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Small Animal medicine Dermatology Section > Pyoderma > Flashcards

Pyoderma Flashcards

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Dermatology Board Prep flashcards
1
Q

Staphylococcus pseudintermedius

A
  • found primarily on hair vs. skin in the anal region, nasal carriage.
  • Produces potent toxins/enzymes
    • B-lactamase- helps break down antibiotics such as penicillin and amoxicillin
    • Protein A : degranulates mast cells, fixes compliment
    • Proteases- irritates nerves and triggers pruritus
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2
Q

Pathogenesis of bacterial infections

A
  • increased adherence of S. pseudintermedius to skin cells in atopic animals
  • inflammatory mediators promote changes in microclimate
  • changes in permeability may allow serum leakage and increased humidity on the skin
  • Cutaneous temperature changes may also contribute to bacterial multiplication
  • Barrier dysfunction
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3
Q

Primary factors of Pyoderma

A

Allergic Skin diseases (Atopy**)

Ectoparasites

Disorders of cornification

Endocrine disease (hypothyroidism**)

Immunodeficiency

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4
Q

What are differential diagnoses for pustules

A
  • pyoderma
  • autoimmune disease
    • Pemphigus foliaceus : pustules
    • Panniculitis: draining tracts
  • Sterile eosinophilic pustulosis
  • Dermatophytosis
  • Sterile pyogranulomatous dermatitis
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5
Q

What are clinical features of Pyoderma?

A

pruritus

patchy alopecia to diffuse thinning of hair coat

Signs vary with depth of infection, duration of infection, primary factors, and severity of infection

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6
Q

What is the diagnostic approach for pyoderma

A

cytology is an absolute must

Physical and dermatological exams

Dermatology data base

CBC, biochemistry profile to look for primary causes

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7
Q

Acute Moist Dermatitis

A

“Hot Spots”

Secondary to trauma, flea infestations, environmental influences

Animals present with acute onset of lesions. Rapidly progressive

Intensive focal pruritus

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8
Q

How should you make a slide of a pyoderma case

A

cotton swab slide prep

roll prep

Pustule cytology

Papule cytology

Impression after lancing

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9
Q

In what situation would you utilize a shampoo therapy for a pyoderma case?

A

Useful for superficial infections

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10
Q

Why are whirlpools efficacious for pyoderma cases?

A

They remove surface debris, reduce pain, and increase blood flow to the skin

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11
Q

What are limitations of topical therapy for Pyoderma cases?

A
  • Client compliance
  • Exposure of clients to antiseptics
  • Delivery of active agent to the skin such as hair coat
  • Evidence of increasing bacterial resistance to antiseptics
  • Evidence of increasing bacterial resistance to antibiotics after exposure to biocides/antiseptics
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12
Q

What are effective antibiotic options to treat pyoderma cases?

A

fluoroquinolones, potentiated amoxicillin, synthetic penicillins, cephalexin

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13
Q

Waht are examples of Cephalosporins

A

Convenia

Simplicef

Cephalexin

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14
Q

Are cephalosporins a good choice for treating a pyoderma case?

A

yes this is the first tier of drugs to choose from

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15
Q

What are examples of Fluoroquinolones?

A

Zeniquin

Baytril

Ciprofloxacin

Orbax

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16
Q

What are limitations of systemic therapy

A

client compliance

adverse effects to the patient

general health of patient - may affect distribution or metabolism of drugs

concurrent medications

ANTIBIOTIC RESISTANCE

17
Q

What are classifications of pyoderma (4)

A
  • Surface- increased colonization, epidermis remains intact
  • Superficial: epidermal and/or hair follicles involved
  • Deep: extension of infection into dermis
  • Cellulitis: invasion of fascial planes and subcutis
18
Q

Acute moist dermatitis: Therapy

A

Clip, clean, and dry lesions

Antimicrobials vs Staph. (topical vs. systemic)

Glucocorticoids to reduce pain and pruritus

Prevention

  • control primary factors
  • topical antimicrobial/glucocorticoids early
19
Q

Impetigo

A

“Puppy pyoderma”

  • staphylococcal dermatitis in young dogs
  • Predisposing factors may include husbandry, parasitism, nutritional factors
  • Pruritus is absent to mild
  • Lesions are subcorneal pustules
20
Q

what are therapies for Impetigo

A

Lesions may resolve spontaneously

  • topical therapy
    • Mupirocin or BPO gel
    • BPO shampoos every 3-4 days
  • Systemic antimicrobial therapy
    • For more generalized cases
    • 21-30 day course of appropriate drug
21
Q

Canine Acne

A
  • Essentially folliculitis (and furunculosis) of the chin
  • Often seen in young dogs (rule-out demodicosis!!!)
  • May “Resolve” spontaneously at maturity
  • Therapy
    • Topical: BPO gel or mupirocin
    • Systemic: 21-30 days of appropriate drug
22
Q

Intertrigo

A

Skin Fold Dermatitis

  • skin folds provide an ideal environment for microbial proliferation
    • ​Bacteria (Staphylococci)
    • Yeast (Malassezia spp.)
  • Breed predisposition! Brachycephalic breeds
  • Management
    • clean and dry the lesion
    • Appropriate antimicrobials (generally topical)
    • Surgical correction
23
Q

Folliculitis

what is it and what are the major differentials

A

inflammation of the hair follicle superficial or deep. this is associated with patchy alopecia.

-papules, pustules, epidermal collarettes (lumpy-bumpy skin)

Common causes: Demodicosis, dermatophytosis, Staph. pseudintermedius

24
Q

therapy for folliculitis

A

topical is a good option if the owners are willling and able

  • Bathe every 3-7 days with antimicrobial shampoos
  • Mupirocin or BPO for focal lesions

Systemic

  • antimicrobials for 30 days
25
Q

Furunculosis

A

progression of folliculitis

Follicles rupture, releasing debris into the dermis -> foreign body-type reactions DRAINING TRACKS

Lesions include papules, nodules, pustules etc

Destruction of the follicle results in permanent alopecia

Pruritus is mild to moderate

26
Q

therapy for Furunculosis

A
  • Topical
    • Classically antibacterial shampoos are of little value
    • Whirlpools, US treatment are useful
  • Systemic therapy
    • Appropriate antibacterial therapy for 30-60 days or as needed
    • Choice of antimicrobial based on cytology or culture results
27
Q

What is post-bathing Furunculosis

A
  • Lesions develop with pain and pruritus 2-7 days after bathing
  • Pseudomonas aeruginosa
  • contaminated shampoo + trauma - if the shampoo has been sitting around for a while, it is usually a Pseudomonas bacteria present
    • Cytology Rod shaped Gram- bacteria
  • Culture and Sensitivity is recommended
28
Q

paronychia

A

claw bed infection

29
Q

Management of Deep Pyoderma

A

diagnostics: Database, bacterial culture, endocrine evaluations

Systemic therapy with appropriate agents

Whirlpool

surgical intervention to open remove fistulous lesions

Client education: long-term management, identify primary factors and predisposing factors

30
Q

Methicillin Resistance

A

This is a zoonotic consideration for owners

MRSP is rising in incidence. Antibiotics that remain our best choices such as Clindamycin, chloramphenicol.

Topical therapy is used more frequently

31
Q

Dermatologic Conditions that Mimic Pyoderma

A
  • Juvenile cellulitis
  • Dermatophytosis (Trichophyton sp. )
  • Autoimmune issues
  • Foreign body reactions
  • Sterile pyogranulomatous diseases.

Small Animal medicine Dermatology Section (7 decks)

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