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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
Q

Treatment for impetigo?

A

Antibacterial shampoo

  • chlorhexidine
  • benzyol peroxide

Topical antibiotic washes/creams

  • chlorhexidine
  • mupirocin
  • fucidin
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26
Q

Causes of superficial pyoderma in dogs?

A

Staphylococcus pseudintermediums - confined to hair follicle

Underlying causes

  • > bacterial
  • > dermatophytes
  • > demodex
27
Q

Tiny pustules in with hairshaft protruding from center
Follicular papule

Patchy focal alopecia
Epidermal collerettes
Scaling-seborrhea
Hyperpigmentation/excoriation

Dx

A

Superficial pyoderma

28
Q

How do you diagnose superficial pyoderma?

A

Lesions

Skin scrape, plucks, cytology
Woods lamp and hair pluck cultures (dermatophytosis)

Cytology - degenerative neutrophils, phagocytosed cocci, proteinaceous background

29
Q

What is the treatment for superficial pyoderma?

A

Antibiotics 21-28days (1 week past resolution)

Antibacterial shampoo

  • chlorhexidine
  • ethyl lactate
  • benzyol peroxide
30
Q

T/F: if you have a deep pyoderma, you should always look for an underlying disorder

A

True

31
Q

What is the pathogenesis of deep pyodermas?

A

Bacterial adhesions -> increased in allergic conditions, humidity, metabolic disease, or in high bacterial numbers

Bacteria can produce toxins —> induce necrosis/ antigens

32
Q

Predisposing causes to deep pyodermas

A

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
Q

Breeds predisposed to deep pyoderma

A

GSD and Bull terriers

34
Q

What do you usually see on a GSD with a deep pyoderma

A

Pustule, ulcer, and fistula
Rump and thoracic wall regions
Skin blackens and becomes thin
Pain and pruritus

35
Q

What do you normally see in a bull terrier will deep pyoderma?

A

Hocks, elbow, ventral abdomen, pododermatitis
UV light trauma may predispose skin to infection/SCC
Associated feet and usually painful

36
Q

T/F: feline pyoderma is very rare

A

True

—check affected cats for retroviruses

37
Q

How would you diagnose deep pyoderma?

A

Cytology
—> pyogranulomatous exudate
—> cocci found

Histopathology
—> biopsy- infection may mask underlying dz
—> allergy - flea, food, atopy
—> endocrinopathies

38
Q

How do you treat deep pyoderma?

A

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
Q

Subcuteous abscess
Draining tracts
Exudate is thick, yellow-grey, hemorrhagic and fowl smelling

DDX?

A

Actinomyocisis or nocardosis

40
Q

In what dogs do you most commonly see actinomyosis?

A

Hunting gos

Infection following trauma, penetrating wounds

41
Q

How can you confirm diagnosis of actinomycetes/nocardia and how would you treat?

A

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
Q

Subcuteanous nodules that slowly developed over months
Non healing abscess, cellulitis, ulcer, fistula
Regional lymph nodes are enlarged
Drain -> sero-anguneous/purulent exudate

Ddx

A

Mycobacterium

Cancerous (SSC?)

43
Q

Treatment for mycobacterium ?

A

Wide surgical excision

Long term AB —> clarithromycin, enrofloxacin, doxycycline

44
Q

Moist, malodorous, macerated, pruritic skin within facial folds of a bulldog?

Dx?

A

Intertrigo

Skin fold pyoderma

45
Q

Treatment for intertrigo?

A

Topical hygiene —> shampoo, rinse, topical antibiotic

Occasionally systemic antibiotics

46
Q

Species of yeast affecting dogs ?

A

Malassezia pachydermatitis

47
Q

Species of yeast affecting cats?

A

Malassezia sympodialis and globose

48
Q

Where is Malassezia usually found?

A 
Ear 
Lip folds 
Ventral neck 
Axillary 
Interdigital 
Perianal
49
Q

What breeds are predisposed to Malassezia ?

A 
West highland white terrier -> they get everything! 
Min poodles 
Bassets
GSD 
Cocker 
English setters
50
Q

What conditions predispose animals to Malassezia ?

A

Allergic dermatitis: food, fleas, allergens
Endocrinopathies
Keratinization disorders
Immunosuppression

51
Q

Pruritus, malodor
Erythema, greasy scaly plaques
Paronchyia
Otitis externa

In lip folds, interdigital, on ventral neck skin, and in skin folds

A

Malassezia

52
Q

Malassezia infection in cats is usually associated with what disease?

A

Immunosuppressive dz (FIV or FeLV)

53
Q

How can you diagnose Malassezia ?

A

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
Q

Treatment for Malassezia?

A

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
Q

What shampoos can be used for generalized severe greasy seborrhea?

A

Selenium sulfide

  • selsun blue
  • head and shoulders intensive
56
Q

What shampoos can be used for dry to moderately greasy seborrhea ?

A

2% ketoconazole + 2%chlorhexidine

1-2% miconazole

57
Q

How is dermatophytosis transmitted>

A

Direct contact

58
Q

Most common sp of dermatophytoisis?

A

Microsporium canis

59
Q

Pathogenesis of dermatophytosis ?

A

Fungal spores can last a long time in the environment

Establish a folliculitis
Young immunosuppressed

60
Q

Clinical dermatophytosis ?

A

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
Q

T/F: dermatophytosis is a zoonosis I

A

True

30-70% of households with an infected cat will have at least one person develop the disease

62
Q

How do you diagnose dermatophytosis??

A

Woods lamp
Microscopy of hair pluck
Fungal culture
—> DTM contains phenol (changes colour at higher pH)

Biopsy

63
Q

DDX for alopecia, crust, follicular papules, and pustules in dogs

A

Bacterial folliculitis
Demodecosis

Pemphigus foliceous/erythematosus

64
Q

How do you treat dermatophytosis?

A

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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