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Introduction to Dermatology Flashcards

1
Q

What is the biggest dermatological problem in Cats/ Dogs?

A

Cats = Swellings
Dogs = Pruritus

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2
Q

What are the most common causes of dermatological problems in dogs/cats?

A

Dogs = Bacterial infection, Parasitic, Neoplastic
Cats = Bacterial infection + Parasitic

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3
Q

What are the common pitfalls with dermatology?

A
  • 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)
  • Errors in interpreting results
  • Errors in therapy
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4
Q

What is the plan for dermatology consultation?

A
  1. History
  2. Examination
  3. List differentials
  4. Plan investigation
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5
Q

How can you save time during consultation?

A

Take history whilst doing physical exam

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6
Q

What are the likely to be the dermatological cause in very young animals (<1 year)?

A
  • parasites
  • congenital
  • food-induced atopic dermatitis
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7
Q

What are the likely to be the dermatological cause in adult animals?

A
  • immune mediated
  • endocrine
  • food-induced atopic dermatitis
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8
Q

What are the likely to be the dermatological cause in elderly animals?

A
  • neoplastic
  • metabolic
  • food-induced atopic dermatitis
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9
Q

What are west highland white terriers more susceptible of getting?

A

Atopic dermatitis

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10
Q

What can male animals get?

A

Sertoli cell tumour

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11
Q

Why does the colour of the animal predispose them?

A

*Squamous cell carcinoma

  • Spontaneous forms
  • oral
  • ungual
  • UV induced
  • de-pigmented skin
  • white hair-coat
  • sparsely haired regions
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12
Q

What are general questions you could ask all patients?

A
  • attitude and exercise tolerance?
  • appetite and thirst?
  • vomiting or diarrhoea?

Relating to complaint:
* number of stools per day?
* sneezing or conjunctivitis?
* seasonal history?
* neurological signs?
* drug history?

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13
Q

What are the possible causes of chronic dermatological problem?

A
  • allergy
  • metabolic
  • endocrine
  • neoplastic
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14
Q

What are the possible causes of acute dermatological problem?

A
  • parasites
  • infectious
  • immune-mediated
  • hypersensitivity
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15
Q

What is an itch that rashes?

A

Atopic dermatitis - everything else is a rash that itches

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16
Q

What is more likely to be a problem in late summer - autumn?

A
  • harvest mites
  • cow pox virus
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17
Q

What is more likely to be a problem in spring-summer?

A

Atopic dermatitis

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18
Q

Why should you ask about previous/current treatments?

A

Improved/ no change/ worse
Adverse effects

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19
Q

What are the potential risks if the animal has travelled abroad or was a rescue?

A
  • leishmaniasis
    *babesia
    *erhlichia
    *dirofilaria
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20
Q

What are the possible parasitic contagions?

A

*Flea bites
*Sarcoptic mange
*Cheyletiellosis

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21
Q

What is a infectious contagion?

A

*Dermatophytosis

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22
Q

What is the morphology of primary/secondary lesions?

A

Primary
* initial eruption develops spontaneously due to underlying disease e.g., papule or pustule
* usually transient
* sample to aid diagnosis

Secondary
* evolve from primary lesions or external factors e.g., crust evolves from a pustule
* may help with diagnosis

Some lesions can be either 1 or 2
* e.g., alopecia is 2 if due to self-trauma or 1 if due to endocrinopathy
* Skin disease is continually evolving
* a mixture of primary and secondary lesions

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23
Q

How many layers does the epidermis have?

A

4

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24
Q

What is within the dermis?

A
  • blood vessels & nerves
  • hair follicles
  • sebaceous glands
  • sweat glands
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25
What are primary lesions?
* Pustule * Papules and pustules * Papular-macular rash * Pigmented macules * Alopecia (demodex) * Erythematous plaques and papules * Alopecia (seasonal flank alopecia) * Vesicle
26
What are secondary lesions?
* Lichenification * Thinned skin (HCA; also calcinosis cutis plaques) * Crusts and erosions * Excoriations/ erosions * Epidermal collarettes * Scale (secondary to chronic inflammation) * Ulcers * Comedones +++ and an erosion
27
What lesion causes thickening of all skin layers due to chronic inflammation?
*lichenification
28
What lesion causes loss of epidermis above basement membrane?
*Erosions
29
What lesion causes loss of epidermis through the basement membrane into the dermis?
*Ulcers
30
Where does cheyletielliosis tend to infect?
Dorsum
31
Where does sarcoptic mange tend to infect?
Ears Elbows Ventral surface
32
Where does atopic dermatitis tend to infect?
Ears Paws Face / muzzle
33
Where does Flea Allergic Dermatitis tend to infect?
Perianal area Caudal dorsum
34
What type of dermatology problem comes and goes? (Waxing & waning)
*Allergic *Immune-mediated
35
What dermatological problems are progressive?
*Metabolic *Endocrine *Neoplastic
36
What dermatological problems are intermittent?
*Parasites *Infections
37
What are the major presenting signs?
*Pruritus *Alopecia *Crusting *Scaling *Nodules
38
What are 2ndry skin infections more common in?
Dogs> Cats
39
What is the most common feline infection?
Cat bite abscess
40
What are primary infections more common in? (Dermatophytosis/viral)
Cats>dogs
41
What are endocrinopathies and neoplasia more common in?
Dogs> cats
42
What is the most common cause of alopecia in cats?
*usually due to self-trauma - pruritus
43
What are the pruritus differentials in dogs?
* Atopic dermatitis * Flea allergic dermatitis * Parasites * Infections e.g., Malassezia and bacterial pyoderma (secondary) * Contact allergy * Cutaneous lymphoma * Pemphigus foliaceus
44
What are the pruritus differentials in cats?
* Feline atopic skin syndrome * Flea allergic dermatitis * Parasites * Infections e.g., dermatophytosis (primary) * Contact allergy * Cutaneous lymphoma * Pemphigus foliaceus
45
How would you exclude pruritus differentials?
*History *Clinical signs *Diagnostic tests
46
What other clinical signs may pruritus lead to?
* Alopecia * Erythema * Hyperpigmentation * Lichenification * Excoriations * erosions and/or ulcers * Secondary infections = papules, pustules, crusts, scales, epidermal collarettes, macular hyperpigmentation
47
What are the spontaneous inflammatory alopecia differentials in dogs?
* Bacterial folliculitis * Demodicosis * Dermatophytosis * IMD of hair or skin
48
What are the spontaneous inflammatory alopecia differentials in cats?
* Bacterial folliculitis * Demodicosis * Dermatophytosis
49
What are the spontaneous non-inflammatory alopecia differentials in dogs?
* Endocrine * Seasonal flank alopecia, Effluvium, dysplasias, Pattern baldness, Alopecia X, congenital, etc.,
50
What are the spontaneous non-inflammatory alopecia differentials in cats?
* Endocrine (RARE) * Paraneoplastic syndrome (RARE) * Effluvium, dysplasias, congenital
51
What are the primary scaling differentials in dogs?
* Canine ear margin seborrhoea * Ichthyosis * Primary seborrhoea * Zinc responsive dermatosis
52
What are the primary scaling differentials in cats?
* Feline acne * Ichthyosis * Primary seborrhoea
53
What are the secondary scaling differentials in dogs?
* Active inflammation (allergy, parasites, bacterial infection, dermatophytosis) * almost any resolving inflammatory dermatosis * Endocrine * Epitheliotropic lymphoma * Leishmaniasis
54
What are the secondary scaling differentials in cats?
* Active inflammation * Diabetes mellitus * Idiopathic facial dermatitis of cats (‘dirty face’ in Persian cats) * Epitheliotropic lymphoma * Feline thymoma-associated exfoliative dermatitis * FeLV/FIV dermatosis
55
What are the differentials for crusting from pustules in dogs/cats?
Infections * Superficial bacterial pyoderma Immune-mediated disease * Pemphigus foliaceus
56
What are the differentials for crusting from erosions/ulcers in dogs?
Immune mediated * Erythema multiforme * Vasculitis/ vasculopathy * Cutaneous/systemic lupus erythematosus Metabolic disease * Superficial necrolytic dermatitis (hepatocutaneous syndrome) Deep microbial infections
57
What are the differentials for crusting from erosions/ulcers in cats?
Allergy * Head and neck pruritus and miliary dermatitis * See feline CRP lecture * Mosquito-bite hypersensitivity Deep microbial infections * Atypical bacteria, fungi, viruses (pox, herpes)
58
What are the differentials for nodules in dogs?
Neoplasia Infectious * Acid-fast bacteria, fungal, viral Inflammatory * Urticaria/angioedema * Interdigital cysts Immune-mediated * Histiocytic, pyogranuloma-granuloma, panniculitis
59
What are the differentials for nodules in cats?
Neoplasia Infectious * Acid-fast bacteria, fungal, viral Inflammatory * Eosinophilic granuloma complex * Urticaria/angioedema Immune-mediated * Feline plasma cell pododermatitis
60
What diagnostic tests can be taken for skin cytology?
* Direct impression smear * Indirect impression smear * Tape strip * Fine needle aspirate (FNA)
61
What diagnostic tests can be taken for parasites?
* Brushings * Tape strips * Hair plucks (trichograms) * Skin scrapes - superficial and or deep
62
What are the possible sampling methods for alopecia?
* Hair pluck (trichogram) - Look at hair and for parasites * Skin scrape for parasites * Cytology for pyoderma * Culture for dermatophytes * Biopsy
63
What are the possible sampling methods for scale?
* Coat brushings * Acetate strip = -Unstained for parasites -Stained for infections * Hair pluck * Skin scrape * Biopsy
64
What are the possible sampling methods for nodules?
*FNA *Biopsy
65
What are the possible sampling methods for crusts?
* Skin scrapes * Lift crust and perform direct impression smear * Biopsy
66
What are the presenting signs of demodex?
* Alopecia * Variable pruritus * Scale (follicular casts) * +/- secondary bacterial infection = -crusts if superficial -nodules if deep
67
What are the presenting signs of sarcoptic mange?
* Crusts +++ * Usually severely pruritic (hypersensitivity) * Self-trauma causing alopecia
68
What are the presenting signs of cheyletiella?
* Scale +++ * Variable pruritus * Self-trauma causing alopecia
69
How would you diagnose ectoparasites?
For surface parasites e.g., fleas, lice, ticks, harvest mites, Cheyletiella and Demodex gatoi * Coat brushings * Flea comb wet paper test * Sellotape impression For shallow and surface mites living in the epidermis e.g., Cheyletiella, Demodex gatoi, Sarcoptes scabei and Notoedres cati * Superficial skin scrapes For deeper mites * Deep skin scrapes * Hair plucks * Biopsy
70
What ectoparasite lives deepest in the skin?
*Demodex - within hair follice

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