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Lent term 5th year (oral cavity elsewhere; also hip and elbow) > Dermatology > Flashcards

Dermatology Flashcards

1
Q

When do female fleas begin egg production after accessing a host and how many do they lay per day

A

Start laying within 24-36hrs
Lay 40-100 eggs per day

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2
Q

Why do we want flea control products with persistent activity

A

Because 5-15% of fleas won’t have emerged from pupae within 3 months; so need treatment to last longer than this with infestation

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3
Q

What parasite are fleas the intermediate host of

A

Dipylidium caninum tapeworm
(zoonotic; common cause of pruritic skin disease in cats)

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4
Q

How do neonicotinoid flea products work

A

Selective agonists of nAChR in insects causing excitation and peristent neuronal depolarisation and paralysis of fleas

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5
Q

What are two neonicitinoid flea products

A

Oral nitenpyram; very effective - kills fleas very quickly but only lasts a short time (excreted within 48hrs)

Imidacloprid (e.g in advantage); topic - more prolonged action of 1 month; takes 12 hours to be absorbed

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6
Q

What kind of products are the ‘laners’

A

Newer flea control agents
= Isooxazoline insecticides
Act to block GABA and L-glutamate gated Cl- channels

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7
Q

How are laners normally administered

A

Orally
(there is now a spot on of adoxolaner ‘nexgard’ available)

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8
Q

How can we argue against idea that laners aren’t good for FAD because flea must bite to get access to product

A

Overall still have a significantly lower cumulative salivery load compared to other flea controls and in these treatments the fleas are killed slowly and will repeatedly attempt to feed

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9
Q

What are some possible side effects of isooxazoline (laners)

A

Neurological adverse effects e.g seizures - because the neurotoxicity not strictly arthropod specific

Take care with using these in any patient with seizure history

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10
Q

How does indoxacarb (activyl) work

A

NOvel oxadiazine spot on insecticide tightly focussed on fleas with 100% efficacy in cats for 4 weeks

= metabolised within flea to more active form; = insect selective Na+ channel blocker

Just as effective as laners; good for those which are resistant

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11
Q

Dog flea products containing what chemical must not be used in cats

A

Permethrin

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12
Q

What is fox mange

A

Sarcoptic mange; from sarcoptes scabei

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13
Q

Signs of sarcoptic mange

A

Alopecia, extreme prurititis
Positive itch-scratch response

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14
Q

Why are sarcoptic mange itchy

A

Irritation directly from burrowing mite
+ hypersensitivity against mite waste

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15
Q

How to diagnose sarcoptic mange

A

Clip large patch, place liquid paraffin and scrape of surface layer - then check
- May need to go deeper if not seeing anything

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16
Q

What can adding potassium bromide before scraping for mites help with

A

Lysing keratin/blood first

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17
Q

Treatment for sarcopic mange

A

Selamectin or moxidectin
+ can use low dose prednisolone one diagnosed to reduce the irritation (but this doesn’t treat the mange itseld)

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18
Q

What is red mange

A

Demodectic mange

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19
Q

Why do we get demodectic mange on some animals

A

Overproliferation of mites (that are normally part of cutaneous flora) related to immune system suppression or defect

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20
Q

What is the classic signalment of demodex

A

young dog with lesion on face

Esp: boxer, bull terrier, bulldogs

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21
Q

Which breed has a different demodex species to others

A

Wire haired fox terriers

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22
Q

What are the two presentations of demodicosis

A

Localised: = 4 or less lesions <2.5cm diameter; tend to self resolve with extra nutrition etc

Generalised: NEED miticidal treatment or unlikely to recover

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23
Q

Where do we tend to see demodex lesions first

A

Face and front legs since puppies get this from mother

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24
Q

Signs of demodectic mange

A

Lesions (starting on face) of erythema, scaling, comedones, alopecia, papules/pustules, hyperpigmentation

Also often get dry seborrhoea of ear margin

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25
Q

Is demodectic mange pruritic

A

Not due to mites BUT get pruritis due to consequences of infection e.g hair follicle rupture and contents leaking into the dermis

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26
Q

How many mites is suspicious of demodex and what is diagnostic

A

1 = suspicious
2 = diagnostic

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27
Q

Diagnosis of demodectic mange

A

Deep skin scarpins; capillary bleeding
Hair blocks
Skin squeezings onto scotch tape
Biopsies

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28
Q

Treatment of generalised demodixosis

A

Best = sarolaner (simparica) or other laners MONTHLY

(could also try advocate imidacloprid andmoxidectin weekly)
+ do antibacterial chlorexidine shampoo

If significant infection can consider antibiotics

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29
Q

How often/long do we treat demodectic mange for

A

Reassess monthly and do samples
Want to treat for 1-2 months after clinical cure (using monthly oral laner)

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30
Q

Can we use steroids with demodectic mange

A

NO NEVER

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31
Q

What extra consideration should we have once a patient has been treated for demodectic mange

A

Advise to neuter and not use for breeding since there is genetic component

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32
Q

What is cat mange

A

Notroectic mange

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33
Q

Signs of notroectic mange

A

Intense pruritis
Mostly ears/head/neck affected
Get excortiation with crusty thickening

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34
Q

Diagnosis and treatment of notroectic mange

A

Tape strips/skin scrapes
Treat with selamectin spot on

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35
Q

What are the two lice that affect dogs and which is biting vs sucking

A

Lignognathus setosus = sucking
Trichodectes canis = biting

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36
Q

Reservoir host of microsporum canis

A

Cats

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37
Q

Reservoir host of trichophyon mentagrophytes

A

Rodents

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38
Q

Reservoir of microsporum gypseum

A

Soil

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39
Q

Reservoir of trichophyton erinaceid

A

Hedgehogs

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40
Q

What must we remember about ringworm

A

It is zoonotic; children often present with this due to thinner skin and more time spent with pets

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41
Q

Which mange is zoonotic

A

Sarcoptes

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42
Q

Signs of dermatophytosis

A

Well circumscribed alopecia, erythema patches
Crustic
Licenificaiton
Pruritis

43
Q

Diagnosis of dermatophytosis

A

Wood’s lamp shows fluorescence of microsporum canis WITHIN HAIR (do not confuse with skin scale fluorescence non speciifc)

Trichogram hair puck
Fungal culutre
Biopsy
PCR

44
Q

Which breeds do we typically see trichophyton ringworm in

A

Ratting breeds e.g Jack Russel

45
Q

Which ringworm species fluoresceses on wood’s lamp

A

Microsporum

46
Q

Treatment of ringworm

A

Start with topical enilconazole or chlorhexidine/miconazole

May need systemic itraconazole (7 days on/off)

Treat for minimum 3 weeks but may need longer

47
Q

Aside from specific fungal treatments what topical treatment can we use in cats with ringworm

A

Lime sulphur

48
Q

What is Dermatophyic granulomas and pseudomycetomas; which breeds

A

Where dermatophilic hyphae spread into dermis/subcutis and cause nodules to form

Esp in persian cats, yorkies

49
Q

What type of yeast is malassezia

A

Lipophilis

50
Q

When do we get overgrowth of malassezia

A

Where there is changes in host defence or local microclimate
e.g ear inflammation due to dermatitis can make it more humid and allow malassezia overgrowth

51
Q

Which is the malassezia species we tend to see

A

M pachdermatis

52
Q

Which breeds are most prone to malassezia

A

Basset hound, WHWT, American cockers, sphynx, devon rex

53
Q

What do malassezia look like on diffquick

A

See peanut appearance; much larger than any staph/strep on there

54
Q

Clinical signs of malassezia (including if chornic)

A

erythema, pruritis, alopecia, greasy exudate, nail bed staining
 If chronic: get hyperpigmentation, licenification and malodour

55
Q

Treatment of malassezia

A

identify and treat underlying cause
2X weekly shampoo with 2% miconazole/2% chlorhexidine

(may need itraconazole or terbinafine systemically)

56
Q

WHat does it show us if malassezia treatment only gives partial pruritis resolution

A

It was a secondary pathogen e.g to atopic skin disease

57
Q

What is the most commonly isolated bacteria from canine skin infection

A

Staphylococcus pseudointermedius
= resident in mares, oropharynx and perianal area but only transient on the skin

58
Q

Is it significant if we find staph pseudointermedius on skin

A

Yes because only should be transient on the skin

59
Q

What is the exception to not using steroids in managing bacterial skin infections

A

Surface skin infections just to reduce pruritis and inflammation

60
Q

What is the classification of skin infections

A

Surface = just epidermis
Superficial = extending into just the hair follicles in the dermis
Deep = extending into the dermis but not contained within hair follicle - means it has transitioned from folliculitis to furunculosis

61
Q

What do you see with superficial pyoderma

A

pustules, erythema –> then crusting after epidermis lifts up when pustules rupture –> epidermal collerete –> then goes to target lesion with central hyperpigmentation

62
Q

Which breed has a defect in mucosal immunity which makes them prone to skin conditions

A

German shepherds

63
Q

When do we do cytology/C and S in pyoderma

A

Always do cytology
Can take C/S at same time as cytology and decide whether to send dependent on response

64
Q

Types of surface pyoderma

A
  • Pyotraumatic dermatitis; i.e hot spot
  • Skin fold pyoderma
  • Mucocutaneous pyoderma
65
Q

How does pyotraumatic dermatitis develop

A

Initial trauma/irritation then lots of scratching and licking which creates a rapidly expanding area of surface pathology

66
Q

Breed predilection of pyotraumatic dermatitis (hot spot)

A

Rottweilers, golden retrievers since these have dense secondary hair coat

67
Q

What should we be thinking if animals present with multiple pyotraumatic dermatitis lesions

A

Another underlying issue: fleas, allergic dermatitis flare up

68
Q

Treatment of pyotraumatic dermatitis

A

Treat as soon as possible; clip/clean wide area around, clean with chlohexidine and dry
Give topical steroids, buster collar etc

Investigate underlying cause

69
Q

Key sites and breeds for skin fold pyoderma

A

Sites = lip fold covered by top lip, facial, vulval, tail folds
Breeds: shar-pei, bulldog

70
Q

Treatment of skin fold pyoderma

A

Clipping, cleaning with chlorhexidine
+ can use clotrimazole cream if there is lots of malasseiza

Surgery = last resort to remove the fold

71
Q

What is mucocutaneous pyoderma

A

Rare conditions of lichenoid inflammation with plasma cells, lymphocytes, neutrophils, macrophages

See lip swelling, pruritis, complete antibiotic-responsiveness

72
Q

Treatment of mucocutaneous pyoderma

A

4 weeks clindamycin + topical cleaning (chlorhexidine) and topical 2% mupirocin ointment

73
Q

What is puppy pyoderma

A

Superficial pyoderma
Non-follicular pustules mostly on ventrum, axillary region, inguinum
Associated with suboptimal husbandry

74
Q

Treatment of puppy pyoderma

A

antibacterial washes

75
Q

What would we see on magnifying lens that shows us it is puppy pyoderma/impetigo

A

Lesions are not follicular

76
Q

What is superficial folliculitis

A

Where there are inflammatory pustules centred around hair follicles
See tufts of hair, moderately alopecic appearance, epidermal collarettes

May have underlying issues involved: demodex, dermatophytosis

77
Q

Treatment of superficial folliculitis

A

Try to manage topically e.g chlorhexidine shampoo every few days
If not working for a few weeks use systemic antibiotics

78
Q

What should we consider if we see extensive epidermal collarettes

A

Could be superficial spreading pyoderma

79
Q

Which breed can have more severe cases of superficial spreading pyoderma

A

Shetland sheepdogs

80
Q

What is superficial spreading pyoderma

A

Common pruritic lesions most often on inguinum and axilla
Secondary
May see with superficial folliculitis

81
Q

What possible underlying causes should we consider with recurrent pyoderma

A

Fleas
Atopic dermatitis
Hypothyroidism
Cutaneous adverse reactions

82
Q

How does chlorhexidine work

A

Coagulation of bacterial proteins and degradation of bacterial membranes

83
Q

How does benzoyl peroxide work

A

oxidising agent to disrupt bacterial cell walls

84
Q

What is furunculosis

A

Extension of pathology from the hair follicle into the dermis (and sometimes subcutis) as the hair follicle breaks down and material released

85
Q

Treating deep bacterial furunculosis

A

Antibiotics for 3 weeks minimum and reassess every 2 weeks
+ topical chlorhexidine washes

86
Q

Some options of systemic antibioitcs for skin infections

A

cephalexin, co-amoxiclav, clindamycin, trimethoprim/sulphonamide

87
Q

Clinical signs of deep bacterial furunculosis

A

Larger pustules, firm nodules +/- discharging tracts, poorly defined oedematous and erythematous plaques, crusts, haemopurulent discharge, haemorrhagic bullae, alopecia, pain, pruritis, often pyrexic

88
Q

What dogs get muzzle furunculosis and what age

A

Short coated dogs e.g dobermans, great dane, bulldog, mastiff

Onset around puberty 5-12 months

89
Q

Treatment of muzzle furunculosis

A

Mild cases use topical treatments e.g 2.5% benzylperoxide + poulticing, gentle squeezing; if very severe use systemic antibiotics

90
Q

Presentation of pedal furunculosis

A

Erythema, alopecia, uneven weight bearing on feet
Firm nodules, draining fistulas in feet
Often interdigital
More so in short coated breeds

91
Q

Treatment for pedal furunculosis

A

podoplasty, separation podoplasty to remove web b/w toes if this area repeatedly affected, fusion podoplasty

If not doing surgery and not infected (i.e inflammation coming from keratin) cn use topical steroids

92
Q

What is traumatic furunculosis

A

Acral lic dermatitis
Due to bored, young large breed dogs licking dorsal aspect of feet; this drives hair follicle deeper, pushing keratin into the dermis and driving foreign body reaction
+ can get bacterial infection too

= behavioural issue

93
Q

How can we deal with resistant staphylococcus

A

manage topically; shampooing every 1-3 days; ethyl lactate, chlorhexidine
May try 1 cup bleach in half a bathtub of warm water and bathe dog

94
Q

What does it suggest that isolation rates of bacteria are very low in healthy cat skin

A

Low adherence to feline skin

95
Q

What is a common cause of deep pyoderma in cats

A

Penetrating fight wounds; then infection with pasteurlla, staphs, E coli, anaerobes

FIV/FeLV could also be involved

96
Q

How does cephalexin work

A

= 1st generation cephalosporin beta-lactam
Bactericidal
Inhibits cell wall syntehsis causing osmotic instability
Excellent gram +ve cover but poor gram -ve

97
Q

How does co-amoxiclav work

A

Beta-lactam _ binds to beta lactamases
Bactericidal
Inhibits cell wall syntehsis causing osmotic instability

Excellent gram +ve cover, some gram -ve against E coli

98
Q

How does clindamycin work

A

Lincosamine antibiotics
Bacteriostatic or bactericidal
Binds 50S subunit of susceptible bacteria and inhibits protein synthesis

Most gram +ve cocci susceptible

99
Q

What antibioitic (used for skin conditions) brings risk of oesophagitis and stricture formation in cats

A

Clindamycin

100
Q

How does cefovecin work

A

3rd gen cephalosporin
Bacteriocidal
Targets cell wall synthesis
Good for skin infections + lasts 2 weeks

101
Q

How do fluoroquinolones work

A

Bactericidal via inhibition of DNA gyrase
Good effect against gram +ve and -ves (but weak on anaerobes)
= protected

102
Q

What adverse affects can fluoroquinolones cause

A

GI upset, rare reports of increased hepatic enzymes, can lead to articular cartilage abnormalities in growing animals

103
Q

What can accidental overdose of enrofloxacin/marbofloxacin in dogs and cats

A

blindness in cats
Bone marrow suppression in dogs

104
Q
A

Lent term 5th year (oral cavity elsewhere; also hip and elbow) (52 decks)

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