Pyoderma

Question 1

pyoderma

Answer 1

pyogenic (pus producing) bacterial infection of the skin

Question 2

does pyoderma occur more often in cats or dogs

Answer 2

dogs

stratum corneum is LESS effective at preventing bacterial invasion due to lack of an ostial (sebum) plug in the entrance of the hair follicle

Question 3

how does disease alter the cutaneous microenvironment

Answer 3

alters the:
- pH
- humidity
- temperature
- lipids
- antimicrobial peptides

leads to an increased risk of pyoderma

Question 4

most common pathogens in canine pyoderma

Answer 4

1. staphylococcus pseudintermedius
2. staphylococcus schleiferi
3. staphylococcus aureus

Question 5

what type of resistance can all strains of staph develop

Answer 5

methicillin resistance

Question 6

is primary or secondary pyoderma most common

Answer 6

secondary - pyoderma associated with underlying disease or other predisposing factors

Question 7

what are the most common predisposing factors to pyoderma

Answer 7

• pruritus (most common)
• inflammatory skin disease
• endocrinopathies (Cushing’s, hypothyroid)
• immunosuppression
• cornification disorders
• hair follicle diseases
• poor grooming, trauma

Question 8

diagnosis of canine pyoderma

Answer 8

clinical signs: compatible skin lesions
cytology: evidence of bacterial invasion/proliferation

can monitor response to antimicrobial therapy

Question 9

classification of pyoderma

Answer 9

depth of involvement and where the infection INITIATED

• surface
• superficial
• deep

Question 10

surface pyoderma

Answer 10

starts in the stratum corneum

• pyotraumatic dermatitis
• intertrigo
• mucocutaneous pyoderma

Question 11

superficial pyoderma

Answer 11

starts in the epidermis

• impetigo
• superficial folliculitis

Question 12

deep pyoderma

Answer 12

starts in the dermis

• deep folliculitis & furunculosis
• cellulitis

Question 13

whats the most common form of pyoderma in dogs

Answer 13

superficial folliculitis

Question 14

what are the most common pathogens in feline pyoderma

Answer 14

1. staph pseudointermedius
2. staph schleiferi
3. staph aureus

Question 15

lesions associated with feline pyoderma

Answer 15

• miliary dermatitis
• papules
• scale
• collarettes

Question 16

how to diagnose feline pyoderma

Answer 16

cytology

Question 17

diagnosing superficial bacterial folliculitis

Answer 17

1. clinical lesions - pustules, papules, collarettes
2. cytology
3. +/- culture and susceptibility
4. +/- additional diagnostics

Question 18

when is culture and susceptibility testing indicated

Answer 18

only if you suspect antibiotic resistance:
1. <50% reduction in lesions within 2 weeks of empiric antimicrobial therapy
2. new lesions still developing 2+ weeks after starting empiric antimicrobials

Question 19

what should you sample for culture

Answer 19

• rupture intact pustules and culture the material
• underneath crusts
• edges of epidermal collarettes
• over surface of papules

Question 20

treatment of superficial folliculitis

Answer 20

always do topical antimicrobials

+/- systemic antimicrobials

Question 21

topical antimicrobial usage

Answer 21

chlorhexidine + azole antifungals (for synergistic effect)

use for
- localized lesions
- early/mild generalized lesions
- part of ongoing management to prevent recurrence

Question 22

duration of topical antimicrobial therapy

Answer 22

continue for 7 days BEYOND clinical resolution

Question 23

systemic antimicrobial usage

Answer 23

tier 1: empiric therapy
- clavamox, cefpodoxime, clindamycin, cephalexin, etc

tier 2: based on C&S only
- fluoroquinolones, doxycycline, chloramphenicol, rifampin, aminoglycosides

use for deep lesions only

Question 24

duration of systemic antimicrobial therapy

Answer 24

superficial: 2-3 weeks + 1 week beyond clinical cure (4 weeks total)

deep: 4-6 weeks + 2 weeks beyond clinical cure (6 to 8 weeks total)