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Horse Medicine > Surgical equine dermatology > Flashcards

Surgical equine dermatology Flashcards

1
Q

What is the most common skin tumor in the horse?

A

sarcoid

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2
Q

What are differential diagnoses for sarcoid?

A
  1. squamous cell carcinom
  2. melanoma
  3. parasitic lesions
  4. ringworm
  5. equine papilloma
  6. granulation tissue
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3
Q

Where do squmaous cell carcinomas tend to be?

A

head or genital

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4
Q

Where do melanomas tend to be?

A

muzzle? under tail?

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5
Q

Where can parasitic lesions and ringworms be?

A

anywher

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6
Q

What can granulation tissue look like?

A
  1. sarcoid

2. squamous cell carcinoma

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7
Q

What are the characteristics of dry, flat sarcoid

A

dry, flat–hair loss, skin is normal underneath, ressembles ringworm but not silvery. palpate bmps and irregularities at edge of lesion–true edge of lesion

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8
Q

What are the features of a mixed sarcoid

A

hyperpigmentation
not itchy or painful
ddx staph folliculitis–but PAINFUL

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9
Q

What are the classifications of sarcoids?

A
  1. dry, flat
  2. mixed
  3. nodular (type A, Type B)
  4. verrucose–feel like warts
  5. fibroblastic
  6. occult
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10
Q

How common are periorbital sarcoids

A

common

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11
Q

What is the etiology of sarcoids?

A
  1. can occur one-off
  2. can occur in groups of horses–“outbreak” then go away without treatment
    these have different etiologies
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12
Q

What are the features of fibroblastic sarcoids?

A

highly aggressive
can be primary but usually secondary to inadequate intervention
will invade!!

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13
Q

Tumors on the head are what until proven otherwise?

A

squamous cell carcinoma

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14
Q

How do you diagnose a skin lesion?

A

take a biopsy and send to someone that has experience looking at horse skin!!!

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15
Q

Why do you not want to biopsy a sarcoid?

A

may turn fibroblastic because you upset it

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16
Q

What are treatment options for sarcoids?

A
  1. surgical removal
  2. surgical removal and cryptherapy
  3. crypotherapy
  4. laser therapy
  5. immunotherapy
  6. chemotherapy–cisplatin
  7. brachytherapy–radiation
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17
Q

How do you correctly surgically remove a sarcoid?

A
  1. don’t prep–take surface active cells and scrub over surgical field then cut through and seed them into your margins
  2. don’t clip
  3. make big square line block and cut inside square
  4. pick up skin margin with towel clamps, not thumb forceps
  5. often don’t have to go very deep (dermal based tumors)
  6. horses have many myofibril cells in skin–as soon as make any sized hole, will become 30% bigger v/ quickly–warn client!
  7. put big tacking sutures across the wound. near far, far near, tight! if a few days will be loose–massively improve bandage, treatment time
  8. smear vasoline down the side of the horse (and have fly spray)
  9. time it with spring, late fall so there a fewer flies because these wounds are fly magnets!
18
Q

How should you do cryotherapy on sarcoids?

A

do 3 cycles

19
Q

What are the steps of cryotherapy

A

rapidly freeze tissue–ice crystals
slow thaw–aggregation of ice crystals so ice block in cell gets larger
rupture of cell
microthrombus formation–avascular necrosis of remaining tumor cells left behind–tell client that more will die!!!

20
Q

What is CO2 laser therapy?

A

a treatment for sarcoid

21
Q

What is the problem with treating sarcoids on the ear?

A

very unforgiving tissue, could damage cartilage and disrupt proper structure of ear

22
Q

What is the BCG vaccine?

A

a vaccine for sarcoids

23
Q

What is the issue with the sarcoid vaccine?

A

some animals have a major anaphylactic reaction and drop dead (second time?) may pretreat with dex but given risk and success rate probably don’t use this

24
Q

What drug is used with immunotherapy?

A

cisplatin
can inject into mass (use luer lock syringe)
cisplatin beads–make small incision in sarcoid and drop beat in and cruciate suture over it–works quite well but the beads are a pain–small, quite fragile
multiple treatments
if first injection doesn’t work, could try a second but no more than that if second does not work

25
Q

What is the current definitive treatment for sarcoids?

A 
brachytherapy (radiation)
inject grains, or wires
don't want in a midthoraxic, axillary region!!!
gold
strontium wand
etc
26
Q

Why might you not be able to get a good freeze with cryotherapy after surgery?

A

the blood flowing can thaw the tissue faster than you can freeze it

27
Q

Why do you want to get a very good freeze on sarcoid after surgery?

A

because want to penetrate deeply

28
Q

What are topical therapies for sarcoids?

A

AW4-LUDES
5-fluorouracil and oil of rosemary
ok, not great

Xterra: not FDA approved, not for sale in canada. No controlled trials!!!
blood root extract

29
Q

Melanomas are most ocmmon in…

A

grey horses

30
Q

What are the 3 types of melanoma

A
  1. classical benign
  2. benign-malignant-benign
  3. malignant
31
Q

Where can the melanomas under the tail metastasizze to (rare)

A

to the spine and cause ataxia

32
Q

What is the appearance of melanomas?

A

hard spherical nodules

33
Q

How do melanomas typically spread?

A

locally

34
Q

Where can melanomas be found?

A

tailhead

salivary gland?

35
Q

What is a differential for melanomas at salivary gland region?

A

enlargement of salivary gland with low grazing?

36
Q

What are the features of squamous cell carcinomas?

A
  1. invasive tumor of squamous cells of skin, resporatory mucosa etc etc
  2. most common are eyelid/nictitating membrane and penis
  3. high U/V levels and smegma thought to be inciting causes
  4. penile condition more common in geldings
37
Q

What may be the initial sign of squamous cell carcinoma in eyelid/nictitating membrane?

A

epiphora

prolapse nictating membrane and look underneath for grey fleshy mass that could be early SCC

38
Q

Why should you feel inguinal lymph nodes?

A

SCC from penis may go there (can feel very rectal)

but just because not enlarged does not mean they have not metastasized there

39
Q

Does granulation have nerves (before maturation)

A

no

40
Q

Why can it be difficlt to differentiate granulation tissue and sarcoid?

A

because can be similar in appearance and becuase sarcoid can arise from previous region of trauma

Horse Medicine (14 decks)

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