Derm 3: Immune-mediated, cutaneous crusting/misc skin disorders, nodular dermatoses (E2) Flashcards Preview

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Flashcards in Derm 3: Immune-mediated, cutaneous crusting/misc skin disorders, nodular dermatoses (E2) Deck (54)
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1

How are immune-mediated skin disorders diagnosed?

Histopathology of multiple biopsies 

+/- IHC

2

Label these layers 

A: Stratum corneum

B: Stratum lucidum

C: Stratum granulosum

D: Stratum spinosum

E: Stratum basale

F: Dermis

Cats Love Going Sun Bathing (Daily)

3

What are the 2 first-choice immunosuppresive drugs to treat immune-mediated skin disorders?

Glucocorticoids

Cyclosporine A 

4

_______ ______ is a vesiculobullous to pustular group of disorders of the skin or mucus membranes characterised by the loss of cohesion between keratinocytes, known as _______. 

Pemphigus complex

Acantholysis

5

What is the benign form of pemphigus? Which breeds are predisposed? What are the classical clinical signs and where do they occur?

Pemphigus erythematosus 

Collies and GSD

Erythema, pusular dermatitis of face and ears 

Transient lesions (oozing crusts, scales, alopecia, eorsions, epidermal collarettes)

Depigmentation of nose

6

What are the differential diagnoses for pemphigus erythematosus?

Bacterial folliculitis

Dermatophytosis

Demodicosis

Facial pemphigus foliaceus

DLE

SLE

Dermatomycositis

Leishmania

Zinc responsive dermatitis

Drug rxn

7

T?F: Sun avoidance and systemic glucocorticoids or cyclosporin are the accepted treatments for pemphigus erythematosus.

False, sun avoidance and TOPICAL glucocorticoids or cyclosporine 

8

The most common immune-mediated condition is ______ ________. The major antigen is the adhesion molecule ________. 

Pemphigus foliaceus

Desmoglein 1 

9

Where are lesions typically found in a dog with pemphigus foliaceus? Cats?

Dogs: Starts at face and ears, commonly involves feet, clawbeds, footpads and groin

Cats: Nail beds, nipples 

Also nasal depigmentation

10

Where does cellular infiltration in pemphigus foliaceus occur? Which skin layers loss adhesion in pemphigus vulgaris and bullous pemphigoid?

Foliaceus: Between stratum corneum and granulosum 

Vulgaris: Stratum spinosum and basale

Bullous pemphigoid: Epidermis and dermis 

11

Where is the most common lesion location for an animal with pemphigus vulgaris? Where are cutaneous lesions common? What is the claw bed lesion?

Which other condition causes lesions in these areas?

Oral cavity (75-90% have lesions in mouth)

Axillae and groin

Ulcerative parochyia (clawbeds)

 

Bullous pemphigoid

12

What drugs are used to treat pemphigus vulgaris?

High dose prednisolone an azathioprine PO

Cats: Chlorambucil 

13

What condition involves autoantibodies against antigens of the basal cell hemidesmosomes of the skin and mucosa? What drugs predispose to this condition?

Bullous pemphigoid

Sulphonamides, Penicillins, Furosemide 

14

Which cells predominate in lupus erythematosus? Which specifically in DLE and SLE?

T-cells

DLE: T-Helper

SLE: T-Suppressor 

15

Damage to which cells activate T cells in DLE and what do the damaged cells have high levels of? What type of antibody is often formed?

Keratinocytes 

ANA (Anti-nuclear antibody)

IgM

16

Pemphigus vulgaris can involve antibodies reacting against a certain molecule, what is this molecule and in what species is it found?

Desmoglein 3

("V"  (vulgaris) rhymes with "Three")

Dogs

17

What are some breeds predisposed to DLE? What are the lesions?

Collies, GSDs

Shetland sheepdogs, Siberian huskies, Brittany spaniels, German shorthaired pointers

Lesions: Depigmentation, erythema, scaling of nose, progress to erosions, ulceration and crusting

18

What part of the skin is thickened in DLE due to cellular infiltration?

Basement membrane 

19

What clinical signs occur in dogs with SLE? Is there a sex prediliction in dogs or cats?

Fever

Polyarthritis

Proteinuria

Alopecia, erythema, vesciculobullous to ulcerative lesions

 

Dogs- males over-represented

Cats- no sex prediliction 

20

Your canine patient with SLE has developed glomerulonephritis. What do you expect and what is the prognosis?

Progressive renal failue 

Poor prognosis 

21

What is the drug that most commonly causes cutaneous adverse drug reactions? What does it mean if this reaction is idiosyncratic? 

Penicillin

Idiosyncratic: unpredictable, dose-independent, related to host immune system (opposite of predictable reaction which is drug- and dose-dependent)

22

Your patient acutely develops erythematous macules which have spread peripherally and cleared centrally. There are also urticarial plaques. Lesions are primarily on the ventrum, axillae, and groin. What type of degeneration is occuring and what is this condition called? How is it treated?

Hydropic degeneration (all levels of epidermis)

Erythema multiforme

Tx: Eliminate trigger, wait for it to spontaneously regress. 

23

What will a skin biospy from an animal with toxic epidermal necrolysis reveal?

Full-thickness epidermal nercolysis 

Minimal inflammation

24

What do the lesions that characterize vasculitis look like and where do they occur?

Purpura, wheals, edema, papules, plaques, nodules, alopecia, scarring, necrosis and ulceration (punched out ulcers)

Extremities- paws, pinnae, lips, tail, scrotum, oral mucosa

25

Other than determining the underlying disease, what drugs are used to treat vasculitis?

Pentoxifylline (increases erythrocyte flexibility and reduces inflammation.)

Immunosuppressive and immunimodulatory drugs 

26

What 3 conditions commonly cause seborrhea, crusts or scales WITH pruritus? What if there is no pruritus?

Allergies (FAD, AD, FA)

Parasites (sarcoptes, cheyletiella)

Infections (pyoderma, malassezia) *+/- pruritus* 

No pruritus: demodicosis, dermatophytosis, endocrine diseases (hypothryoid, HAC, alopecia X) 

27

What is the difference between syndrome 1 and syndrome 2 of zinc-responsive dermatosis?

Syndrome 1 is decreased capacity to absorb zinc from GIT

Syndrome 2 is RARE and caused by dietary deficiency 

28

What breeds get breed-related zinc-responsive dermatosis? 

Siberian huskies

Alaskan Malamutes

Bull terriers

29

What clinical signs are associated with zinc-responsive dermatosis? Where do they occur and when do they start?

Pruiritus and scales/crusts 

Mouth, chin, eyes, ears, elbows, pressure points, scrotum, prepuce, vulva 

Hyperkeratotic foodpads

Signs begin around 1-3yrs of age

30

What are some speculated causes of sebaceous adenitis?

Inherited sebaceous gland destruction 

Cell-mediated immunological rxn

Defect in keratinization/obstruction of sebaceous ducts

Abnormal lipid metabolism