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BVETMED3 > Skin > Flashcards

Skin Flashcards

1
Q

What is trombiculosis

A

Trombicula (small orange mite) can cause sever pruritis to being asymptomatic. Strictly season appearance ( July-oct).
* usually treated with fiprinil (not licenced)

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2
Q

what is Cheyletiellosis

A 
surface mite that is zoonotic. 
Clinical signs include:
> scaling - 'walking dandruft'
> Pruritis - mild to severe
> Primarily on dorsal trunk
  • therapy difficults. fipronil (dog/cat) or ivermectin (cat/rabbit) for 6 weeks. all off label
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3
Q

What are the possible manifestations of demodicosis

A

Demodex are commensuals, occurs when theres a larger than normal amount of numbers, often a host immune deficiency.

  1. Juvenile onset - Localised demodicosis. Often from mother when suckling, lesions on nose, mouth, dorsal limbs. will resolve spontaneously
  2. Juvenile onset. Generalised lesions. Inherited predisposition
  3. Adult onset - can be localised or generalised. > 2years old, suspect possible immunosuppresion. either stop steroid treatment, endocrinopathy or neoplasia
  • treatment lasts atleast 12 weeks. AVOID steroids, worsen immunosuppresion
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4
Q

Describe sarcoptic mange

A

Causes a severe pruritis. Usually seen in dogs and immunosuppressed cats, notifiable in horses.
On skin scrape can see the mite or its burrow containing eggs, however only seen on 50% cases, sensitivity poor. Therefore cant rule out based on skin scrape. best samples from crusted papilla.

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5
Q

Describe FAD and how its managed and diagnosed

A

Flea allergic dermatitis is a IgE mediated or delayed cell mediated hypersensitivity to either, flea saliva/ faeces/excreted metabolites/enzymes/toxins.
> Typically hair loss around rump

Diagnosis: based on history plus signs. presence of fleas or flea dirt. Allergy testing on 30% sensitivity in cats and 30-70% in dogs. ELISA bit better.

Management:
> Flea control regime
> Antipruritic meds (steroids and or antihistamines)

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6
Q

Describe the action of nitenpyram

A

Tablet given to dogs and cats (especially stray cats) for flea treatment. Has a rapid kill of 3 hours but has no residual activity. Can be used for heavily infested animals that need to go into surgery

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7
Q

Describe the action of comfortis

A

Comfortis (spinosad) Only used for fleas. rapid kill (80-100% in 3-4 hours). has 3-4 week persistence. possibility of causing vomiting plus dont give with ivermectin.

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8
Q

Describe the action of Bravecto

A

A type of isoxazidine, active ingredient is fluralaner. kills fleas (>95% in 8hrs) and ticks (>95% in 12hrs) and has 12 weeks of residual activity. can give as a spot on or chewable tablet for dogs

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9
Q

Describe the action of next guard

A

a type of isoxazidine, active ingredient is Afocolaner. Protects against fleas, ticks, heartworm, roundworm, hookworm and whipworm and works faster than bravecto however has residual activity of 5 weeks.

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10
Q

Describe the action of simparica

A

a type of isoxazidine, active ingredient is sarolaner. Effective against fleas ticks for 5 weeks. Also effective against sarcoptes (given 2x 1 month apart) and demodex (3x 1 month apart) and otodectes. Works quicker than both next guard and bravecto

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11
Q

What is a seresto collar

A

Collar for cats and dogs containing imidacloprid (same as advantage). Protects against fleas and tcks for 7-8 months, + is ant feeding.

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12
Q

Describe the action of advantage

A

Active ingredient is imadocloprid. prevention and treatment of fleas in dogs (also biting lice) , cats and rabbits. residual action of 4 weeks for cats and dogs and 1 week in rabbits. Kills fleas n 24 hours

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13
Q

Describe the action stonghold

A

Active ingredient is selamectin. Treatment of otodectes, sarcoptes, sarcoptes, biting lice and heart worm. used at 4 week interval for flea prevention

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14
Q

Describe the action of advocate

A

Active ingredients are imadocloprid and moxidectin. effective against fleas (4weeks) , mites, biting lice(1mnth), demodex, sarcoptes (2x 4 weeks apart), ear mites (1mnth), heartworm, angiostrongylus and nematodes. Also used in ferrets for flea control and heart worm.

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15
Q

What is indorex spray

A

Active ingredients permethrin and pyriproxyfen. Spray that kills fleas, larvae and eggs in environment. residual activity for 8 months. Wont kill eggs in pupal window, therefore hoover.

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16
Q

Whats the most common cause of pyoderma

A

Staphylococcus pseudintermedius, if its not that then its S.aureus. Normal flora of the URT and spread by grooming. Initial trauma required to allow infection

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17
Q

Name the different types of surface pyoderma

A

Surface pyoderma is an acute moist dermatitis. Bacteria proliferate on skin surface and cause an inflammatory reaction. occurs with FAD. treatment include anti inflams and flea control.

> Skin fold pyoderma - Lack of ventilation caused by skin folds. topical glucocorticoids + regular peroxidase shampoo

> Mucocutaneous pyoderma - Condition involving the whole lip and adjacent skin. Systemic antibiotics used.

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18
Q

Describe the types of superficial pyoderma

A

Bacteria infect the superficial epidermal layers just under the stratum corneum and upper portion of hair follicle.

> Impetigo ‘puppy pyoderma’ - Prior or during puberty. Development of pustules in the epidermis, NOT centered around hair follicle. Antibiotics and shampoo

> Superficial folliculitis - Secondary to other condition such as demodicosis, allergy or hypo T4. Infection in hair follicle. Resolve initial problem, antibiotics + shampoo. can lead to a spreading superficial pyoderma

> Malassezia dermatitis - Infection of budding M. pachydermatis. Diagnose by skin scrape/scotch tape and diff quik. treat with miconazole and chlorohexidine.

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19
Q

What are the types of deep pyoderma

A

More serious. Involves furunculosis (infection of hair follicle and dermis) or cellulitis (infection of subcutis). Predisposed by immunodefeciency.

> Muzzle folliculitis and furunculosis - canine acne. Occurs in dogs approaching puberty and resolves spontaneously, can become life ling problem. Caused by keratinisation defect. Treat with benzyl peroxidase shampoo

> Pyotraumatic folliculitis - moist dermatitis

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20
Q

When should you skin biopsy

A 
> if neoplasia suspected
> persistent ulceration
> Unusual/severe signs
> No response to rational therapy
*Never with equine sarcoids - may activate it and it may become more aggressive
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21
Q

Whats the difference between hyperkeratosis and hyperplasia of the skin

A

Hyperkeratosis is increase in stratum corneum whereas hyperplasia is an increase in stratum spinosum.

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22
Q

What are the patterns of skin inflammation

A 
> Perivascular
> Nodular
> Diffuse/interstitial
> Paniculitis - subcutis
> Interface - Between dermis and epidermis.
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23
Q

What is a follicular cast

A

Accumulation of keratinous debris around the hair shaft,.
ddx:
> demodicosis - most likely
> Primary keratinasation defect
> Sebaceous adenitis - Sebaceous glands destroyed causing localised scaling/casting and varying alopecia. Treat with shampoo, essential fatty acids and cyclosporin. Possible for glands to regenerate.

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24
Q

What is a comedo

A

Dilated hair follicle plugged with keratinous & sebaceous debris. Initially scrape for demodex. Can also be caused by endocrinopathy or primary genetic keratinosis

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25
Q

Where are itch receptors located

A

dermo epidermal junction

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26
Q

What is the pruritic threshold

A

The level of sensation above which the animal begins to scratch. Influenced by temperature, anxiety and mental stimulation.
* often an underlying issue which isnt enough to reach threshold e.g allergic dermatitis. Then secondary issue has a summation effect.

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27
Q

what are most common pruritic skin diseases

A

> Parasitic - Surface mites (cheytiella), burrowing mites (sarcoptes), demodex and trombicula
microbial overgrowth - S.pseudintermedius, malasezzia and dermatophytes
Hypersensitivity - FAD, atopic dermatitis and food hypersensitivity.

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28
Q

What are primary fungi causing skin infection in domesticated animals

A

Dogs/cats - M.pachydermatitis
Calfs - Trichophytan verrucosum - crusty grey lesions on head/neck
equine - Trichophytan equinum

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29
Q

What is pemphigus foliaceus

A

Is an intradermal pustule disease. Result of immune system attacking desmosomes. Pustules eventually turn into crust. Can differential from Staph infections because the whole body is effected, including face (nose) and neck/feet. On biopsy of crust, keratinocytes are amongst neutrophils.

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30
Q

What is dermatophyte pseudomycetoma

A

Microsporum canis infects the deep dermis/subcutis causing a large neoplastic like lesion which has relentless progression. sulphur granules can be seen

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31
Q

What are the possible diagnostic methods of diagnosis fungal skin infection

A

> Hair pluck - Looking for hyphae or arthrospores. 50% sensitivity but cheap ad quick
Fluorescent microscopy - Calcoflour white stain - binds to chitin - fluorescence under UV microscope. 80% sensitivity.
Skin scrape - KOH + diff quick, look for hyphae
Wood lamp - Apple green fluorescence trichophytan spp dont fluoresce.
culture hair pluck - 4 weeks for results. phenol red indicator, white colonys and red medium change.

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32
Q

Whats the treatment for fungal skin infections

A

Cats - miconazole
Dog - enilcanazole (dog/cattle/horse)
Steroid contraindicated
Also give systemic griseofulvin

33
Q

Whats the difference between a hypersensitivity and an allergy

A

> hypersensitivity - Exposure to a defined stimulus produces objectively reproducible events at doese tolerated by normal individuals. unknown mechanism

> Allergy - Same as hypersensitivity except initiated by immunological hypersensitivity.

34
Q

What are uticaria and angiodema

A

> Uticaria - Multiple wheals of oedematous swelling seen most commonly in horses
Angiodema - Marked localised subcutaneous oedema

  • both due to mast cell degranulation, causing an increase in vascular permeability. Except with uticaria its superficial capillaries and angiodema is deeper vessels.
35
Q

What is atopic dermatitis.

A

Heritable condition (0.5) involving both genetic and environmental factors. Typically have defects of the epidermis leaving the skin prone to inflammation. This allows pruritis and decrease in skin barrier and increase IgE sensitization to allergens + microbe proliferation which causes more inflammation. viscious circle.

> lesions vary from none, erythema to erythematous maculopapular rash.
seen on feet, chest, ears, mandible, ventral stomach and eyes (goggles)
rule out parasites first
is responsive to steroids.

36
Q

What is Allergen specific immunotherapy (ASIT)

A

ASIT is subcutaneous injections of allergen at increasing doses for 9 months (monthly). The allergens that are injected are decided by a previous intradermal allergy test. 60% efficacy in dogs.
> must be off anti histamines (7d prior) and steroids (14d prior)
> Can also do serology testing. May be needed if animal will deteriorate if they come off anti itch therapy

  • Also sublingual immunotherapy - drops under tongue instead of injections.
37
Q

What is epitheliotropic lymphoma

A

ddx for pruritic skin with increasing age and no allergy. mimics scabies.
> depigmentation of the nasal planum
> Exfoliative erythrodema (red and scaly)
> Crust on foot pad - only condition that does this

Diagnosed by histopathology - poor prognosis

38
Q

Whats the difference between crust and scale

A

Scale is a accumulation of loos cornified fragments of stratum corneum
Crust is the presence of dried exudate on skin surface

39
Q

What is seborrhea and spaniel seborrhea

A

Seborrhea is a loose term for scaling and greasy exudate
> Spaniel seborrhea is a primary defect in cocker spaniels that causes an increased mitotic rate causing hyper proliferation. causing scaling and casting.

40
Q

What is superficial necrolytic dermatitis

A

Uncommon skin condition in middle-older aged dogs, causing crusting and ulcers.
> effects foot pads and orifices.
> on histology resembles france flag
- Blue = epidermal hyperplasia/inflammation
- white = Intracellular oedema
- red = Parakeratosis

41
Q

What is hypotrichosis

A

Congenital alopecia

42
Q

What are the mechanisms of hair loss

A

> Traumatic removal of hair (self trauma?) - work up as a pruritis cases, is it parasitic? bacteria/yeast? hypersensitivity? If theres accompanied inflammation suspect this.
Damage to hair follicle
Hair cycle arrest (telogen)
Malformed/dysphoric/dysplastic or atrophic hair follicles

43
Q

What effect does estrogen have on hair

A

Hyperoestrogenism and hypothyroidism cause impaired anage and premature catagen

44
Q

What is recurrent flank alopecia

A

Usually a symmetrical issue inwhich the aetiology is not understood. Skin will be hyper pigmented. Seasonal onset annualy.
*Boxers and bulldogs predisposed.

45
Q

What is eosinophilic granuloma complex (cats)

A

Includes 3 types of possible lesions

  1. eosinophilic ulcers which are erythmatous and well circumscribed on the lip or oral mucosa
  2. eosinophilic plaques which are raised erythmatous lesions on the medial thigh or abdomen
  3. eosinophilic granuloma which preset on the posterior aspect of the rear leg of young cats. Also found on tongue hard palate and oral mucosa.

Diagnose via impression smear or FNA.
treatment is ectoparasite control and look for food allergy. if unsuccessful then steroids.

46
Q

What causes para neoplastic alopecia in cats

A

Seen with pancreatic adenocarcinoma/bile duct carcinoma. Poor prognosis

47
Q

What is plasma cell pododermatitis

A

Condition in cats where the foot pads are infiltrated with plasma cells causing pain, swelling.
FNA can be done to see plasma cells.
Treated with doxycline for up to 10 weeks - good prognosis
FIV in 50% of cases so screen for.

48
Q

What is idiopathic facial dermatitis

A

Condition in persian cats, black adherent materian on skin and hair. Also erythema. Treated with antibiotics and topical tacrolimus (immunosuppressive)

49
Q

Where to chorioptic mange lesions usually occur on the horse

A

Common cause of pastern dermatitis. Peaks in winter.

treatment includes fipronil spray (repeat after 1 month) or avermectin injection

50
Q

What is oxyuris equi

A

Also known as pinworm infestation. Adults migrate from teminal parts of intestine to the anus where they lay eggs.
Cause tail rubbing and self trauma around base of tail

51
Q

What is ‘sweet itch’

A

Insect bite hypersensitivity in horses. Most common skin allergy in horses. type hypersensitivity to the salivary proteins of culloicoides.
Management:
> Avoid - stable between 16.00 - 8.00. Use rugs and hoods and fans
> Repellents - Synthetic pyrethroids
> Anti inflammatories - anti histamines or glucocorticoids

52
Q

What is dermatophilus congolensis and what does it cause

A

Branchin filamentous actinomycete. Continuous wetting or trauma of the stratum corneum leaves the skin vulnerable to dermatophilus congolensis. Causes ‘Mud fever’
> Typically causing crusts and thick scabs covered by layers of yellow/green pus which when removed cause alopecia. Affecting pastern and distal limbs
> also cause rain scald (same but on shoulders, neck and dorsum)
> Fleece rot in sheep
> Hair pluck, leave in saline for 30 minutes and then make a smear.
> Tx: chlorohexidine, systemic antibiotics and keep dry

53
Q

What is the treatment for surface/superficial/deep pyoderma

A

Topical antibacterial therapy alone is enough for surface and superficial pyoderma.
> If systemic antibacterial is required, first tier drugs for empirical use are used: Cefalexin (works in 80-90% of superficial pyoderma cases), amoxicillin calv and potentiate sulphonamides.
Deep pyoderma always requires systemic antibiotics, should always culture + sensitivity test.

54
Q

What is MRSP

A

Meticillin resistant staphylococcus psuedintermedius. Meticillin is amarker for B-lactam resistance (encoded by mecA).
> Gentamycin - effective but is nephrotoxic
> Rifampicin - Hepatotoxic
> Isaderm 2-3x weekly and 1 week beyond resolution.

55
Q

What is WHO critically important anti microbials

A 
Antibiotic agents which is the sole or one of the limited available therapys that can treat serious human disease
> Fluoroquinolones
> 3rd/4th gen cephalosporins
> Macrolides
> glycoproteins
56
Q

What are the most clinically relevant multi drug resistant pathogens (eskape)

A 
Enterococcus faecium
Staphylococcus aureus
Klebsiella pneumonia
Actinetubacter baumannii
Pseudomanis aeruginosa
Enterobacter spp
57
Q

What does copper defeciency cause in farm animals (skin)

A

Presents as depigmentaion (grey/brown), especially around the eyes,ears. Eyes have a spectacle appearance. Also cause defective keratinisation = thin/dry/sparse coat.

58
Q

What lice effect sheep and what is the treatment

A

Bovicola ovis. ddx for pruritis.
Tx:
> sheer sheep
> apply insecticide - pour on synthetic pyrethrids (e.g deltamethrin)

59
Q

What mites are significant in sheep

A

> sarcoptes scabei
demodex ovis
choriopte ovis
Psorptes ovis - Causes ‘sheep scab’. Causes pustules, matted fleex and extreme pruritis (no 1 ddx for pruritis). Tx:
- Plunge dip in organophosphates (min 1 min an head emersed 2x) or injectable ML (moxidectin - lasts 28d, 2x 10d apart)

60
Q

What is blowfly strike

A

Eggs layed on wet fleece. Larvae feed on skin causing toxaemia due to skin necrosis + absorption of bacterial toxins.
Tx: Clip surrounding hair and clean tissue removing any visible maggots. Then apply insecticide (coopers spot on)

61
Q

What causes tail mange in cows

A

Chorioptic mange

62
Q

Describe photosensitization in cows

A

Abnormal reaction of skin to sunlight due to photodynamic agent in dermis.
> Primary - Ingestion of lush green plants containing the agent e.g clover
> Secondary - Liver or bile duct damage, result of ingestion of hepatotoxic plant such as ragwort

Clinical signs: Demarcated sun burn like lesions on unpigmented hairless areas, nose/ears.and muzzle.

63
Q

Whats the significant mite in guinea pigs

A

> Trixacarus caviae - Causes the most intense pruritis of any mite

64
Q

What flea prevention used in ferrets and rabbits

A

> ferrets - advocate or fipronil

> Rabbits - Advantage, DO NOT use fiprinil

65
Q

What antibiotics are appropriate for rabbits and which will cause dybiosis

A 
NOT to use: 'PLACE'
Penicillins
Lincosamides
Aminoglycosides
Cephalosporins
Erythromycin
Acceptable:
> Metronidizole
> Fluoroquinolones
> Tetracyclins
> macrolides
> Sulphonamids - first one used
66
Q

How is dermatophytosis treated in rabbits/rodents

A

Mild case = miconazole spray

Severe - Itraconazole oral solution

67
Q

What endocrine disorders result in skin defects in exotics

A

> Cystic ovaries in guinea pigs - Bilateral flank alopecia
Cushings in hamsters - Alopecia + pu/pd.
Hyperoestrogenism ferrets - Swollen vulva, bleedings and alopecia at base of tail
cushing ferret - bilateral symmetrical alopecia

68
Q

What is guniea pigs absolute dietary requirement

A

10mg/kg of vitamin C.

if not met will cause rough coat, scaling pinnae, petechia (small purple spots due to broken blood vessels.)

69
Q

What are the 4 pathological processes of the nail

A
  1. Trauma
  2. Neoplasia
  3. Paronychia: Inflammation of nail fold - Either bacterial/fungal or autoimmune (pemphigus folliaceus)
  4. Symmetrical lupod onychodystrophy - Interface dermatitis targeting nail matrix. Poorly formed nails. Only way to diagnose is amputate digit and send to histopath.
70
Q

What is a vesicle and what are the 4 mechanism of formation

A

Vesicle - Circumscribed elevation of the skin less than 1cm in diamter containing clear fluid.

  1. Genetic structural defect
  2. immune attack
  3. Sever epidermal oedema
  4. Degeneration of keratinocytes
71
Q

What are the most skin tumours in cats and dogs

A 
Dog
> MCT (17%)
> Lipoma (8.5%)
> Histocytoma (8.4%)
> Perianal gland adenoma (8%)
Cat
> Basal cell tumour (23%)
> MCT (16.5%)
> SCC (10%)
> Fibrosarcoma (17%)
72
Q

What are the possible epithelial tumours found on the skin

A
  1. Epidermal tumours
    > Papillomas - Common in dogs not cats. associated with papilloma virus in young dogs. Resolve in 3 months
    > SCC - effects non pigmented skin. Locally invasive but low metastasis rate.
  2. Follicular tumours
    > Basal cell tumour - Often pigmented, dome shaped, hairless and mobile. around head/neck.
    > Intracutaneous cornifying epithelioma - tooth past like material
  3. Tumours of glandular tissue
    > Sebaceous gland tumour - Common in dogs. Wart like and greasy. Excise off
    > Perianal gland tumours - Peri anal adenomas common. seen in entire males, androgen driven.
    > Sweat gland tumour - Apocrine adenomas.
    > Anal sac adenocarcinoma - Common in dogs (cocker spaniels) 27% are paraneoplastic secreting glucose. 50-80% are metastatic, regional LN staging required.
73
Q

What round cell tumours are you wary of on skin

A

> canine MCT - Prognosis dependant on histological report. Stage before surgery. Cytotoxic drugs, accompanied by pred, omeprazole and H1 agonist.

> cutaneous lymphoma - Presents as prefuse skin disease. Often begins with crusting and scaling, progressing to large nodules and pruritis.

> Cutaneous melanoma - Often benign. Most malignant ones occur in oral/mucocutaneous junction or nail bed.

74
Q

What is an aural haematoma and hows it treated

A

Persistent head shaking caused by otitis, allergy, parasites or foreign bodys causes the cartilage of the pinna to split. Arterial haemorrhage occurs causing tissue separation and fibrosis.

Tx: Simply make an incision and remove. Suturing ensure that the sutures are placed vertically, otherwise will cause occlusion of the vessels that run horizontaly. reduce the risk of pinnae necrosis

75
Q

What is TECA, what are the indications and most important complications

A

Total ear canal ablasion is a salvage procedure. Facial nerve runs close to the bulla therefore in 30% cases facical nerve parlysis can occur. over complications include horners syndrome, wound breakdown and deafness. Indications are:
> End stage otitis externa
> Persistent otitis after lateral wall resection
> Para-aural abscess
> Horizontal canal neoplasia - Either ceruminous gland adenocarcinoma or SCC

76
Q

What is a lateral wall resection

A

Lateral wall of the ear canal is removed to allow for better ventilation and drainage.
> Done when there is recurrent ear problems without any permanent damage to ear canal.

77
Q

What is a lateral bull osteotomy

A

Commonly done with a TECA. This is done to allow debridement of tissue and exudate deep within tympanic cavity, reduces risk of abscess formation. Cats have 2 tympanic bulla

78
Q

Describe otitis media

A

Dogs
> Medical treatment involves myringotomy (incision into tympanic membrane). Can be diagnostic or therapeutic.. Surgical treatment includes TECA + lateral bull osteotomy

Cats
> Usually caused by an URT infcetion causing aural polyps (due to inflammation).

BVETMED3 (9 decks)

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