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VMD 461C
Derm Midterm2
| Question | Answer |
|---|---|
| Avg flea life cycle | egg-->larva-->pupa-->adult takes 21days |
| Flea eggs hatch in ______ days | 1-10 |
| There are ____ larval stages of the flea that last _____ days | three 5-11 |
| ______stage of the flea is the most susceptible to heat and dryness | larval |
| The pupae stage of the flea lasts ______ days | 8-9 |
| The _______stage of the flea is the most resistant to dessication and is the most difficult to eliminate. | pupae |
| Flea pupae ex-pupate to become adults in response to ... | heat CO2 Vibrations Physical pressure |
| Adult fleas lay eggs _____ hrs after first blood meal | 24-36 |
| T/F Adult fleas are a permanent ectoparasite unless removed by the host | True |
| Pathogenesis of FAD Flea saliva contains inflammatory or immunologic properties:... | -histamine-like cmpds -proteolytic, cytolytic and anticoag enzymes -complete protein antigens |
| Pathogenesis of FAD immunologic mechanism depends on | -genetic predisposition -duration and degree of flea exposure |
| Pathogenesis of FAD immunologic responses | -Type I hypersensitivity -Late phase IgE mediated response -Cutaneous basophil hypersensitivity -Type IV delayed hypersensitivity |
| T/F Dogs with atopic dermatitis are predisposed to FAD | True |
| Dx of FAD | -Belt test (distribution) -finding fleas/flea dirt -Hx of boarding or high flea area |
| How is the distribution of feline FAD lesions different from dogs? | - not only the caudal half of the body - may include face and neck |
| Types of FAD lesions in dog | Dog -papules, scale and crust -excoriations -dull hair coat from licking |
| Types of FAD lesions in cat | -miliary dermatitis -self induced alopecia eosinophilic skin dz |
| Overall goal in management of FAD | minimize flea bites by quickly killing adult fleas -eradicate fleas in the environment -provide symptomatic relief to the P -treat and prevent infestations on the P |
| Describe the ideal flea control | -quick kill -active against multiple stages (but esp adults) -nontoxic -nonirritating -residual effects |
| Imidacloprid | -adulticide and larvicide -binds post-synaptic nicotinic receptors |
| Fipronil | -fleas and ticks -disrupts Cl- channels in CNS |
| Selamectin | -active against adults, larvae and eggs -increases Cl- permeability in neuronal Cl- channels (causes paralysis) |
| Pyrethrin/pyrethroids | -fast kill -excellent repellant -pyrethroids (permethrin) are toxic to cats -breaks down in UV light |
| T/F Permethrin is safe to use for flea control in cats | False Permethrin (a pyrethroid) is highly toxic to cats |
| Dinotefuran | -neonicotinoid adulticide -for fleas (all 4 stages), ticks, and mosquitoes |
| what is the only commercial flea control that kills all 4 life stages? | Dinotefuran |
| Metaflumizone | -novel mode of action (Na channel blocker) -may cause PF like reaction |
| what is the only commercial flea preventive that blocks Na channels? | metaflumizone |
| Nitenpyram | -neonicotinoid -oral prep -adulticide only -short acting -Gold std for FAD tx |
| what is the gold standard for treatment of FAD? | Nitenpyram |
| Spinosad | -neonicotinoid -oral prep -long acting -not licensed for cats -toxic if given with high dose ivermectin |
| Malassezia is a common canine commensal organism of... | -skin -ear canal -anal sacs -vagina -rectum |
| what allows malassezia to grow into a pathogenic infection? | -underlying dz (immunosuppression) -barrier disruption -excessive sebum/cerumen -immunodeficiency -hypersensitivity? |
| Pathogenesis of malassezia infection | -atopic dogs develop IgE mediated type I hypersensitivity -Dogs with seborrheic dermatitis - type I (immediate)and IV (delayed) immune reaction |
| What is the most common reason we see malassezia infections in dogs? | -the dog has an underlying allergic skin disease (especially atopic dermatitis) |
| Canine predispositions for malassezia infection | **allergic skin dz** -disorders of cornification -chronic inflammation -long term AB and/or corticosteroid Tx -breed predilectons |
| Canine breeds predisposed to malassezia | Westie basset hound (may have intense colonization without dz) springer spaniel GSD |
| Feline predispositions to malassezia infection | -generalized immunosuppressive dz -localized dz (less impt) -allergic skin dz (esp atopic dermatitis and food allergy) -breed (Devon Rex, Sphinx) |
| Feline breeds predisposed to malassezia | -Devon Rex -Sphinx |
| Underlying immunosuppressive dz's that predispose cats to malassezia | -paraneoplastic skin dz (associated with thymoma or pancreatic neoplasia) -erythema multiforme -FelV/FIV -DM -neoplasia |
| Canine malassezia clinical syndromes | Secondary (most common) - chronic inflammatory skin dz Primary (rare)- generalized inflammatory skin dz Severe pruritus (very rare)- restricted to muzzle or perianal area |
| T/F Canine malassezia is usually a primary infection | False. It is most often a secondary to some underlying dz |
| Clinical Signs of malassezia infection | -pruritus, erythema, alopecia, scale, greasiness, lichenification/hyperpigmentation -odor -focal, multifocal, or generalized -sharply demarcated margins -gradual peripheral expansion |
| Where do we see malassezia infections most commonly? | -on the feet (interdigitally) -around the bed of the claws -on the ventral throat |
| malassezia site predilections | -ventral neck -feet -ventral abdomen -face, ears -skin folds -claw beds |
| Dx of malassezia | -skin cytology via: dry skin scrapings or clear tape stripping -ID of sufficient # to consider pathogenic -ID underlying dz |
| Malassezia therapy | -Tx underlying dz -Systemic antifungals -Topicals (shampoos, wipes) |
| Topical anti-yeast Tx | -miconazole, ketoconazole -chlorhexidine -acetic acid -2x per week |
| Systemic drugs for malassezia | -ketoconazole -fluconazole (not metab in liver) -terbinafine -itraconazole |
| T/F Griseofulvin is effective against malassezia | False it is only effective against dermatophytes |
| What are the three most common allergic skin diseases? | -FAD -Atopic dermatitis -Food allergy |
| Atopic dermatitis definition | a genetically predisposed inflammatory and pruritic allergic skin disease with characteristic clinical features that is associated most commonly with IgE antibodies to env allergens |
| allergen definition | antigen that favors the development of a hypersensitivity response |
| Describe the IgE mediated mechanism of atopic dermatitis | -allergens bind to sensitized IgE on mast cells and cause them to degranulate and release inflammatory substances (histamine, serotonin, leutotrienes, cytokines) |
| What route of allergen exposure is most impt in atopic dermatitis? | percutaneous/epicutaneous |
| what role do keratinocytes play in atopic dermatitis? | -they can release inflammatory cytokines and leukotrienes -a defect in epidermal barrier can give allergens and bacteria more access to keratinocytes |
| Atopic dermatitis signalment in dogs | age: 1-7yrs breed: retrievers, terriers, Dalmatians, Shar-peis, Boxers sex: NONE |
| Atopic dermatitis clinical signs in dogs | -pruritis (#1 sign) -erythema -distribution: face, feet, axilla, ears (bilateral otitis externa) |
| T/F Atopic dermatitis dogs commonly have secondary infections | True. Screen all AD patients for secondary infections. Malassezia and staph pseudintermedius are common |
| Staph intermedius and Atopic Dermatitis | - has greater affinity for AD keratinocytes - AD dogs commonly have a hypersensitivity to s.intermedius |
| Atopic dermatitis clinical signs in cats | -pruritus of the face, head and neck with self induced alopecia -miliary dermatitis -eosinophilic granuloma complex -mild cases usually underdiagnosed due to normal grooming of cats |
| Dx of atopic dermatitis | -history (seasonality, <7yrs old) -CS (pruritic face, feet, axilla, ears) -Dx of exclusion (FAD, food allergy, ectoparasites) -Allergy testing |
| Atopic dermatitis Allergy testing | -intradermal testing (gold standard) -in vitro testing |
| Intradermal allergy testing | -gold std -can customize allergens -false +/- -drug interference -need sedation -subjective interpretation |
| In vivo allergy testing | -gives quantitative measurement of IgE -no hospitalization req'd -less affected by drugs -may not be able to choose allergens -false + more common |
| hyposensitization Tx (ASIT = allergen specific immunotherapy) Dogs | -65% success rate -70% of these improve within 4-6mo -may take 1yr in some cases -most req lifelong Tx |
| Hyposensitization in cats | -70% success rate (a little better than dogs) |
| Atopic dermatitis Tx | -ASIT -systemic drugs (steroids, cyclosporine, EFA's) |
| Cyclosporine for the Tx of atopic dermatitis | -suppresses immune mediated hypersensitivity response -no hormonal SE of steroids -$$$ -ketoconazole has sparing effects (P450 inhibition) -may cause anorexia/vomiting, papillomas, pyoderma, hypertrichosis, gingival hyperplasia |
| History for food allergy dogs | -offending diet fed usually >2yrs -acute onset, no seasonality -pruritus not responsive to GCC's |
| Signalment for food allergy in dogs | age: 1/3 are 1yr or younger Breed: retriever, terrier, GSD |
| Clinical signs of food allergy in dogs | -pruritus (similar to AD in distribution) -otitis externa more common than AD -scaling, papules, erythema |
| T/F Atopic dermatitis and food allergy may be distinguished based on distribution of pruritic lesions. | False. They can both be generalized or affect: -face, feet, axilla, ears |
| Clinical signs of food allergy in cats | -pruritus (face and neck), alopecia -miliary dermatitis -eosinophilic granuloma complex -secondary infections (malassezia) |
| Dx of food allergy | -signalment, Hx, lesion distribution -confirmation with strict elimination diet trial - novel protein diet 8-12wks - challenge with previous diet (signs should worsen within 2wks) - challenge with indiv ingredients |
| Food allergy diet trial considerations for diet choice | -past diet history (novel protein) -special nutritional needs -palatability and practicality for O |
| Home cooked diets for food allergy | Adv: control of ingredients, no additives/preservatives Disadv: labor intensive, $$$, may not be palatable, may not be nutritionally balanced |
| most common dog food allergens | beef, cow's milk, chicken, eggs, lamb, corn, soy |
| most common cat food allergens | fish, milk, beef, lamb |
| Contact dermatitis | rare -allergic contact dermatitis -irritant contact dermatitis |
| Allergic contact dermatitis | -rxn in certain indiv only -only upon subsequent exposures -time btw contact and clinical signs |
| Irritant contact dermatitis | -more common than allergic contact dermatitis -rxn in all indiv if sufficient exposure -little/no time btw contact and CS |
| Definition of a "complex" | sum of the factors (CS and lesions) characterizing a disease |
| eosinophilic granuloma complex etiologies | -fleas, food allergy, atopic dermatitis -contact (litterbox sand) -genetic |
| eosinophilic granuloma complex clinical findings | -lesions on caudal thighs, oral cavity, chin +/- peripheral lymphadenopathy -blood and tissue eosinophilia -Classic lesion is raised alopecic, linear, pink to yellow band on caudal thigh |
| eosinophilic granuloma Histopath | -macrophages surrounding collagen -collagen coated with eosinophil-derived granules -collagen NOT DEGENERATING |
| Mosquito bite hypersensitivity CS | -form of EGC -crusts, vesicles, ulcers, swelling on nasal planum, pinna, footpad +/- pruritus |
| Mosquito bite hypersensitivity Dx | Bx - eosinophils and occasional eosinophilic coated collagen |
| Mosquito bite hypersensitivity Tx | -corticosteroids -keep cat indoors (away from mosquitoes) |
| what Dz's can mimic mosquito bite hypersensitivity lesions? | -Feline herpesvirus Ulcerative dermatitis -sporothrix **you don't want to Tx these with steroids** |
| Herpesvirus ulcerative dermatitis Dx | -Hx - lack of response to steroids -dorsal muzzle lesions (may extend to nasal planum) -Bx +/- intranuclear viral inclusions -PCR skin Bx (sens & specific) |
| Herpesvirus ulcerative dermatitis Tx | -alpha interferon -famcyclovir -lysine -Tx secondary infections |
| Sporothrix | -fungal infection -mimics mosq bite hypersens -Dx with histopath (no eosinophils) |
| when you have an ulcerative facial lesion on the cat that is refractory to Tx, what should you do? | Bx |
| Feline lip ulcers etiology | -allergic, idiopathic, hereditary |
| Feline lip ulcers Histopath | ulcerative dermatitis +/- eosinophils |
| Feline lip ulcers Ddx | -Squamous cell CA -Herpes virus dermatitis -Deep fungal infections |
| feline lip ulcers Tx | -mandatory flea control -look for underlying allergies -R/O Ddx -corticosteroids |
| eosinophilic plaques CS | -moist, exudative, discrete, circular/oval, raised lesions on ventral abdomen/inguinal region of the cat +/- peripheral lymphadenopathy |
| eosinophilic plaques Histopath | -eosinophil filled epidermal vacuoles |
| eosinophilic plaques Dx | -**Bx** -impression smear cytology -therapeutic trials for underlying hypersensitivity |
| eosinophilic plaques Etiology | -FAD -cheyletiella -food allergy -atopic dermatitis |
| eosinophilic plaques Tx | -flea control -evaluate for allergies -corticosteroids -cyclosporine -antihistamines, EFA's -AB's for secondary infection |
| T/F eosinophilic plaque and miliary dermatitis are reaction patterns that are highly linked to allergic etiology | True always Tx for fleas and look for underlying allergies |
| Miliary dermatitis CS | - small, discrete, crusted papules on the dorsum, neck and tail base |
| Miliary dermatitis Etiologies | -**fleas**, cheyletiella, lice -food allergy, atopic dermatitis, drug rxn -dermatophytes, bacterial pyoderma |
| Miliary dermatitis Dx | -trial flea therapy -history, lesion distribution -specific tests for possible causes |
| Miliary Dermatitis Tx | -Treat the underlying cause -most of the time it's flea control -if fleas or allergies aren't the cause, use corticosteroids |
| Pemphigous foliaceus Etiology | -antibodies target desmoglein in the granular layer of the epidermis -desmoglein is the glue that attaches adjacent keratinocytes -may be idiopathic or drug induced |
| Pemphigous foliaceus where do you Bx? | -adherent crust and intact pustules |
| Discoid Lupus erythematosus where do you Bx? | -nonulcerated, recently depigmented area |
| basement membrane zone dz where do you Bx? | -intact vesicle adjacent to recent ulcer (vesicle at edge of lesion) |
| pemphigous foliaceus lesion is at what level of the skin? | granular layer attacking desmogleins |
| discoid lupus erythematosus lesion is at what level of the skin | basement membrane |
| How do you Dx autoimmune skin dz? | skin biopsy |
| T/F Patients with PF won't have oral lesions | True oral mucosa doesn't have desmoglein 1 (target of antibodies in PF) |
| Pemphigus foliaceus Breeds | Akita Chow Chow |
| Pemphigus foliaceus CS | -LARGE pustules and crusts -face, dorsal muzzle, nasal planum, pinnae, margins of the foot pads -no oral mucosal involvment -P often sick |
| Pemphigus foliaceus Dx | -cytology (acantholytic cells) -Bx (subcorneal pustules with acantholytic keratinocytes; layered crusting) -CBC (profound neutrophilia) |
| Pemphigus foliaceus Tx | -initial AB therapy -combo of systemic and topical immunosuppressive drugs |
| what is the most common nasal planum disease in dogs? | Discoid lupus erythematosis |
| Discoid lupus erythematosus etiology | -immune mediated and photo-aggravated lymphocytic attack on the basement membrane of the skin (target unknown) |
| Discoid lupus erythematosus CS | -most commonly on nasal planum -depigmentation, erythema, scaling, bilaterally symmetric -loss of cobblestone architecture |
| Discoid lupus erythematosus Dx | -Hx and CS -no response to AB's (Ddx mucocutaneous pyoderma) -Bx (recently depigmented areas) |
| Discoid lupus erythematosis Tx | -avoid sun exposure (sunscreen) -Tetracycline and nicatinamide -topical tacrolimus or GCC's |
| T/F The prognosis if discoid lupus erythematosus is poor to grave. | False DLE is often a cosmetic dz and with Tx, prognosis is very good |
| Erythema multiforme CS | -acute onset -pleomorphic erythematous macules and papules, urticaria, target lesions, ulcers -lesions often coalesce and may be focal or generalized |
| Erythema multiforme etiology | -**drugs** -neoplasia -infection -idiopathic |
| Erythema multiforme Dx | -Bx multiple lesions (avoid ulcers) -histopath hallmark = lymphocytes surrounding apoptotic keratinocytes |
| Erythema multiforme Tx | -stop drugs -look for underlying dz -supportive care -immunosuppressive therapy (depends on concurrent dz) |
| Systemic lupus erythematosus CS | -multiple organs affected (skin, joints, kidney, hematopoietic system) -Pleomorphic skin lesions (erythema, scaling, depigmentation, crusting, ulceration) -muzzle, nasal planum, pinnae, distal extrem, oral cavity |
| Systemic lupus erythematosus Dx | -immune mediated dz in 2 or more organ systems, fever, positive ANA - |
| Systemic lupus erythematosus Prognosis | depends on organ systems involved |
| Systemic lupus erythematosus Tx | immunosuppressive therapy |
| Basement membrane diseases CS | sub-epidermal vesicles |
| Basement membrane diseases Dx | -Bx (histopath confirmation of subepidermal vesicle; immunologic study to determine what protein being targeted) |
| Which is contagious/transmissible, demodex or sarcoptes? | -sarcoptes |
| Demodecosis types | -localized or generalized -juvenile or adult (>2yrs) - |
| Localized Demodecosis | common, mild, and benign self-limiting dz |
| Generalized Demodicosis | -serious and potentially life-threatening -usually <1yr -may be associated with deep pyoderma --> sepsis |
| Juvenile generalized demodicosis | -defective immune response (T cell dysfxn?) -hereditary -breed (Gt Danes, Old English) |
| Adult generalized demodicosis underlying causes | -immunosuppressive drugs (corticosteroids) -hypothyroidism -hyperadrenocorticism -Leishmaniasis -Neoplasia/chemotherapy -idiopathic (won't accept this on exam) |
| Canine demodicosis Dx | -hair pluck (see in follicles) -deep skin scraping -Bx (if you have neg scraping and still suspect) -cytology of pustules |
| Adult onset demodicosis Dx | -look for underlying dz -cbc, T4, ACTH stim, US, chest rads -Hx (drugs, travel) |
| Localized canine demodicosis Tx | -90% Heal spontaneously -AB ointment to manage secondary pyoderma |
| Generalized canine demodicosis Tx | -oral ivermectin -milbemycin oxime -antimicrobial shampoo (to open hair follicles)followed by amitraz dip (don't rinse off) -clip hair coat Tx until you get 2 consecutive qmo neg scrapings |
| Adverse effects of amitraz | -lethargy, hyper/hypoglycemia, vomiting -reversible with yohimbine or atipamezole |
| Adverse effects of ivermectin | -ataxia -lethargy -mydriasis -edematous wheals -beware of collie sensitivity (MDR1 mut'n) |
| how long do you have to treat generalized canine demodicosis? | -do deep skin scrapings monthly and treat until you get 2 negatives -at least 3 mo -often 6mo |
| why do intact females get demodicosis? | -estrus hormones can be immunosuppressive. -they should be spayed |
| Feline Demodicosis species | D.cati (hair follicles) D.gatoi (stratum corneum) |
| Demodex cati CS | -generalized alopecia and otitis -usually an underlying prob (DM, FelV, FIV, Cushing's) |
| Demodex cati Dx | deep skin scrapings hair plucks |
| Demodex gatoi CS | -pruritic -contagious |
| Demodex gatoi Dx | -multiple superficial skin scrapings -scrape in contact cats |
| Demodex gatoi Tx | -lime sulfur dip |
| Demodex cati Tx | -Tx underlying dz |
| T/F Demodex is always pruritic | False it is variably pruritic |
| Canine sarcoptes CS | -highly contagious and pruritic -erythematous maculopapular eruption, crusting and alopecia -secondary self trauma -ventral abdomen, elbows and margins of pinnae |
| Canine sarcoptes etiology | -female burrows by enzymatically melting stratum corneum -hypersensitivity rxn (may only have one or two mites; may never see them) |
| Canine sarcoptes lesion distribution | -**ventral abdomen** -margins of the pinnae (crusting) -elbows |
| Canine sarcoptes Dx | -Hx, PE, and suspicion (rapid onset, lesions, exposure, other animals/people affected) -Skin scrapings only Dx 30-50% -**response to Tx** |
| Canine sarcoptes Tx | -**Selamectin (safe in collies)** -treat all in-contact mammals for several months -Ivermectin -lime sulfur (has antipruritic properties) -amitraz -milbemycin oxime |
| Notoedres CS | -highly contagious and pruritic -crusting, scaling, erythema, alopecia, lichenification -secondary self trauma |
| Notoedres pathogenesis | -direct contact transmission -female burrows, lays eggs -complex hypersensitivity rxn |
| notoedres lesion distribution | -head and pinnae -sometimes body and feet |
| notoedres Dx | -Hx and PE(suspicion, rapid onset, exposure, other animals/people affected) -Skin scrapings -response to Tx |
| Notoedres Tx | -**Selemectin** -treat all in-contact mammals for several months -ivermectin -lime sulfur -amitraz -milbemycin oxime |
| Cheyletiella CS | -contagious -variably pruritic -scaling, crusting, miliary dermatitis(cats) |
| cheyletiella Pathogenesis | -direct contact transmission (animals and fomites) -mites are surface keratin dwellers -probably a hypersensitivity rxn |
| cheyletiella Dx | -Hx (suspicion and exposure) -scotch tape prep -viking mite |
| cheyletiella Tx | -**selemectin** -Tx all in-contact mammals -ivermectin -lime sulfur -amitraz -milbemycin oxime |
| a patient with cheyletiella is treated with selemectin and subsequently becomes more pruritic. How do you explain this to your now pissed off client? | -when the mites die, they release substances that cause more of a reaction -this is a good sign that the Tx is working |
| why aren't lice infestations seen commonly in dogs/cats? | because they are killed by most commercial flea preventives |
| Can humans get lice infestations from a cat/dog? | no, they are species specific |
| How do you treat a lice infestation on a dog/cat? | -selamectin -Tx all in-contact animals of the same species |
| keratinization definition | genetic program of keratinocytes in the basal cell layer to mature, die and produce the stratum corneum |
| cornification definition | keratinization + formation of lipid interstitium holding the keratinocytes together ("bricks and mortar") |
| Scale definition | excess stratum corneum |
| Crust definition | scale and blood, serum, microorganisms, cells, etc... |
| seborrhea definition | descriptive clinical term for excessive scaling, crusting, and greasiness -usually referring to idiopathic breed related keratinization/cornification defects |
| Seborrhea sicca Seborrhea oleosa Seborrheic dermatitis | Descriptive terms: -dry scale -oily -inflammation |
| Breed related seborrhea | -primary scaling/crusting disorder -cocker, westie, irish setter -seondary bacterial and/or yeast infections -variably pruritic -the younger the dog, the more likely it's breed related |
| Breed related seborrhea CS | -scale, crust esp on trunk and pinnae -ceruminous otitis externa -rancid odor -erythema and alopecia vary (self trauma) -lichenification |
| Seborrhea Tx | -antiscaling shampoos (sulfur, salicylic acid) -Tx secondary bacteria/yeast infections -Vit A inj (can slow cornification) -steroids if necessary - +/- cyclosporine |
| secondary causes of cornification disturbances | anything that disturbs normal cell turnover -inflammation (allergy, infections, ectopar) -hormonal dz (hypothyroidism) |
| why does the seborrhea in a hypothyroid dog get worse initially when treated? | -cornification and exfoliation not normal -then treat with thyroid --> exfoliate more rapidly -scale peels off in sheets |
| Regional cornification defects (hyperkeratosis) | -foot pad fronding (Kerry blue terrier) -nasal planum (spaniels, brachycephalics, labs) |
| familial palmoplantar hyperkeratosis | -kerry blue terrier -all paw pads affected by keratinous proliferation (fronds) -Dx (signalment and Bx) -Tx (salicylic acid gel and trimming) |
| Familial nasal parakeratosis of labs | parakeratosis = retention of nuclei in keratinocytes within 1st yr, proliferative lesion of adherent keratin on dorsal nasal planum Tx: topical Vit E, propylene glycol |
| nasodigital hyperkeratosis | -adherent dry keratoinous debris on nasal planum and foot pads -cockers, bassets, brachycephalics -can cause ortho dz Tx: topicals and Tx secondary infections |
| Sebaceous adenitits | -inlfammatory (granulomatous) destruction of sebaceous glands -alopecia, scaling, secondary pyoderma -std poodle, akita, vizsla |
| Sebaceous adenitis Dx | follicular casting seen in Bx and trichogram -keratinized material gets trapped in the hair shaft |
| Sebaceous adenitis Tx | -Keratolytic shampoo + moisturizer -Vit A (monitor for KCS) -Cyclosporine |
| How does vitamin A affect derm? what secondary problem do you have to monitor for? | -retinoids slow cornification -monitor for KCS (tear production) |
| Zinc responsive dermatosis syndrome I | -siberian husky, malamute -genetic defect in intestinal absorption of Zn -adherent scaling and alopecia of mucocutaneous jxn and footpads |
| Zinc responsive dermatosis syndrome II | -any breed, usually young dog fed poor diet -dietary Zn deficiency or excess phytates/minerals -crusting plaques, fissuring foot pads, fever, illness |
| Zinc responsive dermatosis Dx | -signalment and CS -Bx (acanthosis and parakeratosis) |
| Zinc responsive dermatosis Tx | type I - Zn supplementation type II - feed higher quality diet +/- Zn supplement |
| Canine ichthyosis | -congenital dz causing excessive scaling -Golden retrievers, Norfolk, CKCS |
| Canine ichthyosis Dx | -Bx -keratin normal amt but not basket weaved, loose configuration -layer upon layer of keratin (packed, lamellar) -no inflammation |
| Canine ichthyosis Tx | anti-seborrheic shampoos Vit A |
| Acral lick dermatitis | -thickened, depressed, hyperpigmented, erythematous, alopecic lesion -usually left thoracic limb -young to middle age large breed |
| Acral lick dermatitis Causes | -behavioral -deep pyoderma -atopic dermtitis -rare: neoplasia, orthopedic implants, osteomyelitis, fungal infections |
| Acral lick dermatitis Ddx | Leishmaniasis Neoplasia Sporotricosis |
| Acral lick dermatitis Dx | -History and CS -Bx (if atypical Hx or ABs not working) -Rads (old, lame dog) -Culture (if ABs not working) |
| Acral lick dermatitis What do you do if you have a refractory lesion? | -Bx -2 cultures (superficial and deep tissues) |
| Acral lick dermatitis Tx | -AB's (first thing) -psychoactives (amitryptilline, clomipramine) -Narcotic antagonists |
| Grass Awn (Foxtail) migration | -penetrates skin or orifice and migrates with animal movement -secondary actinomyces infection |
| Grass Awn (Foxtail) migration prevention | -decrease access -clip btw digits -check daily during season |
| Grass Awn (Foxtail) migration Ddx | interdigital pododermatitis |
| Interdigital pododermatitis | -short coated breeds -frictional trauma ->folliculitis-> furunculosis -> endogenous FB rxn -multiple interdig spaces involved -nodular lesions at pad margins or on palmar/plantar surface -front feet often worse |
| Ischemic dermatosis causes | -familial K9 dermatomyositis -due to vaccines/meds -idiopathic |
| Ischemic dermatosis Dermatomyositis Signalment | -Collies, Shetland, Pembroke WC, chowchow -variable progression, cyclic recrudescence -early onset -photoaggravated |
| Dermatomyositis CS | -lesions over bony prominences on face, limbs, tail tip and pinnae -alopecia erythema scaling, crusts, uclers, scarring -muscle atrophy -megaesophagus |
| Dermatomyositis Dx | -signalment, CS -skin Bx (lesions of alopecia and erythema) -muscle Bx -EMG |
| Dermatomyositis Ddx | -demodex -dermatophytes |
| Dermatomyositis Tx | -pentoxyfylline makes RBC more deformable -Tacrolimus ointment |
| Ischemic dermatoses Vaccine/drug | -any breed -Vaccine rxn may be 6mo after vaccination |
| Juvenile cellulitis | -idiopathic -puppies<3mo -Sterile pyogranuloma (infection with no bacteria) |
| Juvenile cellulitis CS | -mandibular lymphadenopathy -edema, pustules, papules, crusts periorally, periocularly, muzzle, ears -lethargy, fever, anorexia -polyarthritis/metaphysitis |
| Juvenile cellulitis Dx | -CS -aspirate LN -response to pred (within 24hrs) |
| Juvenile cellulitis Tx | -Pred tapered ~1mo |
| What are the three P's? | -predisposing factors -primary factors -perpetuating factors |
| Three parts of the tympanic membrane | -pars flacida -manubrium of the Malleus -pars tensa |
| What is the most common cause of otitis externa in the dog? the cat? | dog- atopic dermatitis cat- ear mites (otodectes) |
| Otitis externa CS | -head shaking -scratching -pain when opening the mouth -erythema, excoriations, alopecia, odor |
| Three P's (otitis externa) Predisposing factors | -ear conformation -high humidity in ear -obstructive ear dz(polyps, chronic inflammation) -Tx error (plucking) |
| Three P's (otitis externa) Primary factors | -atopic dermatitis/food allergy (malassezia) -parasites -foreign bodies -neoplasia -cornification disorders |
| Three P's (otitis externa) Perpetuating factors | -bacteria (s.pseudintermedius) -yeast (malassezia) -fungi(candida) -chronic pathologic changes -otitis media |
| Describe a good otic examination | -examine pinna and ear canal -palpate ear canal -visualize exudate -thorough cleansing -look for FB, mass, ulceration, appearance of tympanic membrane |
| When would you culture the ears? | -otitis media -rods present (looking for pseudomonas) -chronic ear infections |
| What do combination ear products have in them? Examples | topical AB's glucocorticoid anti-fungal e.g. tresaderm, otomax, mometamax |
| What do glucocorticoids do for an otitis externa? | -antipruritic -antiinflammatory -decrease sebaceous and apocrine gland secretion |
Created by:
modonnell