Introduction to dermatology

Question 1

What are the 4 main presenting clinical signs in dermatology consultations?

Answer 1

• Pruritis
• Swellings
• Otitis
• Alopecia

Question 2

What are some of the most common causes of presenting dermatological problems?

Answer 2

• Bacterial infection
• Parasitic
• Neoplastic
• Allergic
• Fungal
• Metabolic
• Immune mediated

Question 3

What are some of the main dermatological differences between dogs and cats?

Answer 3

• 2ndry bacterial skin infections much more common in dogs
• Cat bite abscess is the most common feline infection
• Primary infections e.g. Dermatophytosis or viral are uncommon, but more common in cats than dogs
• Endocrinopathies are rare in cats although more common in dogs
• Neoplasia more common in dogs
• Parasites and allergy are common in both

Question 4

What are the benefits of dermatological lesions on the outside of the body?

Answer 4

• Facilitates examination and sampling

- Can monitor treatment response

Question 5

What are common pitfalls in dermatology consults/therapy?

Answer 5

• Disregarding history
• Failure to appreciate clinical signs
• Not taking a logical, problem oriented approach
• Errors in taking diagnostic samples
• Errors in allergy testing (it is not a diagnostic test, just a means to decide treatment)
• Errors in interpreting results

Question 6

Give examples of host factors which can influence dermatology

Answer 6

• Age, breed, sex
• Coat colour
• Weight (change)

Question 7

What are the 3 most common dermatological differentials in cases less than a year old?

Answer 7

• Parasites
• Congenital
• Food induced atopic dermatitis

Question 8

What are the 3 most common dermatological differentials in adult cases?

Answer 8

• Immune mediated
• Endocrine
• Food induced atopic dermatitis

Question 9

What are the 3 most common dermatological differentials in elderly cases?

Answer 9

• Neoplastic
• Metabolic
• Food induced atopic dermatitis

Question 10

West highland terriers are predisposed to which dermatological condidion?

Answer 10

Atopic dermatitis

Question 11

Males are predisposed to which dermatological problem?

Answer 11

Sertoli cell tumours

Question 12

Give examples of general history questions to all patients

Answer 12

• Appetite and thirst?
• Vomiting or diarrhoea?
• Number of stools per day?
• Sneezing or conjunctivitis?
• Seasonal history?
• Neurological signs?
• Drug history? Vaccinations?
• Exercise tolerance
• Concurrent disease?

Question 13

Give examples of questions that should be asked to all patients when obtaining their dermatological history

Answer 13

• Symptoms?
• Onset and duration
• How and when it started, has it progressed?
• Is it itchy?
• Is it seasonal?
• Any previous treatments?
• Does it worsen or improve in certain environments?

Question 14

What are some examples of chronic dermatological conditions?

Answer 14

Allergies
Metabolic
Endocrine
Neoplastic

Question 15

What are some examples of acute dermatological conditions?

Answer 15

Parasites
Infectious
Immune mediated
Hypersensitivity

Question 16

Waxing and waning duration is associated with which dermatological conditions?

Answer 16

Allergic

Immune mediated

Question 17

Progressive duration is associated with which dermatological conditions?

Answer 17

Metabolic
Endocrine
Neoplastic

Question 18

Intermittent duration is associated with which dermatological conditions?

Answer 18

Parasites

Infections

Question 19

A dorso-lumbar itchy distribution indiates?

Answer 19

Fleas

Question 20

Feet, face, ear pinnae, ventrum +/- perineum itchy distribution indicates?

Answer 20

Atopic dermatitis

Question 21

Severity of itching is measured using?

Answer 21

The visual analogue scale

- subjective measure of pruritus from 0-10

Question 22

Atopic dermatitis is seasonally at what time of year?

Answer 22

Summer

Question 23

Late summer-autumn seasonal itching can be indicative of?

Answer 23

Harvest mites

Question 24

Steroid treatment commonly causes which adverse effect?

Answer 24

Excessive drinking

Question 25

What factors need to be considered when asking an owner about flea treatment?

Answer 25

* Product(s) * Frequency * Last application * In contact-animals?

Question 26

What is a primary dermatological lesion?

Answer 26

- Initial eruption develops spontaneously due to underlying disease e.g. papule or pustule - Usually transient - Sample to aid diagnosis

Question 27

What is a secondary dermatological lesion?

Answer 27

- Evolve from primary lesions or external factors e.g. crust evolves from a pustule - May help with diagnosis

Question 28

How many layers make up the epidermis?

Answer 28

4

Question 29

What are the main cells in the epidermis?

Answer 29

Keratinocytes

Question 30

What are some of the main anatomical features of the dermis?

Answer 30

- Blood vessels & nerves - Hair follicles - Sebaceous glands - Sweat glands

Question 31

Give some examples of primary lesions

Answer 31

- Pustule - Papule - Papular-macular rash - Alopecia - Erythematous plaques

Question 32

Give some examples of secondary lesions

Answer 32

- Lichenification (thick, leathery skin) - thinned skin - crusts and erosions - Epidermal collarettes - Scale - Ulcers - Comedones

Question 33

What do Epidermal collarettes look like?

Answer 33

Rim of scale around a circular lesion | Occur secondary to pustules

Question 34

Scale occurs secondary to?

Answer 34

Chronic inflammation

Question 35

What are Comedones?

Answer 35

Pores or hair follicles that have gotten blocked with bacteria, oil, and dead skin cells to form a bump on your skin (like a black head)

Question 36

What is lichenification?

Answer 36

Thickening of all skin layers in response to chronic inflammation

Question 37

What are erosions?

Answer 37

Loss of epidermis above basement membrane

Question 38

What are ulcers?

Answer 38

Loss of epidermis through the basement membrane into the dermis

Question 39

Superficial bacterial pyoderma contains a mix of which primary and secondary lesions?

Answer 39

- Papules - Pustules - Crusts - Epidermal collarettes - Pigmented macules

Question 40

A bilateral symmetrical dermatological distribution indicates? give an example

Answer 40

Inside out disease e.g. atopic dermatitis

Question 41

An irregular distribution of dermatological disease indicates? give an example

Answer 41

Outside-in disease e.g. Dermatophytosis

Question 42

What needs to be considered when performing a hair coat examination?

Answer 42

- Change in colour? - Change in texture? - Easily epilated? e.g., telogen? - Broken hairs - self trauma? - Follicular casts?

Question 43

What is a Follicular cast?

Answer 43

An accumulation of keratinous debris around the hair shaft seen protruding from the follicular ostium or present when hairs are plucked and examined. Indicates a defect of follicular keratinisation.

Question 44

If follicular casts are found which 4 conditions are indicated?

Answer 44

Demodex Pyoderma Malassezia Sebaceous adenitis

Question 45

For each lesion found which 4 parts of it need to be described?

Answer 45

- Configuration - Morphology (primary/secondary) - Distribution - Evolution