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Dermatology (small) > Immune-mediated skin disease > Flashcards

Immune-mediated skin disease Flashcards

1
Q

what is immune-mediated skin disease?

A

when the immune system fails to tolerate self-antigen and mounts an immune response to normal skin components

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2
Q

what causes primary immune-mediated skin disease?

A

idiopathic

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3
Q

what causes secondary immune-mediated skin disease?

A

trigger - toxin, drugs, bacteria, virus…

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4
Q

what are the key points to look for on an exam of a dog with suspected immune-mediated skin disease?

A

primary lesions
distribution of lesions
signalment/breed

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5
Q

what are the advantages of using cytology for immune-mediated skin disease?

A

easy, cheap, rapid
determines if sterile or not
determine type of inflammation

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6
Q

what are the two main sampling techniques used for cytology of immune-mediated skin disease?

A

direct impression smear
FNA

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7
Q

what lesions is direct impression smears useful for sampling?

A

pustules, exudative lesions (erosions/ulcers), draining tracts

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8
Q

what are skin biopsies and histopathology used for in immune-mediated skin disease cases?

A

getting a definitive diagnosis

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9
Q

what are the key points to remember when taking skin biopsies to use for immune-mediated skin disease diagnosis?

A

take at least three
sample primary lesions
sample range of lesions
sample entire lesion if possible
avoid erosions/ulcers

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10
Q

why are erosions/ulcers avoided when taking skin biopsies?

A

missing the epidermis so can’t diagnose anything that may be happening in this layer

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11
Q

what skin lesions can be seen in immune-mediated skin disease cases?

A

pustules
plaques/nodules
erythematous macules/patches
hypopigmented macule/patches
alopecia
vesicles
erosions/ulcers
crusts
purpura
scale

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12
Q

what are the main primary lesions seen with immune-mediated skin disease?

A

pustules
plaques/nodules
erythematous macules/patches
hypopigmented macule/patches

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13
Q

what are the least helpful lesions when trying to make a differential diagnosis for immune-mediated skin disease?

A

erosions, ulcers, crusts

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14
Q

what are crusts?

A

dried exudate on skins surface

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15
Q

what can crusts form from?

A

pus from pustules
exudate from ulcers/erosions
blood

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16
Q

what is the list of differentials for pustules?

A

bacterial infection (pyoderma)
pemphigus foliaceus
superficial pustular drug reaction
superficial pustular dermatophytosis

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17
Q

what are the two immune-mediated skin diseases that cause pustules?

A

pemphigus foliaceus
superficial pustular drug reactions

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18
Q

what is the lesion distribution for Memphis foliaceus?

A

footpads, pinnae, muzzle, ocular, lateral flanks

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19
Q

what disease are acantholytic keratinocytes seen with?

A

pemphigus foliaceus

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20
Q

why do we get acantholytic keratinocytes with pemphigus foliaceus?

A

auto-antibodies target desmosomes (these link the keratinocytes in the dermis) and hence the keratinocytes separate and become rounded

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21
Q

what do desmosomes do?

A

link keratinocytes in the dermis

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22
Q

what is the most common immune-mediated skin disease of dogs?

A

pemphigus foliaceus

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23
Q

in general how fast of an onset do immune mediated diseases have?

A

acute onset

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24
Q

what age dogs get eosinophilic furunculosis of the face?

A

young adults

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25
Q

is eosinophilic furunculosis of the face pruritic?

A

yes, very intense

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26
Q

what lesions are associated with eosinophilic furunculosis of the face?

A

eroded/ulcerated plaques and nodules

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27
Q

what is folliculitis?

A

inflammation of hair follicle

28
Q

what is furunculosis?

A

breakdown/bursting of hair follicle

29
Q

what age dog is sterile granulomatous dermatitis and lymphadenitis?

A

young puppies (juvenile cellulitis)

30
Q

is sterile granulomatous dermatitis and lymphadenitis pruritic?

A

no (but is painful)

31
Q

what lesions are seen with sterile granulomatous dermatitis and lymphadenitis?

A

follicular nodules (furunculosis), plaques, diffuse swelling, alopecia, lymphadenomegaly

32
Q

what is the distribution of sterile granulomatous dermatitis and lymphadenitis lesions?

A

face (and lymph nodes)

33
Q

what is the prognosis of sterile granulomatous dermatitis and lymphadenitis?

A

good

34
Q

what is the distribution of sterile nodular panniculitis lesions?

A

trunk

35
Q

what are the types of cutaneous lupus erythematosus?

A

vesicular (rapid onset and rare)
facial discoid lupus erythematosus (chronic and common)
generalised discoid lupus erythematosus (chronic)
mucocutaneous lupus erythematosus (chronic)
exfoliative cutaneous lupus erythematosus (chronic)

36
Q

what is the most common type of cutaneous lupus erythematosus?

A

facial discoid lupus erythematosus

37
Q

what breed is predisposed to discoid lupus erythematosus?

A

German shepherds

38
Q

what lesions are seen with facial discoid lupus erythematosus?

A

loss of cobblestone appearance of nasal planum
hypopigmented macules/patches
erosions, ulcers, crusting
black to blue to pink pigment change

39
Q

what are the main types of erythema multiforme?

A

major and minor

40
Q

what disease is target lesions seen in?

A

erythema multiforme

41
Q

what types of erythema multiforme have target lesions?

A

minor and major

42
Q

is erythema multiforme pruritic?

A

no

43
Q

what can trigger erythema multiforme?

A

virus, drugs, vaccine, infection, neoplasia, food, idiopathic

44
Q

what is the primary lesion of erythema multiforme?

A

annular erythematous macule (target lesion)

45
Q

what is the distribution of lesions of erythema multiforme?

A

ventral abdomen (can be generalised mucosa)

46
Q

what type of inflammation is seen on cytology of dogs with erythema multiforme?

A

sterile non-specific inflammation

47
Q

what is the main finding on histopathology of erythema multiforme?

A

keratinocyte apoptosis

48
Q

what aged dogs are effected by hyperkeratotic erythema multiforme?

A

older

49
Q

what breed is predisposed to uveodermatologic syndrome?

A

akita

50
Q

what aged dogs are effected by uveodermatologic syndrome?

A

young to middle aged

51
Q

is uveodermatologic syndrome pruritic?

A

no

52
Q

what lesions do dogs with uveodermatologic syndrome have?

A

bilateral uveitis
hypopigmented macules

53
Q

what is the distribution of uveodermatologic syndrome lesions?

A

face, nose, lips, periocular skin (occasionally footpads)

54
Q

are disease cause immune-mediated alopecia?

A

sebaceous adentitis
alopecia areata
dermatomyositis
ischaemic dermatopathy
post-injection alopecia

55
Q

what breeds are predisposed to sebaceous adenitis?

A

poodle, akita, vizsla

56
Q

is sebaceous adenitis pruritic?

A

no

57
Q

what lesions are seen with sebaceous adenitis?

A

partial alopecia and poor coat quality
follicular casts and scale

58
Q

what is the distribution of sebaceous adenitis lesions?

A

generalised

59
Q

is alopecia areata pruritic?

A

no

60
Q

where are alopecia areata lesions distributed?

A

head/face

61
Q

what aged dogs get dermatomyositis?

A

young

62
Q

what is dermatomyositis also known as?

A

ischaemic dermatopathy

63
Q

what breed is predisposed to dermatomyositis?

A

collies (or similar)

64
Q

is dermatomyositis pruritic?

A

no

65
Q

what lesions are associated with dermatomyositis?

A

focal/multifocal alopecia
variable hyper/hypopigmentation
scaling
erosions/crusting

66
Q

what is the distribution of lesions associated with dermatomyositis?

A

face and extremities

67
Q
A

Dermatology (small) (7 decks)

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