skin examination

Question 1

description of gorss examination should include

Answer 1

Number of lesions
Location of lesion
Type of lesion
If parasites found, can it be identified?

Question 2

what is a scale

Answer 2

a thin accumulation of keratinocytes (keratin cells) flakes

Question 3

what is a crust

Answer 3

thick accumulation of cells with dried exudate( blood/bus)

Question 4

what is a macule

Answer 4

a non- palpable (not bumpy) change in skin colour that is <1cm in diameter

Question 5

what is a papule

Answer 5

a solid elevation of the skin that is <1cm in diameter

Question 6

what is a pustule

Answer 6

acellular fluid filled lesion (not firm) fluid usually contains neutrophils (type of wbc)

Question 7

what are the different methods to test for ectoparasites

Answer 7

• coat brushing
  -sticky tape preparation
  -skin scraping

Question 8

how to conduct coat brushing and purpose of test

Answer 8

-stand patient over white paper-> brush using flea cmb-> collect any falling scale and cutaneuous debris-> see microscopically with a drop of liquid paraffin
purpose: to look for fur mites, lice and fleas

Question 9

how to conduct sticky tape preperation and purpose of test

Answer 9

press tape firmly on area and then pull off, repeat several times
Tape to microscope slide

purpose: used to identify mites and malassezia /bac (use diff quick stain) (dip table in stains first then paste on microscope slide)

Question 10

what does malassezia look like under the microscope (yeast)

Answer 10

like peanuts

Question 11

purpose of skin scraping

Answer 11

to identify mites investation-> superfical: sarcoptes (fattie bugs)
deep: dermodex (stick)

Question 12

how to conduct skin scraping

Answer 12

superfical: scrap with scalpel the skin surfave
deep: squiz skin surface-> scrape, little blood (demodex live at the bottom of the hair follicle) tiny flash of blood, we are scraping deep enough

Question 13

what are the different tests for fungal testing

Answer 13

woods lamp
hair plucking : trichogram and fungal culture

Question 14

how to conduct woods lamp test and purpose

Answer 14

woods lamp is a fluorence light (blue)
Bright apple green fluorescence along hair shaft (presence of ringworm)
purpose: diagnosing ringworm
note if u dont see anything, does not mean dont have ringworm (limited to microsporum sp- type of ringworm species) and only 50% of microsprum will floresce
Shine light on round lesion (possible ringworm) in a dark room

Question 15

how to conduct hair plucking test and purpose

Answer 15

trichogram:
pluck hairs with root intact (area with crusting/ scaling) -> place onto slide with KOH- liquid paraffin( clears keratin to see hyphae better) cover with coverslip and loop under microscope
purpose: look for fungal hyphae (attached to hair)
fungal culture (preferred)
put hair on culture, agar prevent the growth of other microbials, phenol red added as ph indicator , gel changes colour ( yellow-> red)

Question 16

different tests for bacterial/yeast

Answer 16

skin cytology :
sticky tape prep
direct impression smear
swabbing (between toes/ lesions with discharge)
fine needle aspiration (get cells from bump)

Question 17

what are the two methods to test for skin allergy

Answer 17

intradermal skin testing (preferred)
serum allergy testing (false negatives common)- test kit (blood test)

Question 18

Where are furmites usually found

Answer 18

Clinging to hair like a kuala

Question 19

What does cocci look like (bacteria)

Answer 19

Tiny balls

Question 20

What are the advantages and disadvantages of skin scraping

Answer 20

Adv: easy to perform, cheap, quick
Limitation: face and feet is hard to scrape
False negative is possible (take sample from multiple site, after suspected parasite repeat scrapes after a month of treatment )

Question 21

How to conduct direct impression smear test for bacterial/ yeast infection

Answer 21

Glass slide is pressed directly onto the surface several times in the same site
Sample is then heat fixed before staining with diff quick stain
Slide is there xamined under a microscope

Question 22

How to conduct swap test for bacterial or yeast infection

Answer 22

Use cotton swap, swab in ear, skin surface, interdigital spaces, exudative lesions
Sample is rolled onto glass slide
Slide is then heat fixed and stained
Look under microscope

Question 23

How to desentitise allergy

Answer 23

Given injection or oral dose by owner at home