Keratization Disorders (Santoro) Flashcards

1
Q

Cornification

A
  • Process takes about 21-22 days
  • Forms the stratum corneum
  • Keratinization → formation of lamellar bodies → synthesis of keratohyalin granules → formation of cornified envelop
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2
Q

Seborrhea

A
  • Clinical sign, NOT a disease (but can be in the name of a disease, i.e. primary seborrhea)
  • Nonspecific term that refers to almost any dermatosis
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3
Q

Hormonal regulation of sebum production

A
  • Incr. by androgens, thyroid, progesterone
  • Decr. by corticosteroids, estrogens
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4
Q

Dietary influence on sebum production

A

Fat deficiency → initial decr. and then incr. (experimental)

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5
Q

Factors controling sebum production

A
  • Hormonal regulation
  • Dietary influence
  • Low levels of vitamin A
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6
Q

Sebum composition

A
  • Sterol
  • Diester waxes
  • Free cholesterol
  • Triglycerides
  • Fatty acids
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7
Q

Seborrhea sicca

A

Excessive scale formation

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8
Q

Seborrhea oleosa

A

Excessive secretions of grease on skin & hairs

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9
Q

Seborrheic dermatitis

A

Excessive presence of scales of grease w/ inflammation

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10
Q

Cause of primary seborrhea

A

Inherited dz (genetic component). Clinical signs usually start at a very young age.

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11
Q

Cause of secondary seborrhea

A

Induced by diseases or external stimuli

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12
Q

Causes & pathogenesis of seborrhea

A
  • Inflammation
    • release of histamine, cytokines, LTB4, PGE2
  • Endocrinopathies
    • Hormones incr. cell proliferation
  • Nutrition
  • Environmental factors
    • Excessive bathing
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13
Q

Clinical signs of seborrhea

A
  • Generalized or localized
  • Seborrhea sicca
  • Seborrhea oleosa
  • Seborrheic dermatitis
  • Ceruminous otitis
  • 2º infections
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14
Q

Types of primary seborrhea

A
  • Idiopathic seborrhea
  • Ichthyosis
  • Zinc responsive dermatitis type I
  • Feline idiopathic dermatitis
  • Schnauzer comedo syndrome
  • Acrodermatitis
  • Exfoliative CLE
  • Epidermal dysplasia
  • Vit. A responsive seborrhea
  • Sebaceous adenitis
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15
Q

Types of secondary seborrhea

A
  • Allergy
  • Pyoderma
  • Dermatophytosis
  • Malassezia dermatitis
  • Scabies
  • Demodicosis
  • Pemphigus complex
  • Zinc responsive dermatitis type II
  • Endocrinopathies
  • Cutaneous lymphoma
  • Necrotic migratory erythema
  • Feline acne
  • Feline thymoma-associated exfoliative dermatitis
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16
Q

Primary (idiopathic) seborrhea pathogenesis

A
  • Keratinization/cornification defect
    • Not well understood
    • Acceleration of keratinization process
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17
Q

Primary (idiopathic) seborrhea common breeds

A
  • Cocker Spaniel
  • English Springer Spaniel (?)
  • Cavalier King Charles Spaniel
  • Shar Pei
  • Labrador Retriever
  • West Highland White Terrier
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18
Q

Primary (idiopathic) seborrhea clinical signs

A
  • Greasy skin w/ scales, comedones, follicular casts, otitis
  • Dry skin (Dobermans, Irish Setters)
  • Skin infections common
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19
Q

Primary (idiopathic) seborrhea diagnosis

A

Exclusion of secodary seborrhea

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20
Q

Primary (idiopathic) seborrhea treatment

A
  • Keratocytic/keratoplastic shampoo
  • Antimicrobial shampoo
  • Oral retinoids (isotretinoin)
  • Fatty acids (topical or in food)
  • Abx or antifungals
21
Q

Zn responsive dermatosis type I breed predilection

A
  • Alaskan malamute
  • Samoyeds
  • Siberian husky
22
Q

Zn responsive dermatosis type I pathogenesis

A

Inherited impariment to absorb and metabolize zinc

23
Q

Zn responsive dermatosis type I clinical signs

A
  • 1-3 yrs old
  • Erythema
  • Alopecia
  • White-grey scales and crusts
  • Hyperkeratotic foot pads
  • Mucocutaneous junctions of face and pressure points
  • Malassezia and bacterial infections common
24
Q

Zn responsive dermatosis type II predilection

A

Rapidly growling, large breed puppies

25
Q

Zn responsive dermatosis type II pathogenesis

A

Unbalanced diet high in phytates or minerals that chelate zinc

26
Q

Zn responsive dermatosis type II clinical signs

A
  • Thick, well demarcated plaques & crusts
  • Periocular and perioral areas & genitalia
  • +/- enlarged lymph nodes
  • Malassezia and bacterial infections common
27
Q

Zn responsive dermatosis treatment

A
  • Keratolytic/keratoplastic shampoos
  • Antimicrobial shampoos
  • Zn supplement
  • Abx, antifungals
28
Q

Schnauzer comedo syndrome clinical signs

A
  • Multiple comedones on dorsal midline
  • Alopecia
  • Erythema
  • Crusted papules
  • Follicular cysts
  • 2º infections
29
Q

Schnauzer comedo syndrome treatment

A
  • Keratolytic/keratoplastic shampoos
  • Antimicrobial shampoos
  • Oral retinoids (isotretinoin)
  • Abx, antifungals
30
Q

Malassezia species

A
  • Budding yeast
  • Commensal of skin and ears
    • Incr. number in humid, warm conditions
  • Commensal relationship w/ staph
31
Q

Malassezia predisposing factors

A
  • Incr. humidity, warm
  • Primary dz that incr. sebum production, inflammation, and/or alter surface barrier
    • allergies, keratinization defects, endocrinopaties, infection
  • Skin folds
  • Breed
32
Q

Malassezia clinical presentation

A
  • Pruritis/erythema
  • Scaling/seborrhea
  • Paronchia
  • Lichenification/hyperpigmentation
  • Ventral body (neck, axillae, abdomen)
  • Face, ear pinnae
  • Feet, forelegs
  • Skin folds
  • Otitis externa/media
33
Q

Malassezia diagnosis

A
  • Cytology
    • Scotch tape
    • Impression smear on oozing areas
    • Swabs for ears
    • (sample may be fatty so heat fix before Difquick)
34
Q

Malassezia treatment

A

Kill the yeast and the seborrhea will go away

35
Q

Seborrhea sicca topical treatment

A
  • Moisturizing - emollient vs. humectant
  • Hypoallergenic
  • Oatmeal
  • Lanolin
  • Sulfur +/- salicylic acid
  • Antimicrobial
36
Q

Seborrhea oleosa topical treament

A
  • Selenium sulfate
  • Sulfur +/- salicylic acid
  • Tar
  • Benzoyl peroxide
  • Antimicrobial
37
Q

Keratoplastic

A

Decr. DNA → decr. mitosis → decr. cell ontogenesis

38
Q

Keratolytic

A

Decr. cohesion between corneocytes → incr. desquamation

39
Q

Emollient

A

Moisturize the skin → decr. transepithelial water loss

  • Vegetable oils, animal oils, silicon, waxes, hydrocarbons
40
Q

Humectant

A

Moisturize the skin → decr. transepithelial water loss and reall water from dermis and environment

  • propylene glycol, glycerin, colloidal oatmeal, urea, sodium lactate, lactic acid
41
Q

Benzoyl peroxide

A
  • Keratolytic
  • Antibacterial
  • Degreasing
  • Aggressive use can cause irritation
  • Bleaching agent
42
Q

Selenium sulfate

A
  • Selson Blue
  • Keratolytic
  • Keratoplastic
  • Degreasing
  • Antifungal (malassezia)
43
Q

Sulfur

A
  • Keratolytic
  • Keratoplastic
  • Degreasing
  • Antimicrobial
  • Antiparasitic
  • Antifungal
  • Synergistic w/ salicylic acid
44
Q

Salicylic acid

A
  • Shampoo 0.1-2%
    • Keratoplastic
    • Antipruritic
    • Bacteriostatic
  • Shampoo 3-6%
    • Keratolytic
  • Synergistic w/ sulfur
45
Q

Tar

A
  • Keratolytic
  • Keratoplastic
  • Degreasing
  • Side effects
    • malodourous
    • irritant and photosensitizing
    • carcinogenic
46
Q

Phytosphingosine

A
  • Pro-ceramide
    • naturally in skin
  • Anti-inflammatory
  • Antimicrobic
47
Q

Novasomes & spherulites

A
  • Nanoparticles
  • Adhere to skin & hair
  • Slow release of active ingredient
48
Q

Systemic anti-fungals

A
  • Ketoconazole
  • Itraconazole
  • Fluconazole
  • Terbinafine