Skin assessment

Question 1

What are some breed predispositions for disease?

Answer 1

Uveodermatological syndrome in Akitas
Alopecia X in Pomeranian, Alaskan Malamute and
Chow
Systemic histiocytosis in BMD
Ichthyosis in GR, JRT, Norfolk and Cairn terrier
Hair follicle dysplasia in PWD and IWS
Sebaceous adenitis in Hungarian Viszla and Akita
Dermatophytosis in Persian cats

Question 2

What diseases are more likely with certain coats?

Answer 2

 Colour
Colour dilution alopecia/follicular dysplasias
 Plush coat
PCA/alopecia X

Question 3

What specific dermatology history questions should be considered?

Answer 3

 When disease first started (age, duration)
 What was first noted (lesions, pruritus, distribution)
 Pruritus score
 Progression - acute onset, chronic, episodic
 Seasonality
 Response to treatment
 Current medications
 In contact animals and animal/human contagion
 Previous diagnostic tests

Question 4

What are the primary lesions?

Answer 4

Papule
Pustule
Nodule
Plaque
Vesicle
Macule
Patch 
Tumour
Wheal

Question 5

What are the secondary lesions?

Answer 5

Erosion
Ulcer
Excoriation
Lichenification
Epidermal collarette
Fissure
Scar

Question 6

What are the cross over lesions?

Answer 6

Hyper/ hypopigmentation
Scale
Crust
Follicular cast
Alopecia
Comedones

Question 7

What is diascopy?

Answer 7

 Differentiates erythema from petechiae/ecchymoses
 Press clear glass slide onto erythematous lesion
 Blanching g = vascular engorgement, no change =
haemorrhage

Question 8

What are the main skin sampling techniques?

Answer 8

Skin scrapes
 Trichography
 Coat brushings
 Impression smear cytology
 Acetate tape impression
 Otic sampling
 Fungal culture
 FNA cytology

Question 9

how do you do a skin scrape?

Answer 9

Put liquid parafin on the skin, tense and sqeeze it, scrape in the direction of hair growth, stop when get capillary ooze

Question 10

Outline the use of trichography

Answer 10

 Demodicosis, pediculosis, dermatophytosis,
changes to hair cycle, traumatic alopecia, structural
abnormalities
 Pluck using artery forceps
 Mount in liquid paraffin with coverslip
 Microscopy x4, x10, x40

Question 11

Outline the use of coat brushings

Answer 11

 Cheyletiellosis, flea infestation, lice
 Collect surface debris onto folded paper by rubbing coat
 Gross inspection
 Empty onto liquid paraffin mounted slide with coverslip
 Microscopy x4, x10
 Wet paper test

Question 12

Outline acetate tape impression

Answer 12

 Cheyletiellosis, neotrombiculosis (Harvest mites),
demodicosis (short bodied mite), bacterial overgrowth infection, Malassezia dermatitis
 Press tape onto skin multiple times
 Apply directly to slide for parasites
 Stain with Diff Quik® (avoid fixative) for microbes
 Microscopy x4-x100

Question 13

How do you interpret an impression smear

Answer 13

Bacteria outside neutrophils - overgrowth

Bacteria in neutrophils - infection

Question 14

Outline fungal culture

Answer 14

 Dermatophytosis, other fungal disease
 False positives and negatives with Wood’s lamp
and in house DTM kits
 Laboratory culture gold standard
 Toothbrush combing
 Submit in paper envelope

Question 15

What are FNAs useful for?

Answer 15

 Nodules, plaques, lymph nodes
 Neoplasia, panniculitis, histiocytosis, sterile
pyogranulomatous disease, deep bacterial/fungal
infection

Question 16

What are the indications for skin biopsy

Answer 16

 Suspected neoplastic lesions
 Vesicular lesions
 Persistent ulceration (biopsy lesion margin)
 Lesions failing to respond to rational therapy
 Conditions requiring histopathology for diagnosis (e.g. sebaceous adenitis, SND)
 Unusual/severe disease
 Treatment expensive, prolonged, risk of side effects