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Year 3 > MOD: Skin Diseases > Flashcards

MOD: Skin Diseases Flashcards

1
Q

What are adnexae?

A

Glands that supply hair follicles

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2
Q

What are the 2 sub-types of spontaneous alopecia?

A

Inflammatory: inflammatory infiltrate damages hair follicle

Non-inflammatory: hair growth cycle disruption or abnormal formation of hair

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3
Q

Are pruritic skin diseases usually inflammatory or non-inflammatory?

A

Inflammatory

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4
Q

What are comedones?

A

Blackheads

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5
Q

Give some examples of evidence of self-induced alopecia in cats

A

Short spiky hairs on physical exam
Vomiting hair balls
Hair in faeces
Clumps of hair in environment
Embedded hair in gingival sulci and tongue
Trichogram (look at hair under microscope-broken/frayed tips)

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6
Q

What are the 3 main causes of inflammatory (spontaneous) alopecia?

A

Infectious agents
Parasites
Immune-mediated

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7
Q

What are the 2 main causes of non-inflammatory (spontaneous) alopecia?

A

Hair follicle arrest

Hair synthesis defects

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8
Q

What is the most common cause of bacterial folliculitis in dogs and cats?
Briefly describe it

A

Staphylococcus pseudointermedius (commensal flora)
Focal to multifocal patches of alopecia
+/- pustules, crusts

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9
Q

What is the most common species of dermatophytosis (ringworm) affecting cats and dogs?
What type of animals does it typically affect?

A

Microsporum canis
Young/immuno-suppressed animals
Can have asymptomatic carriers

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10
Q

How would you diagnose dermatophytosis (ringworm)?

A

Wood’s lamp examination
Warm for 5-10 mins, expose hair for 3-5 mins
Apple green fluorescence of hair= positive result
Only 50% of M.canis fluoresce -> false positives and negatives

Could also do trichography
Arthrospores (soap bubbles) surrounding hair shaft, hyphae within hair

DTM (dermatophyte test medium)
Colour change from yellow to red, check every day, false positives and negatives, needs correct culture conditions

External lab fungal culture
Gold standard

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11
Q

For how long should you treat systemically against ringworm?

A

Until you have 2 negative cultures 2-4 weeks apart

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12
Q

How long is M.canis (dermatophytosis) viable for in the environment?

A

Up to 18 months

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13
Q

Which systemic treatments can you use against dermatophytosis (ringworm)?

A

Itraconazole (5mg/kg once a day; 7 days on, 7 days off for cats)
CI: pregnancy, hepatic disease
AE: anorexia, vomiting, hepatic toxicity

Ketoconazole (dogs, 10mg/kg once a day)
CI: pregnancy, breeding animals, hepatic disease
AE: anorexia, vomiting, hepatic toxicity

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14
Q

Describe demodicosis

A

Demodex= commensal skin mite

Can be follicular (long-bodied) or surface mites (short-bodied)

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15
Q

Which 2 species of demodex mite cause feline demodicosis?

A 
Demodex cati (non-pruritic)
Demodex gatoi (pruritic, superficial, contagious)
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16
Q

For how long should you treat systemically against demodex?

A

Until you have 2-3 consecutive negative skin scrapes taken every 4 weeks

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17
Q

What can you use to treat demodex?

A

Amitraz (dogs)

Imidacloprid/moxidectin

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18
Q

What are the cutaneous and systemic signs of leishmaniasis?

A

Cutaneous: alopecia, fine silvery scaling, depigmentation, nodules, erosions, ulcers, crusting

Systemic: lymphadenopathy, pyrexia, depression, hepatomegaly, splenomegaly, renal failure, muscle atrophy, polyarthritis, lameness

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19
Q

What is sebaceous adenitis?

A

Immune attack on sebaceous glands

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20
Q

What is alopecia areata?

A

Lymphocytic attack on hair bulb

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21
Q

What is dermatomyositis?

A 
Aetiopathogenesis unknown, probably genetically determined immune-mediated disease
Dogs 6 months old
Collies, shetland sheepdog etc
Patchy alopecia on face, extremities
Onychodystrophy
Give prednisolone
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22
Q

What is calcinosis cutis?

When is it usually seen and where?

A

Calcium deposits in dermis and epidermis due to hyperadrenocorticism
Common site= cranial dorsal neck

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23
Q

What are the clinical features of non-inflammatory alopecia caused by endocrinopathies?

A 
Symmetrical to generalised alopecia
Dull dry coat
Scaling
Comedones
Hyperpigmentation 
Atrophic skin
Poor wound healing
Post-clipping alopecia
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24
Q

Describe sertoli cell tumour

A

More common in cryptorchid testes (retained)
Atrophy of unaffected testicle
Linear preputial erythema
Feminisation syndrome (due to high levels of oestrogen)
Metastasis rare
Neutering is curative

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25
Q

Describe telogen defluxion (effluvium)

A 
Sudden loss of hair
Occurs 1-3 months after stressful incident (eg pregnancy)
Hairs synchronised into telogen
Shed as new hairs develop
Non-specific hair follicle arrest
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26
Q

Describe feline paraneoplastic alopecia

A

Pancreatic and bile duct carcinomas
Alopecic ventrum and legs
Skin shiny and translucent
Surgical excision curative (if early stage)

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27
Q

Describe alopecia X

A

Plush-coated breeds (eg Pomeranian, Chow chow)
Unknown aetiology- local hormone abnormality?
Primary hairs lost first (puppy coat), later complete alopecia and hyperpigmentation (spares extremities)

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28
Q

Describe post-clipping alopecia

A

Unknown pathogenesis, some form of follicular arrest
Plush-coated breeds
Good prognosis
Regrowth 6 months

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29
Q

Describe congenital alopecia

A

Defect in hair follicles, also adnexae, skin, teeth, claws
Dominant, recessive, X-linked
Hairless breeds eg Chinese crested
Dysplastic hair follicle can be prone to secondary bacterial infections

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30
Q

Which type of alopecia involves miniaturisation of hair?

A

Pattern alopecia

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31
Q

Describe black hair follicle dysplasia

A

Familial disorder
Genetic defects in melaninisation
Defect in pigmentation and hair formation
Progressive: born normal, coat changes by 4 weeks, black hairs become dull, hair fracture and loss

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32
Q

Describe colour dilution alopecia

A

Dilute colour coats (blue, fawn)
Genetic defects in melanisation
Macromelanosomes (melanin clumping) -> hair fragility
Progressive changes: hair fracture and loss -> scaling +/- bacterial folliculitis

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33
Q

What might you add to an animals diet to aid a dry coat and alopecia?

A

Essential fatty acids

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34
Q

Describe anagen defluxion (effluvium)?

A

Sudden hair loss (chemotherapy, severe illness)
Damage to growing hair/follicle
Patchy to complete hair loss (fractured/distorted hairs)
Loss of whiskers

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35
Q

Describe sebaceous adenitis

A

Immune-mediated
Genetic predisposition: standard poodles, akitas
Lymphocytic immune attack on sebaceous glands
Alopecia and dull dry coat. Large adherent scales, follicular casts. Bacterial folliculitis.
Treatment: replenish natural skin moisturisers (EFA’s, propylene glycol/coconut oil to moisturise skin)
Cyclosporin (variable response)

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36
Q

What are the two classifications of alopecia?

A

Spontaneous: no anima involvement. Various aetiopathogeneses. May be inflammatory (infections, parasites, immune-mediated) or non-inflammatory (hair cycle arrests, hair synthesis defects)
Self-induced: animals removes hair. Pruritis (ectoparasites, allergic skin disease), psychogenic (behavioural, internal pain/inflammation)

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37
Q

Give some causes of skin lesions in pigs

A

Physical (objects), lying on rough surfaces
Vices (biting)
Vector driven (flies and lice)
Infection (bacterial, parasitic, viral, fungal)
Congenital (epitheliogenesis imperfecta)
Toxic (PDNS: porcine dermatitis and nephropathy syndrome)

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38
Q

What is the most common flea species amongst cats and dogs?

A

Ctenocephalides felis (‘cat flea’)

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39
Q

How can you identify flea eggs from regular dirt?

A

Put on a damp tissue and break up; flea eggs will appear red (blood)

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40
Q

What are the primary species of biting lice in dogs and cats?

A

Dogs: Trichodectes canis
Cats: Felicola subrostratus

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41
Q

What is the primary species of sucking lice in dogs?

A

Linognathus setosus

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42
Q

What is the difference between biting and sucking lice?

A

Biting chew the skin

Sucking suck blood

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43
Q

What is the difference in head shape between biting and sucking lice?

A

Biting have a wider, rounder head

Sucking have a thinner, more pointed head

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44
Q

What are the two divisions of mites?

Give some examples of each

A 
Surface dwelling (otodectes, Cheyletiella, Trombicula) (long legs)
Burrowing (Demodex, sarcoptes) (short legs)
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45
Q

What shape are Demodex eggs?

A

Lemon-shaped

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46
Q

Describe lice eggs

A

Adhere to hair shaft, have a lid (operculum)

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47
Q

Give some signs of pruritus

A 
Licking 
Chewing
Biting 
Nibbling 
Scratching
Rubbing 
Shaking head
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48
Q

How can you tell if a cat is pruritic?

A

History of over-grooming, hair balls, clumps of fur around house
Clinical exam: hairs caught in teeth/tongue/faeces
Trichogram: fractured/ blunt hair tips

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49
Q

Fleas can can which kind of anaemia?

A

Iron-deficiency anaemia in young animals

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50
Q

Which parasite acts as an intermediate host for fleas?

A

Dipylidium caninum (tapeworm)

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51
Q

Give the clinical signs of FAD

A

Primary: pruritis, papules, erythema
Secondary: excoriation, alopecia, crusts, pyoderma signs

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52
Q

What is FAD?

A

Allergy to flea saliva

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53
Q

Fleas lay eggs within how long of mating?

A

Mating occurs then eggs are lain within 24 hours of first blood meal

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54
Q

Briefly describe the life cycle of a flea

A

Adults lifespan on host is 7-10 days
Eggs laid on host, fall onto environment
1-10 days later: larvae hatch, feed in environment
5-18 days later: pupae hatch
7-140 days later: adults

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55
Q

What percentage of the flea population is adults?

A

5%

95% is in environment (larvae, pupae, eggs)

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56
Q

Give the 3 Demodex species which affect dogs

A

D. canis (limited to hair follicle, commensal)
D. injai (larger than D.canis, reside within sebaceous glands, deep in follicle)
D. cornei (shorter, resides in superficial epidermis)

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57
Q

Eggs of mites are found where?

A

Laid on host, found stuck to hairs or in burrows

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58
Q

Briefly describe the mite life cycle

A

Adult (on host) -> eggs laid on host -> larvae -> nymph -> adult
Takes 2-6 weeks

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59
Q

How often should you treat against mites in order to break the life cycle?

A

Every 2 weeks

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60
Q

Give the clinical signs of sarcoptiform mites

A

Intense pruritis, many crusts, papules, scaling, excoriations, secondary alopecia

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61
Q

Which mite causes canine scabies?

Which areas are affected?

A

Sarcoptes scabiei var canis
Ears, ventral chest, elbows, hocks
Contagious
Zoonotic

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62
Q

What clinical signs does Cheyletiella cause?

What species does it affect?

A

Trunk: increased scale, variable pruritis and erythema
Dogs, cats, rabbits
Contagious
Zoonotic

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63
Q

Give the two primary species of ear mites

A

Otodectes spp

  • Dogs, cats (contagious)
  • Dark brown, waxy discharge
  • Also seen on head and neck

Psoroptes spp

  • Rabbits
  • Profuse waxy scaling
  • Painful
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64
Q

Which species should Fipronil not be used in?

A

Rabbits

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65
Q

What is Fipronil licensed for?

A

Fleas, lice, ticks

Can also be used for Cheyletiella spp

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66
Q

What is imidacloprid licensed for? (Advantage)

A

Fleas and lice

Licensed in rabbits

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67
Q

Permethrin shampoos are toxic to what?

A

Cats

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68
Q

Lime sulfur is used to treat what in cats?

A

Demodex gatoi

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69
Q

Amitraz is toxic to what?

What is it used to treat?

A

Cats and chihuahuas

Mites (Cheyletiella, demodex, sarcoptes), lice

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70
Q

Avermectins, e.g. ivermectin or milbemycin, are toxic to which dog breeds?
What are they effective against?

A

Collies, collie crosses, herding breeds

Lice and mites eg otodectes, Sarcoptes

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71
Q

Describe harvest mites

A

Neotrombicula
Adults live in vegetation
Larvae are parasitic in late summer/autumn
Dogs, cats, livestock, humans
Possible vector of Anaplasma phagocytophilum & Borrelia burgdorferi

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72
Q

How do hookworms enter the host?

A

Eggs pass out in faeces & hatch to larvae

Enter host by ingestion or burrowing into skin

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73
Q

What is the most common cause of bacterial pyoderma?

A

Staphylococcus pseudintermedius
Common commensal of mucosa and skin in healthy dogs
Increased carriage with cAD (canine atopic dermatitis) or pyoderma

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74
Q

Bacterial pyoderma is classified by what?

A

Depth of infection
Surface: Superficial epidermis- overgrowth rather than infection as not pyogenic
Superficial folliculitis: epidermis and hair follicles
Deep folliculitis and furunculosis: epidermis, hair follicles, dermis +/- subcutaneous fat

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75
Q

Give some examples of underlying disease that may lead to superficial pyoderma

A 
Allergy
Ectoparasites
Self trauma 
Other infections eg Dermatophytosis, Leishmaniasis 
Immune deficiency 
Keratinisation defects 
Follicular dysplasia 
Environment / hygiene issues
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76
Q

Give some underlying causes of deep pyoderma

A 
Extension from superficial pyoderma 
Allergic dermatitis and chronic self-trauma 
Demodicosis 
Foreign body 
Trauma 
Pressure point pyoderma 
Immune deficiency
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77
Q

What are the clinical signs of deep pyoderma?

A

Haemorrhagic bullae, crusts, haemo-purulent exudate
Heat, swelling & erythema
Furuncles, nodules & plaques
Thick crusts, ulcers, sinus tracts & exudation

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78
Q

Malassezia affects dogs where?

A

Ears, ventral neck, axillae, groin, perineum and feet

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79
Q

Give the clinical signs of Malassezia in dogs

A

Otitis, erythema, hyperpigmentation, greasy seborrhoea, alopecia

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80
Q

Selenium sulfide should be avoided in which species?

A

Cats

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81
Q

How do you treat Malassezia?

A

Shampoo for skin first line treatment – Chlorhexidine 2% + miconazole 2% (Malaseb shampoo) or chlorhexidine 3% (Microbex)
Other topical preparations for skin and ears
- Clotrimazole, miconazole, nystatin, selenium sulfide (not cats)
- Check authorisation, contraindications, side effects
Systemic antifungals
- Only if severe or chronic & underlying disease addressed
- Check authorisation, contraindications, drug interactions, side effects before use

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82
Q

Define canine atopic dermatitis

A

A genetically predisposed inflammatory & pruritic allergic skin disease with characteristic clinical features, usually associated with IgE, & commonly to environmental allergens

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83
Q

Briefly describe the pathogenesis of cAD (canine atopic dermatitis)

A
  1. Defective cutaneous barrier function
  2. Microbial colonisation and other flare factors
  3. Hypersensitivity reactions to environmental allergens (+/- food)
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84
Q

Give the clinical signs of cAD (canine atopic dermatitis)

A

Pruritus, erythema, papules, saliva stains
Pyotraumatic dermatitis or acral lick dermatitis
Recurrent microbial overgrowths and infections
Alopecia, excoriation, scaling, crusting, hyperpigmentation and lichenification
Skin - dry, moist, greasy or sweaty
Recurrent otitis externa (may be only sign)
Interdigital abscess / furunculosis

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85
Q

Give the common features shared by dogs with cAD (canine atopic dermatitis)

A 
Onset of signs under 3 years of age 
Dog living mostly indoors
Glucocorticoid-responsive pruritus 
Affected front feet and/or ear pinnae 
Non-affected ear margins or dorso-lumbar area
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86
Q

What is CARF?

A

Cutaneous adverse reaction to food (food allergy)

87
Q

How can you diagnose food allergy dermatitis?

A

Blood tests not reliable

88
Q

How can you diagnose food allergy dermatitis?

A

Blood and skin tests not reliable
Dietary history
Positive response to 6-8 (12) week diet trial (usually chicken, beef, dairy, cereals-soy)

89
Q

What would you recommend to an owner doing a home-cooked diet trial with a dog suspected of having food allergy dermatitis?

A

Make it 2/3 carbohydrate, 1/3 protein

Boil/ microwave, make it in bulk and freeze

90
Q

What would you recommend to an owner doing a commercial diet trial with a dog suspected of having food allergy dermatitis?

A

Use single protein diets

Could try a hydrolysed diet (smaller chains of food proteins -> reduced immune response)

91
Q

How can you identify ectoparasites on a pruritic animal?

A

Tape strip, flea comb, scale exam, hair plucks, skin scrapes

92
Q

Atopic dermatitis produces high levels of which antibody?

A

IgE

93
Q

How is atopic dermatitis confirmed?

A

Raised levels of IgE to environmental allergens (75% of cases)
Intradermal skin testing or serology for IgE using dog monoclonal antibody

94
Q

When managing cAD (canine atopic dermatitis), what are the main concerns?

A

Improving skin barrier function (EFAs, moisturising shampoo)
Controlling flare factors (flea prevention, antiseptics)
Allergen avoidance (household insecticides) and allergen specific immunotherapy (ASIT)
Anti-inflammatory treatment

Will require lifelong therapy
Tailor treatment to individual

95
Q

How can you treat the skin barrier when treating atopic dermatitis?

A

Systemic EFAs (essential fatty acids)

  • supplements or diets
  • improves coat quality and decreases trans-epidermal water loss
Topical emollients (moisturise and reduce water loss)
- shampoo, conditioner
96
Q

Describe allergen specific immunotherapy (ASIT)

A

Safe, good compliance, inexpensive
Only intervention that may prevent the development of signs and alter the long-term course of the disease
Slow onset: 3-9 months, trial for 12 months
Concurrent anti inflammatory medication usually required

97
Q

Describe the mechanism of action of allergen specific immunotherapy

A

The aim is to induce or restore tolerance to the allergen by reducing its tendency to induce IgE production. Patients are desensitized through the administration of escalating doses of allergen that gradually decreases the IgE-dominated response. The objective of immunotherapy is to direct the immune response away from humoral immunity and toward cellular immunity, thereby encouraging the body to produce less IgE antibodies and more Th1 regulatory T cells, which secrete IL-10 and/or TGF-beta, which skew the response away from IgE production

98
Q

Which drugs can be given to control flare factors associated with atopic dermatitis?

A

Systemic glucocorticoids
Adverse effects common (PU/PD, panting, Calcinosis cutis)
Eg methyl-prednisolone, hydrocortisone aceponate

99
Q

Which anti histamine drug can be used when treating canine atopic dermatitis?

A 
Cyclosporin 
Delayed response (2-3 weeks)
Reduce dose/frequency gradually
100
Q

What is a JAK inhibitor?

A 
Janus kinase inhibitor, anti inflammatory  
JAK inhibitors block cytokine signalling ie interleukins, thereby blocking Th2 cell differentiation and preventing allergic inflammation 
Eg Oclacitinib (Apoquel)
101
Q

Why do we take samples?

A

Narrow the differential list
Exclude differentials
Make a diagnosis

102
Q

Which parasite causes ‘walking dandruff’?

A

Cheyletiella parasitavorax
Causes alopecia and thick scaling
Can have small numbers in healthy rabbit; may increase if overweight/bad teeth etc
Eggs are loosely attached to hair shaft

103
Q

What is the proper name for ear mites?

A

Otodectes cynotis

104
Q

Is a superficial or deep skin scrape required find Cheyletiella?

A

Superficial- found in crypts of stratum corneum

105
Q

Is a superficial or deep skin scrape required find Sarcoptes mites?

A

Found in epidermis so deep but not as deep as Demodex

106
Q

Describe Demodex cornei

A

Related to demodex canis
Lives in superficial crypts of dermis
Can find with tape (don’t need to do a skin scrape)

107
Q

Where do you take a hair pluck from when investigating pruritic lesions?

A

Edge of lesion

Pull in direction of hair growth

108
Q

What would you see on a trichogram of a dog affected with colour dilution alopecia?

A

Hair is fractured as it is too big for the follicle

109
Q

How do you do a superficial skin scrape?

A

Take multiple scrapings from non-excoriated lesions (crusts, scale; elbows and trunk for Sarcoptes)
Remove hair if necessary with curved scissors
Use mineral oil or KOH (warmed if lots of crust)
Remove crust and scale as you scrape (use No10 blade)
Mix on slide in mineral oil or KOH
Add cover slip and examine on low power

110
Q

Compare liquid paraffin to KOH when looking at ectoparasites under the microscope

A

Liquid paraffin: mites stay alive, messy, poor clearing agent, well tolerated on skin

KOH: mites dead, corrosive, good clearing agent, warming aids digestion

111
Q

How do you do a deep skin scrape?

A 
Take multiple scrapes from new lesions
Remove hair if necessary 
Squeeze skin
Apply mineral oil or KOH 
Scrape (with No10 blade) until capillary ooze 
Scoop up, mix on slide (oil or KOH)
Add cover slip and examine on low power
112
Q

An ELISA for Sarcoptes measures what?

A

Serum IgG

113
Q

What are the 3 parts of a Diff-quick stain?

A
  1. Fixative
  2. Eosinophilic stain
  3. Basophilic stain
114
Q

When investigating skin lesions, when should you culture?

A 
Poor response to treatment 
If infection recurs 
If cytology shows rods and degenerative neutrophils but no bacteria
Multiple treatments 
Health care contact 
Serious infections 
All deep infections
115
Q

What is an epidermal collarette?

A

A circular lesion with a circular rim of scale and/or a peeling edge

116
Q

How does DTM (dermatophyte test medium) work; what do you see? What do you see with contaminants?

A

Dermatophytes use up protein first (red colour change) then after around 10 days start using up carbohydrate (yellow colour change)
Contaminants= opposite

117
Q

How big should a skin biopsy be when investigating skin lesions?

A

10 x15 mm

118
Q

Canine atopic dermatitis tends to affect dogs of what age?

A

6 months to 3 years at onset, most by 6 years

119
Q

Which breed of dog is most prone to atopic dermatitis?

A

West highland white terrier

120
Q

What is seen on the skin in dogs with Sertoli cell tumour?

A

Line of erythema between scrotum and penis

121
Q

Squamous cell carcinomas are seen where?

A

Spontaneous forms:

  • Oral
  • Ungual (nails)
UV induced:
-White hair coat
-Depigmented skin 
-Sparsely haired regions (ear tips, nose, around eyes)
-
122
Q

Which general history questions should you ask when doing a dermatological consult?

A

Every animal:

  • Attitude and exercise tolerance?
  • Appetite and thirst?
  • Vomiting or diarrhoea?

Relating to complaint:

  • No of stools per day?
  • Sneezing or conjunctivitis?
  • Seasonal history?
  • Neurological signs?
  • Previous or concurrent disease?
  • Drug history?
  • Onset and duration?
  • Progressive/intermittent?
  • Has there been any changes eg in distribution?
  • Itchy?
  • Distribution?
  • Usual diet?
  • Flea treatment?
  • Is there worsening/ improvements in certain environments (eg outdoor/indoor/flooring)?
  • Travelled/ rescued from abroad? (Leishmaniasis etc)
123
Q

Give some causes of chronic and acute dermatological disease

A 
Chronic:
Allergy
Metabolic
Endocrine
Neoplastic 
Acute:
Parasites
Infectious
Immune-mediated 
Hypersensitivity
124
Q

Give some causes of dermatological disease which is:
Waxing and waning
Progressive
Intermittent

A

Waxing and waning:

  • Allergic
  • Immune-mediated

Progressive:

  • Metabolic
  • Endocrine
  • Neoplastic

Intermittent

  • Parasites
  • Infections
125
Q

Atopic dermatitis tends to flare up when?

A

Spring to summer

126
Q

Harvest mites and cow pox virus tend to occur when?

A

Late summer - autumn

127
Q

What is VAS?

A 
Visual Analogue Score
Subjective measure of pruritus, out of 10
1= not pruritic
10= constant and severe
2/10 = normal dog
128
Q

Where should you look when doing a dermatological clinical exam?

A

Hair coat
Mucocutaneous junctions and mucous membranes
Skin
Claws, pads, nail beds
Otoscopy (examine good ear first) (may not be possible conscious if animal is painful)

129
Q

What should you describe for each lesion when doing a clinical exam?

A

Configuration (eg focal)
Morphology (eg alopecia, crusts)
Location (eg caudal dorsum)
Evolution (eg papules turned to crusts)

130
Q

How are crusts formed?

A

Pustules rupture and form a crust

131
Q

How can you tell if a lesion originates in the dermis or epidermis?

A

No blood vessels in epidermis, blood vessels in dermis

132
Q

Secondary skin lesions evolve from what?

A

Primary lesions or external factors

133
Q

What is the difference between the epidermis and dermis?

A

Epidermis:

  • Has four layers
  • Keratinocytes

Dermis:

  • Has blood vessels and nerves
  • Hair follicles
  • Sebaceous glands
  • Sweat glands
134
Q

How can you tell whether a lesion is haemorrhage or erythema?

A

Diascopy: hold a slide over the lesion, haemorrhage will not blanch (turn white), inflammatory lesions will (as blood flow is restricted)

135
Q

Chyletiella infestation occurs where?

A

Dorsal spine

136
Q

Sarcoptic mange infestation occurs where?

A

Ventral abdomen

137
Q

Flea infestation occurs where?

A

Lumbar spine, medial thighs, tail base

138
Q

If the dermatological lesions are bilateral and symmetrical, is the cause systemic or from the environment?
What about if it’s irregular?

A

Symmetrical: systemic
Irregular: environment

139
Q

What are follicular casts?

A

Yellow-brown keratosebaceous material adhered to a hair shaft
Associated with sebaceous adenitis

140
Q

What kind of epithelium is present in the middle ear?

A

Simple squamous to cuboidal
Few ciliated cells
Mucous-secreting goblet cells

141
Q

The ear canal is lined by modified skin containing what?

A

Small hairs, ceruminous and sebaceous glands

142
Q

What is the difference between primary, predisposing and perpetual factors?

A

Primary: underlying cause
Predisposing: factors making a condition more likely to occur in an individual
Perpetuating: factors preventing resolution of a condition

143
Q

Give some primary factors that cause otitis

A 
Parasites
Allergic skin disease
Immune-mediated
Neoplasia and polyps
Foreign bodies
Rare/miscellaneous
Epithelialisation defects
Endocrinopathies
144
Q

Neoplasms and polyps in the ear arise from where?

How do they cause otitis?

A

External ear canal, Middle ear

Obstruct cleaning mechanisms

145
Q

Give some examples of predisposing factors for otitis

A

Conformation of ear canal: waxy, pendulous, narrow, hairy
Environment: swimming, high temp and humidity
Iatrogenic: overzealous cleaning, inappropriate cleaning agents

146
Q

Give some commensal microbes that can cause otitis when increased in numbers

A

Gram positive cocci: staphylococcus pseudintermedius, streptococcis canis
Yeasts: Malassezia pachydermatis
Gram negative baccilli: Pseudomonas aeruginosa, Proteus mirabilis

147
Q

What is otitis media?

A

Infection of middle ear that causes inflammation and build up of fluid behind the eardrum

148
Q

What kind of things should you ask when taking a history of a pet with otitis?

A 
Acute or chronic?
Unilateral or bilateral?
Response to previous therapy?
Any other skin problems?
Any systemic signs?
149
Q

What may be the cause of loss of pliability/mobility of the ear?

A

Neoplasia, severe epithelial hyperplasia, cartilage calcification

150
Q

Which anti-inflammatory drugs can you use to treat otitis?

A

Corticosteroids, topical and systemic
Anti-pruritic, decrease glandular secretions, exudation, scar tissue and proliferative changes
eg systemic Prednisolone, 0.5-1mg/kg once daily then taper

151
Q

Which diagnostic tests can you use regarding otitis?

A

Ear sampling (cytology, parasites, culture and sensitivity)
Imaging
Otoscopy and otic lavage

152
Q

Which position is preferred for radiographs investigating otitis?

A

Dorsoventral
Preferred over ventrodorsal as positioning is easier, bullae are closer to film, allows comparison of canals/bullae/petrous temporal bones

153
Q

How can you resolve perpetuating factors affecting otitis?

A

Anti-inflammatory drugs
Otic lavage
Anti-microbial agents
Lavage of middle ear

154
Q

Regarding otitis, which factors are indicative of a poor prognosis?

A

Severe stenosis and fibrosis
Calcification of ear canals and osteomyelitis
Para-aural abscessation

155
Q

How do you treat otitis caused by Malassezia?

A

Topical antifungal therapy eg itraconazole

156
Q

How can you carry out responsible antimicrobial use?

A

Avoid antimicrobials unless necessary (check infection present via cytology not culture)
Control inflammation
Avoid systemic antibiotics, use topical antiseptics

157
Q

How do you do an otic lavage?

A

Remove purulent discharge, flush middle ear
GA and intubation with inflated cuff
Saline flush proximal to distal
Limited by hyperplasia/stenosis (pre-treat with steroids eg prednisolone 7-14 days prior)
Analgesia

158
Q

Most feline otitis cases are due to what?

A

Polyps and neoplasia

159
Q

Most canine otitis cases are due to what?

A

Atopic dermatitis

160
Q

How often should you clean a dogs ears?

A

1-2 times a week

161
Q

Otitis: What kind of topical maintenance therapy should be used in an animal with dry wax and prone to Malassezia?

A

Ceruminolytic agents eg propylene glycol

162
Q

Otitis: What kind of topical maintenance therapy should be used in an animal with moist ears and those prone to bacterial infection?

A

Low viscosity cleaners for flushing

Antimicrobial agents eg chlorhexidine

163
Q

Otitis: What kind of topical maintenance therapy should be used in an animal where the primary factor is allergic skin disease?

A

Topical corticosteroid to control ongoing inflammation

164
Q

Give some adverse effects of otitis treatments

A

Ear canal and/ or tympanic membrane trauma
Vestibuar syndrome
Horner’s syndrome
Deafness
Topical agents: irritation, ototoxicity, sensitisation

165
Q

Notoedric mange affects which part of a cat?

A

Face

166
Q

Feline cutaneous reaction patterns are most commonly seen with which kind of dermatitis?

A

Hypersensitivity

  • Flea bit hypersensitivity
  • Feline atopic dermatitis (non-flea, non-food)
  • Cutaneous adverse food reaction (CAFR)
167
Q

What are the 4 feline cutaneous reaction patterns?

A

Symmetrical Alopecia
Head and neck pruritus
Military dermatitis
Eosinophilic granuloma complex (Eosinophilic plaque/granuloma/ indolent ulcer)

168
Q

What is the most common type of hypersensitivity dermatitis in cats?

A

Flea bite hypersensitivity

169
Q

Briefly describe symmetrical alopecia in cats

A

Most commonly self-induced due to pruritus

  • Non-inflamed
  • Areas cat can reach (symmetrical)
  • Ventral abdomen, lateral thorax, caudal thighs
  • Often linear
  • Loss of hair length not loss of hair growth
170
Q

What are the signs of self-induced alopecia in cats?

A 
Short spiky hairs on physical exam
Vomiting fur balls
Hair in faeces 
Embedded hair in gingival sulci and/or tongue 
Clumps of hair in cats environment 
Trichogram (broken/frayed tips)
171
Q

Give some possible causes of head and neck pruritus in cats

A

Parasites (otodectes, neotrombicula)
Infectious (bacteria, Malassezia)
Less likely: irritant contact dermatitis, behavioural, oro-facial pain syndrome

172
Q

Describe head and neck pruritus in cats

A 
Pruritus
Self-excoriation (linear)
-Erosions
-Ulcers
-Crusts
Face, cranial pinnae, neck
173
Q

Military dermatitis in cats is seen where?

A

Dorsal lumbosacral area
Dorsal flanks and neck
(Caudiomedial thighs, ventral abdomen)

174
Q

Give some differential diagnoses for military dermatitis

A 
Cheyletiella
Lice
Otodectes
Neotrombicula
Endoparasites
Bacterial pyoderma
Dermatophytosis (ringworm)
Hypereosinophilic syndrome
Drug reaction
Fatty acid or other dietary deficiencies
Pemphigus foliaceus
175
Q

Give some proposed aetiological triggers for eosinophilic granuloma complex

A 
Allergens (food, flea, environment-atopic dermatitis)
Viral eg feline herpes virus
Bacterial 
Fungal
Parasites eg cheyletiella 
Foreign body
176
Q

Where are eosinophilic plaques seen (cats)?

A

Abdominal and inguinal skin
Medial and caudal thighs
Neck
Interdigital skin

Highly pruritic

177
Q

Where are Eosinophilic granulomas seen (cats)?

A

Caudal thighs (spontaneous regression, genetic?)
Hard/soft palate +/- necrosis
Swelling of chin (asymptomatic)

Not pruritic

178
Q

Describe the appearance of an Eosinophilic granuloma (cats)

A

Alopecic, raised plaque/nodule

Intact skin or eroded-ulcerated (Ulcerated lesions have central white accumulations)

179
Q

Describe an Eosinophilic ulcer in cats

A

Upper lip, near canines
Well circumscribed, red/brown ulcer with raised border
Non-pruritic
Non-painful

180
Q

What are the differentials for Eosinophilic ulcer in cats?

A

SCC (squamous cell carcinoma), trauma and rare genetic disease

181
Q

What is cyclosporin?

A

Immunosuppressive drug

182
Q

What causes ringworm in cats?

A

Microsporum canis

183
Q

Pediculosis refers to skin disease caused by what?

A

Lice

184
Q

Mange refers to skin disease caused by what?

A

Mites

185
Q

Which species of lice are found in horses?

Where abouts?

A

Haematopinus asini
Sucking louse, feeds on blood
Mane and tail, fetlock and pastern

Werneckiela
Biting louse, feeds on epidermal debri
Dorsolateral trunk

186
Q

Lice in horse are more common in which season?

A

Winter

187
Q

How can you treat lice in horses?

A

Pyrethrins, pyrethroids, permethrin, fipronil

188
Q

Which mite species are found in horses?

A

Chorioptes equi: distal limbs, intense pruritus, draft breeds, winter
Sarcoptes scabiei: head, neck, ears -> entire body, difficult to see on skin scrapings
Psoroptes equi: forelock, mane, tail -> trunk, ears- head shaking
Trombiculidiasis: larvae of free-living adult mites, papules with small orange larvae in centre, face, distal limbs, ventral thorax, abdomen
Demodex: D.equi-body D.caballi-eyelids, muzzle. Rare

189
Q

How do diagnose mites in horses?

A

Skin brushings (skin scrapings not effective)

190
Q

How do you treat mites in horses?

A

Systemically: Avermectins (not licensed)
Topically: lime sulphur
Treat at 2 week intervals (life cycle)

191
Q

Give some non-allergic differentials for self-induced symmetrical alopecia in cats

A

Pruritic: ectoparasites (eg lice, cheyletiella), infectious (bacterial folliculitis)
Non-pruritic: behavioural (anxiety, pain eg orthopaedic, UTI)

191
Q

What are the 3 presentations of eosinophilic granuloma complex in cats?

A

Eosinophilic plaque
Eosinophilic granuloma
Eosinophilic ulcer

192
Q

What should you also check if you find demodex on a horse and why?

A

Immunosuppression, as demodex is rare in horses

193
Q

When are ticks most commonly seen on horses?

A

Spring and summer

194
Q

What is another name for oxyuris equi?

A

Pinworm

Causes perianal pruritus

195
Q

What is Onchocerca cervicalis?
Where do adults live?
Where do microfilarie live?

A

Horse nematode
Live in nuchal ligament
Microfilarie migrate to the skin -> hypersensitivity

196
Q

What are the risk factors for Culicoides (sweet itch) in horses?

A

Standing water, dawn and dusk, no wind

197
Q

What is the difference between scaling and crusting?

A

Scaling is dry and grey, whereas crusting is yellow-brown and wet/damp

198
Q

What is the difference between erosion and ulceration?

A

Erosion is superficial, ulceration is deeper

199
Q

Describe dermatophilosis (‘Rain Scald’) in horses

A 
Dermatophilus congolensis. Gram +ve facultative anaerobe
Chronic moisture and skin damage
Crusts, moist matts of hair
Back, gluteal area, face, neck
Treat with antibiotics
200
Q

What are the 2 main genera of ringworm (dermatophytosis)?

A

Trichophyton, microsporum

201
Q

How do you treat ringworm in horses?

A

Topical antifungals eg Miconazole

202
Q

What are the two causes of photosensitisation in horses?

A

Hepatogenous (liver disease)

Ingestion/application of photodynamic agent

203
Q

‘Warbles’ (seen in horses) are the larval stages of which flies?

A

Hypoderma bovis and lineatum

204
Q

What is a dentigerous cyst (horse)?

A

“Tooth in ear”
Cyst contains all/part of tooth
Horse was born with it

205
Q

What is an atheroma (horse)?

A

‘Nasal Inclusion Cyst’
Non-painful, located in false nostril, a blind pouch in the outer wall of the nostril
Filled with sebaceous material
Present at birth

206
Q

What is a dermoid cyst (horse)?

A

Teratoma
Contains epidermis, hair follicles, sebaceous glands
Derived from residual embryonic cells

207
Q

What is a vascular hamartoma (horse)?

A

Resembles a neoplasm, benign

Composed of tissue elements normally found at that site, but which are growing in a disorganised mass

208
Q

What clinical signs might an owner perceive as pruritus?

A 
Chewing
Nibbling
Licking
Scratching
Rubbing
Shaking head 
Biting
209
Q

Fleas are the intermediate host of what?

A

Dipylidium caninum

210
Q

Where are lesions caused by Cheyletiella found?

A

Trunk

211
Q

Psoroptes ear mites are found in which species?

A

Rabbits

212
Q

What are ‘hotspots’?

A

Pyotraumatic or moist dermatitis
Focal to multifocal, well-demarcated, moist, flat eroded lesion with erythematous halo
Exacerbated by continued licking or chewing
Dogs

Year 3 (28 decks)

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