dematology Flashcards
(210 cards)
1
Q
what are the advantages of clinical eye method of diagnosis
A
- quick method
- cheap
- if effective generate confidence
*
2
Q
what are the disadvantages of ‘clinical eye” method
A
- frequently fails
- it cannot be repeated and it cannot be taught
- it does not allow to progress
- fastest way to reach a wrong dianosis
3
Q
explain how the diagnosis is made with “performing successive diagnostic test’
A
- different tests are performed until an abnormality is found
- then a diagnosis is made on the basis of the alteration found.the clinical signs are therefore explained
4
Q
how good is the diagnosis from performing successive diagnostic tests
A
apparently it is well founded
5
Q
what are the disadvantages of successive diagnostic tests
A
- slow and unpredictable
- expensive.a lot of useless tests are performed, the ownrs get tired
- it cannot be explained and systematized easily.
6
Q
what is the advantage of performing successive diagnostic test
A
depending on the test chosen in the first place, a differential diagnosis can be reached
7
Q
what is the advantage of problem orioented approach
A
- it can be explained and taught
- it mixes subjective decisions (problem definition) with science based actions
- it is effective
- minimum expenses to reach the dianosis
8
Q
list all the primary cutaneous lesions
A
- macule/patch
- papule
- plague
- pustule
- vesicle or bulla
- wheal
- nodule
- tumer
- erythema
9
Q
list all the secondary lesions
A
- epidermal collarette
- erosion
- ulceration
- excoriation
- lichenification
- scar
- fissure
10
Q
list all the lesions which can be either primary or secondary
A
- alopecia
- scale
- follicular cast
- crust
- comedo
- pigmentary abnormalities/changes
11
Q
circumscribed area up to 1 cm in diameter, characterised by change in the color of the skin i.e
- hyperpigmented (melanotic)
- erythematous
- haemorrhagic
A
macule
12
Q
circumscribed area greater than 1 cm in diameter characterised by change in color of the skin
A
patch
13
Q
small elevation of the skin up to 1 cm in diameter
A
papule
14
Q
what are the color characteristics of papule
A
- normal color, erythematous,hyperpigmented
15
Q
what is a plague
A
coalescing papules
16
Q
small elevation of the epidermis which is filled with pus
A
pustules
- it is fragile
- follicular/non follicular
17
Q
small elevation of the skin which is filled with clear fluid
A
vesicle
- it is fragile and transient
*
18
Q
a vesicle with a diameter greater than 1 cm
A
bullae
19
Q
sharply circumscribed,raised lesions consisting of dermal edema usually erythematous
A
- wheal
- variable shape and size
- transient (appears and disappears in minutes or hrs)
20
Q
solid elevation greater than 1 cm in diameter with a variable depth and attachment to the underlying tissue
A
- nodule/tumer
- it can be inflammatory or neoplastic
21
Q
encircling rim of epidermal scalle with the free edges towards the central area.
A
- epidermal collarette
- represents the margins of an earlier pastule or visicle
22
Q
breaks in the continuity of the skin with exposure of the dermis
A
- erosions/ulcers
- variable depth,shape,bleeding
- erosion=more supeficial defect without damage of the basal membrane
- excoriation= self produced erosion
23
Q
thickening of the skin characterised by exagerated skin markings(wrinkles)
A
- lichinification
- usually due to chronic trauma(pruritis)
- more frequent in the ventral skin
- often accompanied by hyperpigmentation
24
Q
areas of fibrious tissue that has replaced the damaged dermis or subq tissue
A
- scar
- most scars in cats and dogs are alopecic,atrophic, and depigmented
25
loose fragment of stratum cornum visible to the naked eye
* scale
* variable size,color,consistency
26
accumulation of keratin and sebaceous material that adheres to the hair shaft extending above the follicular ostia
follicular cast
27
accumulation of dried exudate,blood, cells,hairs, adhered to the skin
crust
* the underlying skin is excoriated/eroded/ulcerated
* variable color
28
dilated hair follicles which appears full of keratinaceous material
* comedo
* clinically appears as black points
29
cs of induced alopecia
* appears in the areas of pruritus only.
* commonly broad and symmetric
* associated with arythema and other lesions such as lechinification
30
what are the cs of folliculitis alopecia
focal multifocal alopecia
31
what are the cs of allopecia due to disturbance of hair growth
* symmetrical non pruritic alopecia
* frequently on the trunk
* slowly progressive
32
what are the cs of post scarring alopecia
localised,limited to areas of previous damage. pigment loss is permanent
33
discuss the pathogenesis of alopecia
Auto-induced:--Consequence of pruritus
Sequela of folliculitis:--Infectious/non-infectious
Disturbances of the hair growth:--Hair cycle abnormalities (telogenization)
Follicular dysplasia-Post-scarring
34
what are the ddx of focal-multifocal alopecia
* demodicosis
* dermatophytosis
* bacterial folliculitis
35
discuss demodecosis
* transmission to puppies
* effect of bite
* Mites are transmitted to nursing puppies by direct contact with bitch during the first 2-3 days of neonatal life
* Innate immune system controls Demodex populations in the skin
* Disease state: increased number of mites inside the hair
* follicles folliculitis alopecia +/- bacterial infection =
_demodicosis_
36
name the 2 demodex identified in dogs
* D. canis - commensal in hair follicles of all dogs
* D. injai - found in sebaceous glands,
mostly terriers
37
name the parasite
D canis
38
name the parasite
D.injai
39
different presentation of demodecosis
* localised
* generalised
* juvenile onset
* adult onset
40
discuss localised democosis
* transient and focal overpopulation of demodex mites
* puppies 3-6 mnths of age
* immature immune system
* 1 to 4 areas of alopecia with variable erythema,scaling and hyperpigmentation
* lesions no greater than 2.5 cm
* no pruritus,no systemic signs
41
discuss generalised demodecosis
* generalised overgrowth of demodex
* +/-severe skin lesions
* +/-systemic illness
fever,lethargy,inappetance
peripheral lympadenopathy
42
discuss juvenile onset of generalised demodecosis
* likely a genetic defect leading to a dysfunctional control of demodex populations
* affects dogs of 2 mnths to 2 yrs
* there is breed predisposition
43
discuss adult onset of generalised demodecosis
* dogs that are older than 2 yrs old
* no sex or breed predisposition
* immunocompromised
44
cs of demodecosis
* multiple or regional alopecia(moth eaten appearance)
* variable erythema
* papules,crusts and comedones
* pastules,collarretes, draining tracts=2ndary bacterial infection
* **non pruritic-**mild to moderate when secondary infection is present
* systemic signs (anorexea, fever) usually seen in advanced cases with secondary infection
* lesions seen anywhere there are hair follicles
45
clinical presentation of pododemodecosis
* erythema,swelling,draining tracts on haired skin
* front paws or all four limbs affected
46
clinical presentation of otitis externa due to demodex
* bilateral erythematous, ceruminatous otitis externa
* mites found in ear cytology
47
diagnosis of demodex
* skin scraping
* trichinosis
* cytology--bacterial infection
* deep skin scraping
* occassionally:biopsy and histological examinations
48
discuss D.injai
* long episthosoma
* live in the sebaceous glands
* **seen in terrier breeds**
* greasy seborrhea of dorsal stripe of trunk
* mild to severe pruritis
* diagnose thru deep scraping(sometimes difficult) or biopsy
* histopath reveals a marked hyperplasia of the sebaceous glands
* treatment is the same as for D.canis demodicosis
49
discuss treatment of localised demacosis
* Benign neglect
* Bathing with benzoyl peroxide 2.5% shampoo 1-2x/week
Demodicosis: treatment
Topical antibiotics
50
discuss treatment of genralised demodecosis
* Amitraz deeps (0.03-0.05%) weekly
* Macrocyclic lactones PO
- ivermectin and moxidectin: 0.4-0.6 mg/kg PO daily
- milbemycin: 2 mg/kg PO daily
* Macrocyclic lactones topical
- moxidectin (Advantage Multi®): q weekly
**Don’t forget to treat the secondary pyoderma!**
51
common sources of dermatophytosis
* Microsporum canis (zoophilic)
* M. gypseum (geophilic)
* Trichophyton mentagrophytes (zoophilic)
52
clinical presentation of squamous form of dermatophytosis
alopecia,
erythema,
scales,
hyperpigmentation
53
clinical presentation of kerion form of dermatophytosis
alopecic,
erythematous and exudative,
papule or plaque
54
clinical presentation of pruritus form of dermatophytosis
variable, usually low
55
diagnosis of dermatophytosis
* woodlamb examination
* microscopic examination of hairs
* fungual culture
* biopsy
56
topical theraphy of dermatocosis
* enilconazol 0.2%,clotrimazole
* lime sulfur
* clohexidine
57
systemic therapy of dermatophytosis
* itraconazole
* fluconazole
* ketokenazole
* terbinafine
58
where is D.injai found and in which breed is predispose
* Live in the sebaceous glands
* Seen in terrier breeds
59
histopath of sebaceous lnn reveals marked hyperplasia,which mites do u suspect
D.injai
60
treatment for _localised_ demodex
* Benign =neglect
* Bathing with benzoyl peroxide 2.5% shampoo 1-2x/week
* Topical antibiotics
61
treatment for Canine generalized demodicosis:
* Amitraz deeps (0.03-0.05%) weekly
* Macrocyclic lactones PO
- **ivermectin and moxidectin:** 0.4-0.6 mg/kg PO daily
- milbemycin: 2 mg/kg PO daily
* Macrocyclic lactones topical
- moxidectin (Advantage Multi®): q weekly
* Don’t forget to treat the secondary pyoderma!
62
discuss the dosing of ivermectin
Ivermectin - start with 0.1 mg/kg/day and increase slowly in
0.1mg/kg increments daily until you reach 0.6mg/kg/day
63
in which breed should ivermectin be avoided
* Do not use in collies and collie crosses!
“White feet, don’t treat
64
what are the side effects of ivermectin
* neurologic toxicity
Miosis (u walk the dog in sunglight and the pupil is dilated instead of constricting), lethargy, ataxia, seizure, coma
* Genetic testing for ABCB1-Δ1 (MDR-1) @ WSU esp. if its a mixed breed and u are nt sure if it has collie genes
65
when should you stop treatment for demodex
* \*\*Maintain therapy until two consecutive negative deep skin scrapings achieved
* Negative skin scraping = zero mites, not dead mites
* Avoid use of glucocorticoids
* Correct possible underlying immunosuppressive factors (malnutrition, parasites, endocrinopathy, etc.)
66
whats the prognosis for demodex treatment
The cure rate in cases of good compliance is \>90%.
67
what should be a plan in case the demodex is not cured after 4 months
* Occasionally some patients need lifelong treatment
Pulse therapy with ivermectin
Advantage Multi q 2 weeks or monthly
* If after 4 months of treatment lesions and/or parasites still persist, consider:
- Check ivermectin dose is at 0.4 - 0.6 mg/kg/day
- Change to different class of drug
- Investigate hidden predisposing causes
68
which dematophyte is zoonotic
m.icrosporum canis
69
discuss the transmiossion of dermatophyte
* Transmission by direct-indirect contact (contaminated environment)
70
discuss the effect of dermatophyte in dogs
* Uncommon cause of canine focal-multifocal alopecia
* Dogs of any age and breed can be affected,
* however, more common in:
* Young animals : \< 1 year old, - Yorkshire terriers (and may be other terriers)
71
discuss the clinical picturre of dermatophyte
* One or multiple alopecic areas on the trunk,head or limbs
72
discuss the clinical presentation of squamous dermatophyte
* alopecia,
* erythema,
* scales,
* hyperpigmentation
73
discuss the clinical presentation of kerion dermatophytosis
* alopecic,
* erythematous and exudative,
* papule or plaque
74
dermatophytosis dx
* woodlamp
* microscopic examination of the hair
* fungal culture
* biopsy
75
list the drugs used to treat topical dermatocosis
* enilconazole 0.2%, clotrimazole
* lime sulfur 2% to 4%
* chlorhexidine 3-4%
76
discuss drugs used systemically to treat dermatocosis
* itraconazole (5-10 mg/kg/ 24h; PO with food)
* fluconazole (10 mg/kg/ 24h; PO with food)
* ketoconazole (10 mg/kg/ 24h, PO with food)
* terbinafine (30-40 mg/kg/ 24h; PO)
77
discuss environmental treatment for dermatophytes
bleach diluted 1:10 in water
78
how long should treatment for dermatophyte be continued
Treatment has to be continued until 3 to 4 weeks beyond 2
consecutive negative follow-up fungal culture results
performed q 2-4 weeks
79
which bacteria causes more folliculitis
* S. pseudintermedius is the etiologic agent in \> 90% of cases;
* the rest: S. aureus, S. schleiferi
* Opportunistic pathogen
Present in most dogs (perineum, perioral skin,
nose)
Usually a primary cause triggers the overgrowth of
S. pseudintermedius
80
list the primary causes of bacterial folliculitis
* atopic dermatitis
* humidity,sarborrhea
* corticotheraphy
* hypotherodism
81
what are the cs of bactrial folliculitis
* Multifocal areas of alopecia, follicular papules / pustules, crusts, scales, collarettes and hyperpigmentedmacules
* Short-coated dogs present often a moth-eaten patchy alopecia
* Long-coated dogs, typical signs include dull haircoat, scales and excessive shedding
* All haired skin can be affected, but glabrous regions more commonly affected
* Pruritus variable, from mild to moderate or severe
82
diagnosis for bacterial folliculitis
* History, clinical signs
* Cytological examination
(papules, pustules, epidermal collarettes)
* Response to antibiotic therapy
Biopsy / bacterial culture –
not first line tests
83
discuss topical treatment of bacterial folliculitis
* Chlorhexidine 2-4%
* Benzoyl peroxide 2.5%
84
discuss antibiotic therapy for bacterial folliculitis
* Cephalexin (25-30mg/Kg/ 12h; PO)
* Amoxicillin-clavulanate (25mg/kg/ 12h; PO)
* Clindamycin (11mg/kg/12h; PO)
85
discuss the length of treatment for deep and superficial bacterial folliculitis
* \*\*Superficial pyoderma – 4-6 weeks
* \*\*Deep pyoderma – 8-12 weeks
86
what type of alopecia is seen in short coated dogs due to bacterial folliculitis
Short-coated dogs present often a moth-eaten
patchy alopecia
87
what type of alopecia is seen in long coated dogs due to bacterial folliculitis
Long-coated dogs, typical signs include dull haircoat, scales and excessive shedding
88
list 2 topical medication for bacterial folliculitis
* chlohexidine
* benzol peroxide
89
list the antibacterials used to treat bacterial folliculitis
* cephalexine
* amoxiciline
* clindamycin
90
how long does it take to treat superficial pyodema
4-6 weeks
91
how long does it take to treat deep pyodema
8-12 weeks
92
which ares are normally affected by demodecosis
head,trunk and legs
93
which areas are normally affected by dematophytosis
head and legs
94
which areas are normally affected by bacterial folliculitis
* Trunk,
* abdomen,
* glabrous skin,
* head is typically spared
95
Lesions/Clinical manifestations of acute pruritus
* erythema
* partial alopecia
* scaling
* escoriation
* pyotraumatic dermatitis
* crusting
96
Lesions/Clinical manifestations of chronic pruritus
* same as with acute( list them)
* hyperpigmentation,
* lichenification (dog),
* acral lick dermatitis
97
discuss pruritus due to malassazia
* M. pachydermatis is a commensal of the skin
* Overgrowth = marked pruritus (hypersensitivity)
* Usually secondary to allergic dermatitis
* Primary Malassezia dermatitis due to abnormalities in
the cutaneous ecosystem
* Normal to find large numbers in Bassett hounds
98
clinical signs of mallassazia dermatitis
* Alopecia, erythema, scaling, hyperpigmentation,
lichenification
Greasy to the touch
Malodourous (esp. ears)
99
discuss distribution of Malassezia dermatitis
* Skin
* , claw folds
* , mucocutaneous junctions,
ear canals
100
mallassazia diagnosed
skin cytology
101
list the topical medication for malassazia
* chlohexidine
* enilconazol
* miconazole
102
list the systemic treatment of malassazia
* ketaconazole
* itraconazole
* fluconazole
* \terbinafine
103
list the drugs that can be used to prevent malassazia infection
* chlohexedine
* enilconazole
*
104
discuss transmission of sarcoptic mange
* direct transmission from infected host or environment
105
severity of sarcoptic mange depends on
* hypersensitivity 1
* n.b.zoonotic:the owner may complain about rash
106
cs of sarcoptic mange
* \*\*Severe pruritus (9-10/10)
* Usually non-/poorly responsive to glucocorticoids
* Signs may worsen with glucocorticoids
* Erythema, papules, alopecia, excoriations, scaling,
* crusts, lichenification (chronicity) and self-induced alopecia
107
distribution of sarcoptic mange
* ear margins
* legs
* elbows
* hocks
* ventrum
* In chronic cases: lesions are generalized +/-
lethargy, lymphadenopathy, weight loss
108
discuss diagnosis of sarcoptic mange
* History
* Clinical signs (PRURITUS)
* Pinnal-pedal reflex (~80%)
* Broad, superficial to deep skin scrapings
\*Mites are found only 25-50% of the time
* Therapeutic trial (selamectin, ivermectin
109
which topical is used to treat topical sarcoptic mange
amitraz
110
discuss systemic treatment of sarcoptic mange
* ivermectin
* moxidictine
*
111
which ectoparasites is ivermectine used for
* sarcoptic mange
* demodicosis
112
ddx of ectoparasites which causes prutitis in dogs
* sarcoptic mange
* cheylectiellosis
* fleas
113
ddx for allergic dermatitis
* Flea allergy dermatitis
* Atopic dermatitis
* Food intolerance/allergy
114
which hypersensitivity reactions are due to flea bite
hypersensitivity type 1 and 4
115
discuss the distrbution of pruritis in dogs as a result of flea allergy dermatitis (FAD)
* Severe pruritus predominantly in the lumbosacral area and caudal half of the body (“pants”)
116
what is the primary lesion due to flea allergy dermatitis
papules
117
secondary lesions due to Flea allergy ermatitis(FAD)
* alopecia,
* erythema
* , scaling
* , crusts,
* lichenification,
* pyotraumatic dermatitis
118
discuss dx of flea allergic dermatits (FAD)
In most cases the diagnosis is based on history and clinical signs
Confirmation can be obtained:
Evidence of fleas or flea faeces (flea dirt)
Good response to flea control program (8 weeks)
Flea allergy test (serology/intradermal
119
discuss ways of treating fleas
* flea control
* Anti-pruritic drugs (ex. Prednisone; short term)
120
ch topical drugs are used to treat fleas
* Imidacloprid,
* fipronil,
* indoxicarb,
* dinotefuranq 3 weeks
121
systemic drugs used to treat fleas
* Spinosadq 3 weeks to monthly
* Nitenpyramas needed
122
Food allergy vs. intolerance
* **food intolerance**
* No involvement of the immune system
* Reactions are dose dependant
* Gradual onset of clinical signs; never life-threatening
**Food allergy**
* Type I, III, and IV hypersensitivity reactions
* Any amount of offending food will cause reaction
* Can be life threatening
123
clinical signs and distribution of of Cutaneous adverse food reactions (CAFR)
* _Non-seasonal pruritus_
* Only partially responsive to steroids
* Erythema, signs of self-trauma
* 2ndary infections
* Face, neck, abdomen, perianal and perioral regions, paws
* Otitis externa
* Concurrent GI signs in 20% cases
124
offending allerges in Cutaneous adverse food reactions (CAFR
* In humans -glycoproteins MW \> 12 kD
* **In dogs –typically meat proteins**
* Beef, chicken, soy, dairy, corn, wheat
* Cross-reactive proteins:
* Duck, turkey, venison, buffalo
125
define Canine atopic dermatitis (CAD)
Inflammatory and pruritic skin disease associated with a genetic predisposition to produce IgEagainst environmental allergens
126
most common allergens for Canineatopic dermatitis (CAD)
* House dust mites, storage mites
* Pollens, molds, feline and human dander, insects
127
discuss the pathogenesis Canineatopic dermatitis (CAD)
* Type I hypersensitivity reaction (IgE)
* Epidermal barrier abnormalities
* Increased adherence of bacteria / yeast = infection
128
discuss age of onset of CAD
6 mnths to 3 yrs
129
cuss seasonality of CAD
* Variable
* Many dogs start with season signs that progress to non-seasonal after 2-3 years
* \*\*MAIN CLINICAL SIGN IS PRURITUS
130
what are the cs of CAD
none or erythema
131
secondary cs of CAD
red-brown salivary staining, excoriations, self-induced alopecia, papules, collarettes, crusts (2o pyoderma), lichenification(2o Malasseziadermatitis)
132
discuss the distribution of CAD
face, ears, extremities, paws and abdomen
133
CAD Diagnosis
* history, clinical signs and ruling out other pruritic diseases
Sarcopticmange(scabies)
Fleasandfleaallergy
Bacterial folliculitis
Malasseziadermatitis
Cutaneousadversefoodreaction
* Atopicdermatitis is a diagnosis madebyexclusion
134
Atopicdermatitis: Treatmentof acuteflare-ups
* Control secondary infection: topical treatment (chlorhexidine) or systemic antibiotics
* Increase hygiene: frequent baths
* Use topical or systemic steroids (prednisone, 0.5-1 mg/kg/24 h)
135
Atopicdermatitis: Long-termtreatment
* Allergen-specific immunotherapy
Custom-formulated based on intradermal and/or serum allergy test results
* Cyclosporine A
* Oclacitinib
Improve skin barrier functionw topical tx
Atopicdermatitis: Long-termtreatment
136
discuss disadvantages of allegy testng
* Identification of the main allergens causing clinicalsigns
* \*\*Cannot use allergy testing to makea diagnosis of atopicdermatitis
*
* Clinicallynormal dogs can have false positivere sultson IDAT and SAT
* Only test if owners want to pursue allergen specifici mmunotherapy Allergy testing
137
advantages of Allergen specific immunotherapy (ASIT)
* Can induce a change in the immune response and “cure” the disease
* Veryfew side effects (itch in some patients)
* Can combined with other therapies
138
disadvantages of Allergen specific immunotherapy (ASIT)
* Lowefficacy (especially in very severe cases of CAD)
* Requires allergy testing with clear results
* Long time before improvementin clinical signs is noted(resultsshould not be evaluated prior to 9 months)
* No predictabilityof results
* Lackof standardized, validated protocols
* Needs high compliance and time dedication of the owners
139
drug is use to treat CAD
Inhibits synthesis of several interleukins (IL-2) and cytokines (considered immunomodulatingagent at low doses)
5 mg/Kg PO QD; 1 month, then reduce the dose
(5mg/kg/48h, then 5 mg/kg/72 h)
High effectiveness in the control of CAD 85% cases.
Slow acting (14-28 days)
Side effects common [but mild]: vomiting, diarrhea, anorexia; 10-15% of cases
140
what are the advantages of cyclosporine
* High effectiveness, almost as effective as steroids
* Can be used safely for long term treatment
* Very easy to use, previous allergy testing not needed
* Can be combined with other therapies
141
disadvantages of cyclosporin
* Side effects (15% dogs vomit)
Long term side effects not completely assessed
* Slight delay in response time
* Cost can be a limitation in some big dogs
142
discuss the pharmacokinetics of Oclacitinib [Apoquel]
Inhibits Janus Kinase 1 (JAK 1) and 3 (JAK 3) blocking the action of many pro-inflammatory/allergic cytokines (stops the signal transmission and gene transcription)
143
in which ways does the cat manifest pruritus
* Scratching
* Licking, chewing
* Overgrooming
* Rubbing
* Seizure-like activity
* Often secretive
* Many different clinical presentations for the same diseases
144
what are the clinical presentations of pruritic cats
* 1 Facial pruritus with facial lesions: excoriations, crusts
* 2. Miliary dermatitis: crusted papules over
dorsum
* 3. Symmetric truncal/flank/inguinal alopecia
* 4. Eosinophilic plaques, ulcers, granulomas
145
what are the ddx for pruritus in cats
* ectoparasites
* allergic dermatits
* infectious dz
146
list the ectoparasites that causes prutitus in cats
* notoedris cati
* demodex cati/gatoi
* fleas
* otodectes cynotis
147
which allergies causes pruritus in cats
* flea allergy dermatitis
* atopic dermatitis
* food intolerance/allergy
148
which infectious dz causes pruritus in cats
* dermatophytosis
* malassezia dermatitis (rare)
* superficial pyoderma
149
what are the cs of notoedric mange
* intense pruritus (9-10/10)
* typically affects head and pinnae--occassionally entire body and feet
* crusting,scalling, erythema, alopecia, 2dary self trauma, "suizures"
* in severe cases,peripheral lymphadenopathy, anorexia, emanciation,death
150
discuss the pathogenesis for notoedric mange
* Transmission through direct contact with infected cat (obligate parasite)
* ı Female mite burrows into skin, then lays eggs
* ı Complex hypersensitivity reaction
* ı Rarely zoonotic
* ı Can transiently infest dogs
151
diagnosis for notoedric mange
* superficial skin scraping
* response to treatment i.e if history is suspecious, do emperical acaricidal therapy
152
treatment for demodicosis in cats
* **selamectin--q 2 weeks ,3 times**
* ivermectin
* 2% lime sulfur
* amitraz
* treat all in contact animals
153
discuss D,gatoi
* contagious
* normal habitat unknown
* found in stratum corneum
* in the US most frequently encounted in the south
* rare to common (depends on geometry
154
discusss D.cati
* normal comensal of the skin
* usually only seen in very sick cats--metabolic dz,immunosuppressive dz
* non pruritic condition
* patchy,regional multifocal alopecia
* can be localised or generalised very rare
155
what are the cs of feline demodicosis
* variable pruritus;non -moderate
* alopecia- focal,patchy,generalised,symetrical
* +/-erythema,crusts,scales
* +/-secondary pyoderma
* +/-ceruminous otitis externa
*
156
dx for feline dermodecosis
* superficial skin scraping -non affected cats
* acetate tape
* fecal floats
* emperical treatment and response to lime sulfur dips
157
treatment for feline dermodicosis
* lime sulfur dips- 1-2 times per week
* amitraz dips-anorexia,lethargy,diarrhoea
* D. cati
can resolve spontaneously if
underlying disease is addressed
158
walking dundraft
* Cheyletiellosis
* C. blakei, C. yasguri, C. parasitovorax
159
discuss the characteritics for Cheyletiellosis
* where it lives
* feeding habits
* transmission
* Live on hair, feed on skin
–
* Very superficial!
•
* Highly contagious
–
* Often more than one pet affected
•
* Uncommon, but can be common in areas
where flea preventatives not used
160
discuss the pathogenesis of Cheyletiellosis
* Transmission via direct contact with infested animals, through fomites
•
* Hypersensitivity reaction likely
•
* Occasionally zoonotic
161
cs of Cheyletiellosis
Scaling/crusting\*
•
Miliary dermatitis
•
Walking dandruff
•
Primarily a disease that causes dorsal lesions\*
•
Pruritus is absent to severe
162
treatment for Cheyletiellosis
Acaricidal therapy
**Selamectin q 2 weeks, 3 times**
•
* Ivermectin
* 2% lime sulfur
* •
Amitraz
•
Milbemycin oxime
•
**Treat all in-contact mammals!**
163
Superficial fungal infection of hair shafts
and stratum corneum
* Dermatophytosis
•
* Microsporum canis
(zoophilic)
•
* Microsporum canis
* Microsporum gypseum (geophilic )
•
* Trichophyton mentagrophytes
(zoophilic)
•
Transmission by direct-indirect contact
164
which dermatophytosis is common in cats
* M. canis
\* in 98% of cases
•
* Zoonotic
•
* Common in Long haired cats, shelters, multi haired cats, shelters, multi
-
cat homes cat homes
•
* Asymptomatic carriers
–
Long-haired cats, Persians
•
* Young, immunocompromised more
susceptible
165
what are the cs of dermatophytosis
* Highly variable
* Circular areas of alopecia with erythematous border
* Transient follicular pustules
* Miliary dermatitis
* Scale/crusts absent to severe
* Rarely, dermal nodules
(pseudomycetoma)
•
* Pruritus variable
166
Dx forDermatophytosis (cats)
* Wood’s lamp examination
–
Only 50% of M.canis will fluoresce
* Trichogram
* Fungal culture and ID
* Biopsy + special stains (PAS)
167
discuss treatment of dermatophytosis in cats
Treatment of individuals:
•
Identify all affected animals/carriers
•
Everyone receives treatment
•
Quarantine
•
Clipping hair (controversial)
•
Treat until 2 consecutive negative fungal
cultures
168
discuss topical treatment of dematophytosis in cats
Lime sulfur dips
169
disadvantages of treating dermatophytosis in cats with sulfur dips
* Will stain white cats
–
* Smells awful
–
* Remove silver jewelry
170
discuss systemic therapy of dermatophytosis
* Itraconazole/fluconazole 7-10mg/kg PO q 24h
–
* Cats do not tolerate ketoconazole
–
* Terbinafine ~40mg/kg PO q 24h
171
treatment of environment for dermatophytosis
* Dilute bleach 1:10 for all hard surfaces
* Change air filters
* Throw away anything that may harbour spores
•
* Steam clean carpets, drapes, wash bedding
* Enilconazole
172
cs of food allergy dermatitis in cats
Pruritus
1. Self-induced alopecia
Typically neck, back, lumbar skin
2. Papules, miliary dermatitis
3. Eosinophilic skin disease
173
what iis the most common allergen in cats
fish
174
cs of Food allergy/intolerance
## Footnote
(cutaneous cutaneous adverse food reaction)
* Pruritus
\***\*Face/neck in 40-50% of cases**
* Self-induced alopecia
Focal, generalized, bilaterally symmetrical,
regional
* Papules, miliary dermatitis
* Eosinophilic skin disease
175
other cs of Cutaneous adverse food reaction
* Vomiting, diarrhea concurrent in 10% of
* If GI signs and pruritus = food allergy
* Lymphocytic-plasmacytic colitis
176
what causes feline topical dermatitis
* Type I hypersensitivity reaction
* similiar to dogs
* Signalment is not well characterized
* Barrier dysfunction not characterized in cats
177
what are the cs of Feline atopic dermatitis (syndrome)
* Pruritus
* Self-induced alopecia
Focal (facial), generalized, bilaterally
symmetrical, regional
* Papules, miliary dermatitis
* Eosinophilic skin disease
* Sneezing, respiratory signs
178
Diagnostic approach to the pruritic cat
* Rule out ectoparasites
* . Implement strict flea preventative program
–Selamectin, spinetoram
* If skin lesions present,--cyt/bx
* . Treat secondary infections if present
* . Begin elimination diet trial 8-12 weeks
* . Diagnosis of atopic dermatitis
179
Treatment for feline atopic dermatitis
* Chlorpheniramine 2/kg/12 hours
–
* PreniSOlone 1 – 1.5mg/kg/day
* Methylprednisolone 0.8mg/kg/day
–
* Cyclosporine A 7mg/kg/day
* Allergy testing + allergen-specific
immunotherapy
180
discuss Feline allergy testing
* Some dermatologists do NOT recommend doing IDAT (intradermal allergy testing) because cats do not make “nice” wheal-flare reactions
* Serum allergy testing
* * Allergy testing is only recommended if owners want to follow through with hyposensitization with allergen-specific immunotherapy (ASIT)
* *
181
what are the most common allergens ASAIT( cats(
* House dust mites,
* house dust,
* weeds,
grass
, tree pollens
182
feline allergy dermatitis treatment
* Antihistamines:
Pretty safe
* Glucocorticoids:
PU/PD/PP not as common in cat --\>Skin fragility, Curling of pinnae
* Cyclosporine A
GI upset, weight loss, possible renal toxicity
183
184
what predispose the cats toEosinophilic granuloma complex (EGC) / Eosinophilic skin disease
* Genetic predisposition to aeosinophilic response
* persensitivity reaction (fleas, food, environmental allergens...)
185
list the 3 main clinical presentation of Eosinophilic granuloma complex (EGC) / Eosinophilic skin disease
* Eosinophilic plaque
:
* Eosinophilic granuloma
* Indolent ulcer
186
describe eosinophilic plaque in Eosinophilic granuloma complex (EGC) /Eosinophilic skin disease
* erythematous pruritic coalescing papules and plaques (groin, abdomen)
*
187
describe eosinophilic granuloma in Eosinophilic granuloma complex (EGC) /Eosinophilic skin disease
: nodules, nodules, plaques with
variable pruritus (rear thighs, footpad, lower
lip, oral cavity)
188
describe indolesent ulcer in Eosinophilic granuloma complex (EGC) /Eosinophilic skin disease
non-pruritic, non-painful
unilateral or bilateral non-bleeding ulcers
(upper lip
189
what are the clinical presentation of cutaneous and mucocutaneous erossive-ulcerative disease
Erythema,
depigmentation,
erosions,
ulcerations
and crusts
* Occasionally, vesicles / pustules are seen
•
Pruritus is minimal, not the main complaint
190
what are the specific areas affected by cutaneous and muco-cutaneous erosive-ulcerative disease
* nose(planum nasale)
* fooodpads
* mucosal membranes( oral,urogenital)
191
Clinical diagnostic criteria for cutaneous n mucocutaneous erosive -ulcerative disease
* Uncommon diseases
* Adult dogs
* Chronic/progressive diseases
* Non-pruritic
* Non-antibiotic or corticosteroid responsive
* Symmetrical lesions (erosions, ulcers, pustules,crusts)
* Presence of lesions in non-haired skin and MM
* Possible concurrent systemic signs
192
list the cutaneous and mucocutaneous erosive-ulcerative diseases which are autoimmune
* Discoid lupus erythematous (DLE),
* Pemphigus foliaceus,
Uveo-dermatologic syndrome (VKH)
193
list the cutaneous and mucocutaneous erosive-ulcerative diseases which are immune mediated
* Erythema multiforme (EM) / Toxic epidermal necrolysis (TEN),
* Adverse drug reactions
194
list the cutaneous and mucocutaneous erosive-ulcerative diseases which are metabolic
Superficial necrolytic dermatitis
| (NME / hepatocutaneous syndrome)
195
list the cutaneous and mucocutaneous erosive-ulcerative diseases which is neoplasia
Epitheliotrophic T-cell lymphoma
196
Autoimmune skin disease characterized by formation
of subcorneal pustules due to
acantholysis
Pemphigus folicaeus
197
discuss pampificus folicaeus
* breaking of intercellular bridges-desmosomes resulting in intrathelial blister formation
* Vesicles contain acantholytic cells and variable numbers of polymorphonuclear (PMN) cells
198
what causes Pemphigus folicaeus
IgG autoantibodies against desmosomal
proteins (autoimmune mechanism)
* Humans--target is desmoglein I
* Dogs--desmocollin I
199
list the Three main clinical presentations (lesions): of pampifigus foliaceous
1. Papules, _pustules_,collarettes, crusts (yellowish);generalized
2. 2Depigmentation, erosions, ulcers, crusts on planum nasale, dorsal muzzle, pinnae, periocular skin
3. Footpad hyperkeratosis
Single patient can present with 1, 2 or 3
200
201
202
203
204
205
206
207
208
209
210
