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Year 1/2 > Defense & Barriers 2: Folliculitis > Flashcards

Defense & Barriers 2: Folliculitis Flashcards

1
Q

what kinds of lesions can be PRESENT due to folliculitis?

A

MANY TYPES on the SAME ANIMAL

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2
Q

TOP 3 DIFFERENTIALS for FOLLICULITIS?

how can we distinguish? (TRICK)

A
  1. BACTERIAL FOLLICULITIS
  2. DEMODICOSIS
  3. DERMATOPHYTOSIS

we CANNOT distinguish WITHOUT DIAGNOSTICS!

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3
Q

prior to diagnostics, what 3 things should we gather/do for FOLLICULITIS?

A
  1. COMPLETE DERMATOLOGIC HX
  2. COMPLETE DERMATOLOGIC EXAM
  3. COMPLETE GENERAL EXAM
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4
Q

3 diagnostics to do for folliculitis & what you’re looking for/ruling out?

A
  1. SKIN CYTOLOGY –> rule in or out BACTERIAL FOLLICULITIS
  2. DEEP SKIN SCRAPING –> rule in or out DEMODICOSIS
  3. TRICHOGRAM –> look at hair shaft for DEMODEX or FUNGI (dermatophytes)
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5
Q

PREVALENCE of causes of folliculitis in DOGS & CATS?

A

DOGS = BACTERIAL > DEMODICOSIS > DERMATOPHYTOSIS

CATS = DERMATOPHYTOSIS > BACTERIAL > DEMODICOSIS

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6
Q

DERMATOPHYTOSIS?
what is it? (+ what 3 structures it affects)
how are they classified? what are the 3 classes?
zoonotic?
2 methods of transmission? (second has 3 subs)

A

= FUNGAL infection affecting the keratinized structures of skin (hair, superficial layers and claws)

classification? = based on PREFERRED HOST OR LOCATION
1. Zoophilic = animal is the PREFERRED HOST (microsporum canis)
2. Geophilic = found in the ENVIRONMENT (microsporum gypseum)
3. ANTHROPOPHILIC = HUMANS are the preferred host

YES ZOONOTIC

transmission?
(1) CONTACT with INFECTED HAIRS/NAILS between an INFECTED or ASYMPTOMATIC animal –> MOST COMMON METHOD
(2) CONTACT with ARTHROSPORES SHED INTO ENVIRONMENT from…
1. Dust particles
2. Fomites (grooming supplies, bedding, collars)
3. Ectoparasites (fleas)

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7
Q

how long is microsporum canes VIABLE in the environment? what is it?

A

UP TO 18 MONTHS

DERMATOPHYTE (ringworm, fungi)

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8
Q

what 4 things predispose an animal to DERMATOPHYTOSIS?
why?

A

4 things?
1. PRURITUS
2. HUMIDITY
3. GROOMING
4. ECTOPARASITES

due to DISRUPTION OF THE STRATUM CORNEUM, so more likely in ALLERGIC, ITCHY ANIMALS

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9
Q

identify disease & genus/species

A

DERMATOPHYTOSIS (microsporum canis)

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10
Q

Trichophyton mentagrophyte
what is it?
classification?
found in what animals?

A

what is it? –> DERMATOPHYTE

classification? –> ZOOPHILIC

found in SMALL MAMMALS & DOGS/CATS

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11
Q

DERMATOPHYTOSIS in CATS…
5 clinical signs to remember?
4 lesion distributions?

A

clinical signs?
1. erythema
2. comedones
3. hyperpigmentation
4. ABNORMAL NAIL GROWTH
5. VARIABLE PRURITUS

lesions?
1. Face
2. Ears/pinna
3. Muzzle
4. Around eyes

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12
Q

4 other things that can cause wood’s lamp fluorescence?

what SHOULD we pluck for fungal culture/trichogram?

A
  1. DETERGENT RESIDUE
  2. CRUSTS
  3. SCALE
  4. MEDICATIONS

only pluck hairs that FLUORESCE APPLE GREEN

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13
Q

FUNGAL CULTURE…
2 methods? (one for first, three for second & why FALSE NEGATIVES are common)
what media is used?
HOW does the media change color for DERMATOPHYTES vs SAPROPHYTES?
false positive risk for CULTURE?

A

2 methods?
1. toothbrush
–> BRUSH COAT for 2-3 minutes with TOOTHBRUSH (~20 strokes)
–> Spores will LIVE UP TO 18 MONTHS so CAN KEEP

  1. hair plucking
    –> Pluck hairs/crusts from edges of suspect lesions
    –> Pluck hairs that FLUORESCE with wood’s lamp
    –> PLUCK AS MANY HAIRS AS YOU CAN because there’s high chance of FALSE NEGATIVE

what media is used?
–> Dermatophyte Test Media = Saboraud’s Dextrose Agar (SDA)

HOW does the media change color = Dermatophytes will INITIALLY UTILIZE PROTEIN –> creates ALKALINE ENVIRONMENT –> RED COLOR

dermatophytes vs. saprophytes?
1. DERMATOPHYTES use protein FIRST
–> Change usually occurs within 7 days
2. SAPPROPHYTES USE CARBS FIRST and PROTEINS LATER
–> Change usually occurs 10-14 DAYS LATER

**CAN READ FALSE POSITIVES IF ONLY BASING ON COLOR CHANGE

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14
Q

identify GENUS/SPECIES

A

MICROSPORA CANIS

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15
Q

identify GENUS/SPECIES

A

MICROSPORA GYPSEUM

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16
Q

identify GENUS/SPECIES

A

T. MENTAGROPHYTES

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17
Q

identify GENUS/SPECIES

A

MICROSPORA GYPSEUM

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18
Q

identify GENUS/SPECIES

A

MICROSPORA CANIS

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19
Q

identify GENUS/SPECIES

A

T. MENTAGROPHYTES

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20
Q

DERMATOPHYTE PCR…
= what does it test for? what clinically does this mean?
3 things that could cause POSITIVE result?
3 things that could cause NEGATIVE result?
timing for PCR vs. fungal culture?

A

= TESTS FOR PRESENCE OF DNA, so NOT helpful for determining response to treatment

POSITIVE result due to…
1. ACTIVE infection
2. FOMITE carriage
3. DEAD FUNGAL ORGANISMS from a treated patient

NEGATIVE result due to…
1. POOR SAMPLING technique
2. Successful cure
3. No infection in the first place

**FUNGAL CULTURES TAKE 4 WEEKS TO CONFIRM, PCR ONLY 1 WEEK

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21
Q

HISTOPATHOLOGY & DERMATOPHYTOSIS
what will it do for dermatophytes?
often needs these 2 things to visualize?
what 3 clinical presentations would indicate this?

A

MAY or MAY NOT help identify dermatophytes!

needs…
1. SPECIAL STAINS
2. H&E

clinical presentations?
1. NON-HEALING (indolent) wound or nodule
2. CHRONIC facial lesions that RESEMBLE PEMPHIGUS
3. Lesions of UNKNOWN CAUSE

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22
Q

TREATMENT for dermatophytosis…
RECOMMENDED protocol?
when can we stop treatment?
which medication is ALWAYS required?

A

protocol?
= Some pets will SELF-CURE, but since zoonotic potential, treatment RECOMMENDED FOR ALL INFECTED ANIMALS with COMBO SYSTEMIC & TOPICAL

stop treatment?
= MUST CONTINUE TREATMENT UNTIL OBTAINING 2 NEGATIVE DERMATOPHYTE CULTURES

**TOPICAL TREATMENT ALWAYS REQUIRED

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23
Q

SYSTEMIC therapies for DERMATOPHYTOSIS…
AZOLES? (2)
include one that’s good for dogs/bad for cats, compounding, pulse-dosing, side effects, mechanism of action

ALLYLAMINES? (1)
method of action?
3 side effects?

A

(1) AZOLES
1. IMIDAZOLES (ketoconazole)
**AVOID KETOCONAZOLE IN CATS (hepatotoxicity)
–> In dogs, COMMONLY USED with rare S/E

  1. TRIAZOLES (itraconazole)
    –> Requires a SPECIAL FORMULATION for absorption through GI tract
    –> ONLY USE BRAND-NAME because COMPOUNDED has VARIABLE BIOAVAILABILITY
    –> Can be given PULSE dosing (week on week off) because it’s LIPOPHILIC & ACCUMULATES in the EPIDERMIS & SEBACEOUS GLANDS

Side effects?
–> In both cats/dogs, ANOREXIA common but usually well-tolerated

Mechanism of action?
= INHIBITS LANOSTEROL 14-ALPHA DEMETHYLASE, which is a FUNGAL P450 ENZYME and converts LANOSTEROL –> ERGOSTEROL
–> Ergosterol needed for FUNGAL MEMBRANE INTEGRITY, so its depletion = FUNGISTATIC EFFECTS

(2) ALLYLAMINES (TERBINAFINE)
Method of action?
= inhibits SQUALENE EPOXIDASE to INHIBIT ERGOSTEROL SYNTHESIS

Side effects?
1. ELEVATED LIVER ENZYMES
2. Soft stool/D+
3. INTENSE FACIAL PRURITUS (rare in cats)

24
Q

2 most effective SYSTEMIC TREATMENT OPTIONS FOR DERMATOPHYTOSIS?

A
  1. TRIAZOLES (ITRACONAZOLE)
  2. ALLYLALMINE (TERBINAFINE)
25
Q

what determines the TOXICITY of azoles?

A

depends on drug’s AFFINITY for MAMMALIAN P-450 ENZYME SYSTEMS

26
Q

LIME SULFUR DIP…
good choice for what organism?
safe for…
formulation? (1)
application? (rinsing, how often to apply?)
side effect? (1)

A

DERMATOPHYTES

Safe to use in ALL AGES CATS/DOGS

formulation?
= Available in concentrated form, but needs DILUTE 4 OZ/GALLON OF WATER

application?
1. **DO NOT RINSE AFTER APPLICATION
2. Recommended 1-2X/week

side effect?
1. Can irritate mucous membranes, so keep pets in E-collar until dry

27
Q

how many times per week and for how long should bathing be done for DERMATOPHYTOSIS?

A

2X per week for AT LEAST 10 MINUTES

28
Q

2 topical options for dermatophytosis?

A
  1. LIME SULFUR DIP
  2. MICONAZOLE + CHLORHEX shampoo
29
Q

with what & when are we FINISHED with DERMATOPHYTOSIS treatment?

A
  1. 2 NEGATIVE DERMATOPHYTE CULTURES
  2. Do first culture 3-4 weeks after starting therapy, then every 2-4 weeks after
30
Q

environmental decontamination for DERMATOPHYTOSIS?
how does dermatophytosis exist in environment?
how long can it stay in environment?
why is it dangerous?
what is the MOST important part of the clean?

A

Infective spores are SHED INTO THE ENVIRONMENT WITHIN INFECTED HAIRS

REMAIN FOR UP TO 18 MONTHS

Hairs can be source of RE-INFECTION

**THEREFORE, THE MOST IMPORTANT PART IS THE HARD CLEAN OF HAIRS/DEBRIS

31
Q

RARE presentations of dermatophytosis…
2 types?
3 clinical signs?
WHAT SPECIES/BREEDS?

A

= PSEUDOMYCETOMAS & MYCETOMAS
1. SQ infections
2. Nodules w/ draining tracts
3. Exudate often has tissue grains

YORKIES & PERSIANS

32
Q

identify DISEASE & UNIQUE PRESENTATION

A

DERMATOPHYTOSIS

**PSEUDOMYCETOMAS & MYCETOMAS

33
Q

identify GENUS/SPECIES
where does it live?

A

DEMODEX CANIS

HAIR FOLLICLES

34
Q

identify GENUS/SPECIES
body description?
where does it live?
what breeds?

A

DEMODEX INJAI

LONG-BODIED MITE

lives in FOLLICLES, SEBACEOUS GLANDS/DUCTS

in TERRIERS

35
Q

identify GENUS/SPECIES
body description?
variation of…

A

DEMODEX CORNEI

SHORT-BODIED MITE

variation of CANIS

36
Q

DEMODICOSIS…
3 species?
classification? (+3 age markers)

A

DEMODEX INJAI, CORNEI and CANIS

classification = JUVENILE-onset or ADULT-onset possible!
1. Juvenile = DOGS LESS THAN 2 YEARS
2. Adult = DOGS OVER 4 YEARS
3. Dogs between 2 and 4 years may have CHRONIC UNDIAGNOSED DISEASE

37
Q

identify disease

A

JUVENILE DEMODICOSIS

38
Q

JUVENILE DEMODICOSIS…
what age?
what breeds?
why does it develop?
should we breed affected dogs?

A

IN DOGS LESS THAN 2 YEARS

More common in BULLY-TYPE breeds

May develop BECAUSE OF AN ABNORMALITY IN T-CELL FUNCTION

HERITABLE, DO NOT BREED

39
Q

LOCALIZED demodicosis
in what age dogs?
lesion number/outcome?
generally, treatment..?
when IS treatment necessary?
what treatment would you give/when would you recheck?

A

IN YOUNG DOGS ONLY

IF LESS THAN 4 LESIONS = IT’LL SELF CLEAR

Treatment GENERALLY NOT NEEDED as most will RESOLVE ON THEIR OWN within 1-2 months

If progress to GENERALIZED  TREATMENT RECOMMENDED

Can consider TOPICAL TREATMENT WITH ANTIMICROBIAL activity
–> Recheck in 1 month

40
Q

GENERALIZED demodicosis…
how many lesions/how much of body affected?
what specific area tends to be affected?
how long are the lesions present?

A

> 4 LESIONS or an ENTIRE BODY REGION AFFECTED

Some say it’s if the FEET are affected

LESIONS PRESENT FOR >6 MOS

41
Q

identify DISEASE

A

DEMODICOSIS

42
Q

identify DISEASE

A

DEMODICOSIS

43
Q

identify DISEASE

A

DEMODICOSIS

44
Q

4 unique clinical signs of DEMODICOSIS?
can SYSTEMIC illness occur?

A
  1. FOLLICULAR CASTS = sebaceous adenitis or demodicosis
  2. DRAINING TRACTS if FURUNCULOSIS present
  3. Usually NON-PRURITIC unless SECONDARY BACTERIAL FOLLICULITIS PRESENT (this is common and occurs in most cases)

SYSTEMIC Dz POSSIBLE!

45
Q

DIAGNOSIS of demodicosis? (2)

A
  1. DEEP SKIN SCRAPING = need to find AT LEAST 2 mites, ONE NOT ENOUGH
  2. TRICHOGRAM = for when we can’t scrape, like around eyes and face, less sensitive
46
Q

identify DISEASE

A

DEMODICOSIS

47
Q

what 3 situations would a BIOPSY be indicated for DEMODICOSIS diagnosis?

A
  1. SHAR PEIs because CANNOT GET CYTOLOGY
  2. LICHENIFIED SKIN
  3. PODODERMATITIS
48
Q

identify DISEASE

A

DEMODICOSIS

49
Q

identify GENUS/SPECIES
in what species?
what kind of mite?
body?

A

DEMODEX GATOI

CAT

FOLLICULAR mite

LONG-BODIED

50
Q

identify GENUS/SPECIES
where does mite reside?
body?
causes WHAT clinical sign?
contagion?
most often associated with WHAT clinical presentation? what 4 kinds are there?
2 treatment options? (topical & oral)

A

DEMODEX CATI

SUPERFICIAL MITE

SHORT-BODIED

causes SEVERE PRURITUS

CONTAGIOUS AS HECK

Most often associated with IMMUNOSUPPRESSION…
1. Corticosteroid administration
2. FeLV/FIV
3. Diabetes
4. NEOPLASIA

topical?
1. SELAMECTIN/SAROLANER or FLURALANER TOPICAL
2. ORAL LOTILANER

51
Q

identify GENUS/SPECIES

A

DEMODEX CATI

52
Q

PYODERMA…
= definition
usually caused by WHAT?
what 4 things usually cause SECONDARY pyoderma?

A

= any PYOGENIC inflammation in the skin

usually caused by BACTERIAL (staph) infection

secondary pyoderma?
1. Allergic skin diseases
2. Endocrinopathies
3. Immunosuppression
4. Ectoparasites

53
Q

STAPHYLOCOCCUS…
is a ____ resident of the ____ and ____ ____ in ____ and ____

coagulase POSITIVE staph? (3, including PRIMARY reservoirs & which are MOST COMMON)

coagulase NEGATIVE staph? (how many species? 2 traits?)

A

NORMAL, SKIN, MUCOUS MEMBRANES, MAMMALS, BIRDS

coagulase POSITIVE staph?
1. S. PSEUDINTERMEDIUS = MOST COMMON, DOGS are primary reservoir (cats & herbivores included)

  1. S. SCHLEIFERI = SECOND MOST COMMON, DOGS/HUMAN primary reservoir
  2. S. AUREUS = HUMANS primary reservoir

coagulase NEGATIVE staph?
> 45 species!
usually COMMENSAL/TRANSIENT

54
Q

taking a CULTURE for staph from CONTENTS of pustule vs. crust/epidermal collarette?

A

If a culture is from CONTENTS of a pustule in ASEPTIC MANNER, then MORE LIKELY TO BE TRUE DIAGNOSIS/PATHOGENICITY than crust/epidermal collarette, which contains contaminants

55
Q
A

Year 1/2 (139 decks)

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