauma

Dx?

A

Pyotraumatic dermatitis

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22
Q

What is the treatment for pyotraumatic dermatitis?

A

Antibiotic/steroid
Short term course corticosteroids

Predisposing causes?

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23
Q

Young dog with vesicles/pustules and non-follicular pustules in the ventral areas of the body

Dx?

A

Impetigo

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24
Q

What are causes of impetigo?

A 
Staphylococcus 
Poor husbandry ( poor hygiene, nutrition, internal parasites)
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25
Treatment for impetigo?
Antibacterial shampoo - chlorhexidine - benzyol peroxide Topical antibiotic washes/creams - chlorhexidine - mupirocin - fucidin
26
Causes of superficial pyoderma in dogs?
Staphylococcus pseudintermediums - confined to hair follicle Underlying causes - > bacterial - > dermatophytes - > demodex
27
Tiny pustules in with hairshaft protruding from center Follicular papule Patchy focal alopecia Epidermal collerettes Scaling-seborrhea Hyperpigmentation/excoriation Dx
Superficial pyoderma
28
How do you diagnose superficial pyoderma?
Lesions Skin scrape, plucks, cytology Woods lamp and hair pluck cultures (dermatophytosis) Cytology - degenerative neutrophils, phagocytosed cocci, proteinaceous background
29
What is the treatment for superficial pyoderma?
Antibiotics 21-28days (1 week past resolution) Antibacterial shampoo - chlorhexidine - ethyl lactate - benzyol peroxide
30
T/F: if you have a deep pyoderma, you should always look for an underlying disorder
True
31
What is the pathogenesis of deep pyodermas?
Bacterial adhesions -> increased in allergic conditions, humidity, metabolic disease, or in high bacterial numbers Bacteria can produce toxins —> induce necrosis/ antigens
32
Predisposing causes to deep pyodermas
Compromised skin defense - Strep pseudintermedius is the most important pathogen —> allergy —> seborrhea —> follicular pathology —> hyperadrenocortisim or hypothyroidism —> primary immunodeficiency (rare) —> secondary immunodeficiency - ehrlichia, distemper, retrovirus
33
Breeds predisposed to deep pyoderma
GSD and Bull terriers
34
What do you usually see on a GSD with a deep pyoderma
Pustule, ulcer, and fistula Rump and thoracic wall regions Skin blackens and becomes thin Pain and pruritus
35
What do you normally see in a bull terrier will deep pyoderma?
Hocks, elbow, ventral abdomen, pododermatitis UV light trauma may predispose skin to infection/SCC Associated feet and usually painful
36
T/F: feline pyoderma is very rare
True —check affected cats for retroviruses
37
How would you diagnose deep pyoderma?
Cytology —> pyogranulomatous exudate —> cocci found Histopathology —> biopsy- infection may mask underlying dz —> allergy - flea, food, atopy —> endocrinopathies
38
How do you treat deep pyoderma?
Topical - > shampoo and rinses (massage and leave in for 15mins, every 3-7days) - > hydrotherapy removes cysts - >steroid -antibiotic combinations Systemic antibiotics - > B-lactamase resistant penicillins - > multiple cultures : treat strep first - > high dosage for bioavailability to skin , long treatment (6-8weeks or 2 weeks past resolution ) Immunomodulation (adjunct therapy) -cimetidine and levamisole
39
Subcuteous abscess Draining tracts Exudate is thick, yellow-grey, hemorrhagic and fowl smelling DDX?
Actinomyocisis or nocardosis
40
In what dogs do you most commonly see actinomyosis?
Hunting gos Infection following trauma, penetrating wounds
41
How can you confirm diagnosis of actinomycetes/nocardia and how would you treat?
Diagnosis - anaerobic culture - histopathology with special stains —> sulfur granules - cyology RX -surgical debulking -long term antibiotics Actinomycosis -> penicillin G, erythromycin, clindamycin Nocardisois -> TMS, ampicillin, erythromycin, minocyline
42
Subcuteanous nodules that slowly developed over months Non healing abscess, cellulitis, ulcer, fistula Regional lymph nodes are enlarged Drain -> sero-anguneous/purulent exudate Ddx
Mycobacterium Cancerous (SSC?)
43
Treatment for mycobacterium ?
Wide surgical excision Long term AB —> clarithromycin, enrofloxacin, doxycycline
44
Moist, malodorous, macerated, pruritic skin within facial folds of a bulldog? Dx?
Intertrigo | Skin fold pyoderma
45
Treatment for intertrigo?
Topical hygiene —> shampoo, rinse, topical antibiotic Occasionally systemic antibiotics
46
Species of yeast affecting dogs ?
Malassezia pachydermatitis
47
Species of yeast affecting cats?
Malassezia sympodialis and globose
48
Where is Malassezia usually found?
``` Ear Lip folds Ventral neck Axillary Interdigital Perianal ```
49
What breeds are predisposed to Malassezia ?
``` West highland white terrier -> they get everything! Min poodles Bassets GSD Cocker English setters ```
50
What conditions predispose animals to Malassezia ?
Allergic dermatitis: food, fleas, allergens Endocrinopathies Keratinization disorders Immunosuppression
51
Pruritus, malodor Erythema, greasy scaly plaques Paronchyia Otitis externa In lip folds, interdigital, on ventral neck skin, and in skin folds
Malassezia
52
Malassezia infection in cats is usually associated with what disease?
Immunosuppressive dz (FIV or FeLV)
53
How can you diagnose Malassezia ?
Cytology —> Cytobrush, swab, cello tape Yeast has round to oval, budding peanut shape (Bowling pins or foot prints >2 per high power field is clinically significant
54
Treatment for Malassezia?
Underlying cause Topical - antiyeast shampoo - ketoconazole, miconazole, selenium sulfide (2-3x a week) - antiyeast rinse - enilconazole Systemic -ketoconalole or itraconazole - chronic therapy in some
55
What shampoos can be used for generalized severe greasy seborrhea?
Selenium sulfide - selsun blue - head and shoulders intensive
56
What shampoos can be used for dry to moderately greasy seborrhea ?
2% ketoconazole + 2%chlorhexidine 1-2% miconazole
57
How is dermatophytosis transmitted>
Direct contact
58
Most common sp of dermatophytoisis?
Microsporium canis
59
Pathogenesis of dermatophytosis ?
Fungal spores can last a long time in the environment Establish a folliculitis Young immunosuppressed
60
Clinical dermatophytosis ?
Focal alopecia lesions Circular alopecia with scaling Pruritis rare, unless secondary bacterial infection —> peripherally expanding alopecia, crust, follicular papules and pustules —> whole body seborrhea
61
T/F: dermatophytosis is a zoonosis I
True 30-70% of households with an infected cat will have at least one person develop the disease
62
How do you diagnose dermatophytosis??
Woods lamp Microscopy of hair pluck Fungal culture —> DTM contains phenol (changes colour at higher pH) Biopsy
63
DDX for alopecia, crust, follicular papules, and pustules in dogs
Bacterial folliculitis Demodecosis Pemphigus foliceous/erythematosus
64
How do you treat dermatophytosis?
Underlying disease, source, treat organism Topical —> shampoos, ketoconazole —> creams sustained —> rinses - enilconazole Systemic therapy —> grisofluvin —> ketoconazole —> 6-12months Management of catteries —> separate infected —>decontaminate environment

RUSVM SAM 2 (44 decks)

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