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Integumentary (Exam3) > Module 8: Scaling, Crusting Disorders, and Miscellaneous Skin Conditions of Small Animals (Weeks 10 & 11) > Flashcards

Module 8: Scaling, Crusting Disorders, and Miscellaneous Skin Conditions of Small Animals (Weeks 10 & 11) Flashcards

1
Q

Introduction to autoimmune Skin Diseases

A

Introduction to autoimmune Skin Diseases

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2
Q

Definition:
Are characterized by tissue damage in anatomically diverse locations

A

Autoimmune disorders

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3
Q

Autoimmune Skin Diseases:
Inflammation is mediated by …

A
  • Innate cells
  • Migrating autoreactive lymphocytes
  • Circulating pathogenic autoantibodies
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4
Q
  • Self-reactive T cells are activated inappropriately by microbial peptides with homology to those from self
  • Example: “Fogo Salvagem” (wildfire)
    - Endemic form of pemphigus foliaceus (PF) in Brazil, associated with sandfly bites
    - Protein of the salivary glands of the sandfly crossreact with Desmoglein -1, the main autoantibody in human PF
A

Molecular Mimicry

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5
Q

Is a diversification of the epitopes recognized by the immune system

A

Epitope Spreading
- an epitope is an antigenic determinant, or a site on the surface of an antigenic molecule, to which a single antibody binds

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6
Q
  • Auto-reactive B & T cells are activated in an antigen-independent manner
  • E.g. There is a high incidence of allergies in Systemin Lupus Erythematosus (SLE) patients
    - Inflammatory cytokines released in response to environmental antigens like house dust mites can activate autoantibody production by B cells
A

Bystander activation

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7
Q

Autoimmune Skin Diseases:
In our patients, What are the most common autoimmune skin diseases of dogs and cats?

A
  • Pemphigus foliaceus (PF)
  • Facial Discoid Lupus erythematosus (DLE)
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8
Q

What condition is characterized by a specific humoral or cell-mediated immune response against the body’s tissue?

A

Autoimmunity

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9
Q

Pemphigus Complex

A

Pemphigus Complex

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10
Q

Autoimmune Dermatoses and Life-Threatening Diseases

A

Autoimmune Dermatoses and Life-Threatening Diseases

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11
Q

List the most common autoimmune skin diseases of dogs and cats:

A
  • Pemphigus foliaceus (PF)
    • superficial
  • Facial Discoid lupus eythematosus (DLE)
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12
Q

Term:
is a condition characterized by a specific humoral or cell-mediated immune response against the body’s own tissue

A

Autoimmunity

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13
Q

Term:
are a subfamily of desmosomal cadherins, the transmembrane constituents of desmosomes

A

Desmocollins

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14
Q

Term:
- a structure by which two adjacent cells are attached, formed from protein plaques in the cell membranes linked by filaments.
- are intercellular structures that holds cells together

A

desmosome

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15
Q
  • Autoantibodies are directed against desmocollins =(form part of the desmosomes)
A

Pemphigus
- Systemic signs are uncommon (WNL)
- Pruritus is variable
- we don’t see secondary infections very offen

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16
Q

Term:
The binding of the antibodies to the desmocollins causes the release of enzymes that degrade the desmosomes

A

Acantholysis

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17
Q

Pemphigus (Term):
are immature, detached keratinocytes that are the hallmark of pemphigus diseases

A

Acantholytic keratinocytes

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18
Q

Trichophyton mentagrophytes can also cause …

A

Acanthosis

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19
Q

What are the primary lesions for Pemphigus Foliaceus?

A

Pustules (rarely seen)

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20
Q

What are the Secondary lesions for Pemphigus Foliaceus?

A

Crusts, scales, alopecia, erosions and erythema - Are seen more often

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21
Q

What is the Distribution of the lesions for Pemphigus foliaceus?

A
  • Muzzle: dorsal aspect often affected
  • Pinnae- inner and outer aspect
  • Footpads: hyperkeratotic, crusty, maybe the only site affected
  • CATS (maybe the only place affected) Paronychia
  • General distribution
  • Oral mucosa rarely affected
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22
Q

Term:
A skin infection that occurs around the nails

A

Paronychia

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23
Q

Differential diagnosis:

A
  • Bacterial folliculitis
  • Dermatophytosis
  • Demodicosis
  • P. erythematosus
  • DLE
  • Superficial necrolytic dermatitis (footpads)
  • Zinc responsive dermatosis (footpads)
  • Cutaneous lymphoma
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24
Q

What will you see in Skin cytology?

A
  • Multiple acantholytic keratinocytes
  • Nondegenerate neutrophils
  • +/- Eosinophils
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25
Q

Localized Discoid Lupus Erythematosus

A

Localized Discoid Lupus Erythematosus

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26
Q
  • Is the second most common autoimmune skin disease after PF
  • Only skin is affected, no systemic signs
  • Lesions are exacerbated by UV light
A

Discoid Lupus Erythematosus (DLE)

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27
Q

List the Clinical Signs for DLE:

A
  • Initial Lesions:
    • Depigmentation and erythema of the planum nasale
      • Can progress to erosions, ulcers, scaling and crusts
  • Lesions usually heal with a scar – loss of cobblestone architecture of the nose
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28
Q

Describe the distribution of the lesions for DLE:

A
  • Often limited to the planum nasale and dorsal aspect of the muzzle
  • Other areas can be affected
    • Mucocutaneous junctions, scrotum, pinnae
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29
Q

Differential diagnosis:

A
  • PF
  • P. erythematosus
  • Dermatomyositis (skin and muscle, scars)
  • Zinc responsive dermatosis
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30
Q

Pemphigus erythematosus

A

Pemphigus erythematosus

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31
Q
  • Is uncommon
  • It is a benign form of Pemphigus
  • It does have some similarities to Discoid Lupus erythematous (DLE) - a crossover between PF and DLE?
A

Pemphigus erythematosus

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32
Q

List the clinical signs of Pemphigus erythematosus:

A
  • Lesions are similar to PF, localized to the face and planum nasale
  • Primary Lesions are rare (Pustules)
  • Secondary lesions are common (Crusts, Erosion, Alopecia, erythema)
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33
Q

Describe the diagnosis of histopathology for Pemphigus erythematosus:

A
  • Subcorneal or intraepidermal pustule
  • Basal keratinocyte vacuolization and presence of apoptotic cells in the basal layer
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34
Q

(T/F) Most cases of the autoimmune disease need lifelong treatment

A

True

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35
Q

(T/F) Approximately 50% of the cases respond to oral glucocorticoids as a sole therapy

A

True

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36
Q

(T/F) An early lesion of facial discoid lupus erythematosus is nasal depigmentation

A

True

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37
Q

Generalized DLE

A

Generalized DLE

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38
Q
  • Is a newly recognized canine variant of cutaneous lupus erythematosus
  • Ten cases were recently described, criteria for diagnosis included:
    - > 3 months history of generalized skin lesions
  • Skin lesions resembling those of human - annular (discoid) to polycyclic plaques with depigmentation, adherent scaling, follicular plugging and central alopecia below the neck
  • Presence of microscopic lesions typical of DLE interface dermatitis with basal cell damage
A

Generalized discoid lupus erythematosus (GDLE)

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39
Q

Clinical Signs:

A
  • 40% had mucocutaneous lesions most commonly around the genitalia
  • Pruritus in 40% of cases
  • Pain in 30% of cases
    (NO systemic clinical signs)
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40
Q

Histopathology:

A
  • interface dermatitis with basal cell vacuolization and apoptosis
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41
Q

Vesicular cutaneous lupus erythematosus

A

Vesicular cutaneous lupus erythematosus

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42
Q
  • Ulceration dermatitis affecting predominantly the ventrum of shelties and collies also reported in border colli
  • Mucocutaneous junctions and the concave aspect of the pinnae can also be affected
  • Age of onset: 3-8 years old
  • Onset usually during summer
  • Females may be over-represented
A

Vesicular cutaneous lupus erythematosus
- no systemic signs
- may be painful
- it affects the quality of life

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43
Q

Lupus disease responds very nicely to …

A

Cyclosporine

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44
Q

Mucocutaneous lupus erythematosus

A

Mucocutaneous lupus erythematosus

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45
Q
  • Age 3-13
  • Presence of mucocutaneous erosive lesions and lupus-specific histopathology
  • Most dogs start showing between 4-8 years of age
  • German Shepard Dogs
  • Dyschezia/dysuria
A

Mucocutaneous lupus erythematosus

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46
Q

What are the main differential diagnoses?

A
  • Mucocutaneous pyoderma
  • Mucous membrane pemphigoid (autoimmune)
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47
Q

Exfoliative Cutaneous Lupus erythematous

A

Exfoliative Cutaneous Lupus erythematous

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48
Q
  • German Short-haired Pointers
  • Lesions:
    • Scaling - most common
    • Alopecia
    • Erythema
    • Erosions
    • Ulcers
A

Exfoliative Cutaneous Lupus erythematous
- Distribution: Muzzle, pinna, Dorsum
- Progressive, poorly responsive to treatment!

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49
Q

Life-threatening Skin Diseases

A

Life-threatening Skin Diseases

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50
Q
  • Atopic dermatitis
  • Canine generalized demodicosis
  • Otitis externa/media
  • Deep pyoderma
A

common diseases Difficult to control

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51
Q
  • Thymoma-associated exfoliative dermatosis
    • Severe scaling and erythema
    • Alopecia
    • Start on the head, neck and pinae
    • Pruritus absent or minimal; may be intense with secondary bacterial or Malassezia infections
    • Systemic signs
    • Respiratory signs
    • Cats
  • Paraneoplastic alopecia - pancreatic adenocarcinoma
    • Rare
    • cats (> 10 years)
    • Associated with Pancreatic adenocarcinoma
    • Glistering skin
A

Paraneoplastic syndromes

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52
Q

Cutaneous Adverse Drug Reactions

A

Cutaneous Adverse Drug Reactions

53
Q

Most common:
- Sulfonamides
- Penicillins
- Cephalosporins
- Carprofen

A

Cutaneous Adverse Drug Reactions
- Can be any drug though

54
Q

(T/F) Clinical signs for Cutaneous Adverse Drug Reactions are extremely variable

A

True

55
Q

Erythema Multiforme (EM)

A

Erythema Multiforme (EM)

56
Q
  • Exact pathogenesis is unknown
  • Could also be drug reactions
  • Target lesions
A

Erythema Multiforme (EM)

57
Q

Toxic epidermal Necrolysis

A

Toxic epidermal Necrolysis

58
Q
  • Rare
  • Vesiculobullous and ulcerative
  • Most cases are drug reactions
  • poor prognosis
  • skin biopsy immediately
  • drug withdrawal
  • nikolsky sign often present: gentle skin manipulation results in sloughing
  • wound management
A

Toxic epidermal Necrolysis

59
Q

Cutaneous Vasculitis

A

Cutaneous Vasculitis

60
Q

Term:
Cutaneous reaction pattern cause by diseases were blood vessel walls are target of an inflammatory response
- Infection-bacterial, rickettsiala, viral, fungal
- Malignancy
- Food hypersensitivity
- Drug reaction
- Rabies vaccination
- Metabolic diseases
- SLE
- Idiopathic

A

Cutaneous Vasculitis

61
Q

Lesions for Cutaneous Vasculitis :

A
  • Purpura
  • Hemorrhagic bullae
  • necrosis
  • ulcers
  • urticaria
  • atrophic skin
  • alopecia (non-inflammatory hair loss)
62
Q

Locations for Cutaneous Vasculitis :

A
  • Paws
  • Pinnae
  • Tail
63
Q

(T/F) Not easy to document Cutaneous Vasculitis in histopathology

A

True

64
Q

Management of Cutaneous Vasculitis:

A
  • Pentoxifylline (anti-inflammatory effects)
65
Q

Miscellaneous Skin Conditions of Small Animals

A

Miscellaneous Skin Conditions of Small Animals

66
Q
  • Uncommon condition
  • 3 wks to 4 months of age
  • predisposed breeds (there are many
    • labradors …
A

Juvenile cellulitis
- A sterile process, no bacteria
- probably vaccine or medication-induced

67
Q

List clinical signs of Juvenile cellulitis:

A
  • Pyrexia, lethargy, lameness, paresis
  • Facial swelling
  • Otitis externa common
68
Q

Other Differentials you should have in mind:

A
  • Deep pyoderma
  • Demodicosis
    • deep skin scrape
  • Angioedema
69
Q

List the treatment for Juvenile cellulitis:

A
  • Systemic glucocorticoids
    • Prednisone
      • then slowly taper prednisone once the lesion is in remission
  • Oral antibiotics if secondary infection present
  • Recurrence is rare
70
Q

(T/F) You can vaccinate a puppy with Juvenile cellulitis

A

False

71
Q

Diseases of the Claw

A

Diseases of the Claw

72
Q
  • Rare
  • Claws are composed of hard and soft keratin
  • Claws grow slowly
A

Diseases of the Claw

73
Q

What is the most common claw disease that you would see?

A

Paronychia

74
Q

Common Claw terminology:
Malformed

A

Onychodystrophy

75
Q

Common Claw terminology:
- Abnormal hypertrophy & curving

A

Onychogryphosis

76
Q

Common Claw terminology:
Complete loss

A

Onychomadesis

77
Q

Common Claw terminology:
- Softening

A

Onychomalacia

78
Q

Common Claw terminology:
- Separation of claw from bed

A

Onycholysis

79
Q

Common Claw terminology:
- Brittle, splitting, breaking

A

Onychorrhexis

80
Q

Common Claw terminology:
Inflammation of tissue folds surrounding the claw

A

Paronychia

81
Q

Dermatophytosis

A

Dermatophytosis

82
Q

Term:
Fungal infection of the nail and the nail bed

A

Onychomycosis

83
Q

Fungal Culture:

A
  • Clean with 70% alcohocl
  • Scrape the nail bed
84
Q

Neoplasia

A

Neoplasia
- Squamous cell carcinoma
- Melanoma
- Mast cell tumor

85
Q

Lung-digit syndrome in …

A

cats

86
Q

Sysmmetric Lupoid Onychodystrophy

A

Sysmmetric Lupoid Onychodystrophy

87
Q
  • The most common inflammatory disease to cause abnormal claws
  • Cause - Unknown
  • Normally involves multiple claws on all four paws
  • Uncommon to rare in dogs
  • Most commonly seen in middle-aged dogs
  • Nails may be normal in appearance but come off
A

Sysmmetric Lupoid Onychodystrophy

88
Q

Biopsy for Sysmmetric Lupoid Onychodystrophy requires:

A

Onychectomy

89
Q

Treatment for Sysmmetric Lupoid Onychodystrophy:

A
  • Empirical therapy
    • vitamin E
  • +/- food trial
  • Treat paronychia if present
90
Q

Superficial Necrolytic Dermatitis (SND)

A

Superficial Necrolytic Dermatitis (SND)

91
Q
  • Rare
  • Affects humans, dogs, cats, black rhinoceros
A

Superficial Necrolytic Dermatitis (SND)

92
Q

Dogs
- Hepathopathy (often unknown etiology)
- Only 8% dogs have glucagonoma (glucagon-secreting pancreatic tumor)
- elevated plasma glucagon levels

A

Superficial Necrolytic Dermatitis (SND)
- skin lesions: degeneration of keratinocytes
- Changes most likely caused by cellular starvation or other nutritional imbalance

93
Q
  • Most will present for skin lesions
  • hyperkeratotic paw pads
  • Crusting, erosions, ulcers, vesicles
  • +/- pruritus
  • can also present for systemic illness prior to skin lesions
A

Superficial Necrolytic Dermatitis (SND)

94
Q

List the differential diagnosis of Superficial Necrolytic Dermatitis (SND) :

A
  • PF
  • Systemic lupus erythematosus
  • Zinc responsive dermatosis
  • Generic dog food dermatosis
95
Q

Superficial Necrolytic Dermatitis (SND) Diagnosis:

A
  • Abdominal Ultrasound = Honeycomb pattern
  • Histopathology
    - RED: Parakeratosis , WHITE: Edema, BLUE: Hyperplastic stratum basale pattern
  • Skin Cytology
  • Bloodwork
96
Q

Urticaria

A

Urticaria

97
Q
  • Superficial Dermal Edema and erythema
  • Localized or generalized
  • generally well demarcated
  • Variable pruritic
  • Can coalesce forming bizarre patterns
A

Urticaria
- IN THE DERMAL LAYER
- treat: Antihistamines

98
Q

Causes of Urticaria:

A
  • many things
  • Insect bite/sting
  • vaccinations, other injections
  • Drug reactions
99
Q

Anal Sacs

A

Anal Sacs

100
Q

Each anal sac is between the _______ and _______ anal sphincter and has one duct

A

internal, external

101
Q

Describe what is Normal in an anal sac:

A
  • Bacteria, keratinocytes
  • Seems to be relatively consistent within the same patient, but highly variable between patients
102
Q

Term:
Sac ruptures and material released into surrounding tissue -> cellulitis & fistula formation

A

Anal Sac abscess

103
Q

What are the normal components of the anal sac?

A
  • Desquamated keratinocytes
  • Normal bacterial flora
  • Glandular secretion
104
Q

What treatment is not an appropriate treatment option for symmetric lupoid onychodystrophy?

A

Apoquel

105
Q

List normal findings with superficial necrolytic dermatitis:

A
  • Heterogenous echotexture (“honeycomb”) of the hepatic parenchyma on abdominal ultrasound.
  • “Red, white, and blue” cutaneous changes on histopathology.
  • Crusting of the distal limbs and hyperkeratosis of the paw pads on dermatologic examination
106
Q

What is the first line of therapy for the treatment of juvenile cellulitis?

A

Corticosteroids

107
Q

Keratinization Disorders

A

Keratinization Disorders

108
Q

Scaly skin is a very common clinical presentation in the dog

A

Seborrhea

109
Q

List the Primary disorders of keratinization:

A
  • Defect in the keratinizing epithelium or glandular function
  • Hereditary, breed predilections
  • Discourage breeding of affected dog
110
Q

(T/F) Majority od cutaneous scaling dermatoses are secondary (80%)

A

True

111
Q
  • Mild to severely dry, waxy, or greasy
  • Comedones
  • Alopecia
  • Pruritus
A

Cutaneous scaling dermatoses

112
Q

A scaling dermatosis should never be diagnosed as a primary cornification defect without ruling out ___________________

A

secondary causes of scaling

113
Q

List some K-9 Primary keratinization disorders:

A
  • ZInc-responsive dermatosis
  • Sebaceous adenitis/Granulomatous to pyogranulomatous peri adnexal dermatitis
  • Canine acne
  • Canine ichthyosis
114
Q

List a feline primary Keratinization disorder:

A

Feline acne

115
Q
  • Siberian Huskies, Alaskan malamutes, bull terriers
  • Suggests genetic linkage: the decreased capability to absorb zinc from the intestine
  • Do not breed affected dogs
  • Age range: 6 months to 10.5 years - 41% before they were 2 years old
A

Zinc-Responsive Dermatosis
- scaling, crusting, alopecia
- head
- mouth, chin, eyes, ears
- pruritic

116
Q

Biopsy for Zinc-Responsive Dermatosis:

A

Marked diffuse epidermal and follicular parakeratotic (nuclei are retained) hyperkeratosis

117
Q

Treatment for Zinc-Responsive:

A
  • Oral zinc supplementation -> vomiting side effect
  • low dose of glucocorticoids
  • Omega 3/6
  • Keratolytic shampoos
118
Q

Sebaceous Adenitis

A

Sebaceous Adenitis

119
Q

Term:
An inflammatory disease directed against the sebaceous glands

A

Sebaceous Adenitis
- uncommon in dog, rare in cats
- abnormal keratinization

120
Q

Clinical Features:
- No sex predilection
- Young to middle-aged dogs
- Standard poodle, Akita, Samoyed, Belgian Sheepdog, GSD, Golden retrievers
- Bilaterally symmetrical
- Dorsal surface
- tight adherent to the fur

A

Long-coated Breeds

121
Q

In the biopsy findings:

A
  • Granulomatous inflammation at the level of the sebaceous glands
  • Advanced disease: absence of sebaceous glands
122
Q
  • “Short-coated” “sebaceous adenitis”
  • Vizsla, dachshund
  • an inflammatory disease directed against the entire periadnexal region with occasional destruction of the sebaceous glands
  • UNCOMMON in DOGS
  • Cause and pathogenesis: unknown
A

Granulomatous to Pyogranulomatous Periadnexal Dermatitis
- Annular areas of scaling and alopecia that enlarge and coalesce
- Intermittent edematous swelling of muzzle, lips, eyelids

123
Q
  • Hereditary and usually congenital
  • Defective certification, abnormal stratum corneum
  • scaling
  • Norfolk terror, jack russell terrier, golden retriever, American bulldog, great dane, ckcs
  • Definitive diagnosis; Biopsy/Genetic testing
A

Ichthyosis

124
Q
  • Norfolk terrier - autosomal recessive
  • Suprabasal keratinocyte vacuolation and lysis, hypergranulosis, marked hyperkeratosis
  • Mutation in K10 gene
  • Mild pigmented scale, alopecia, roughened skin
A

Epidermolytic Ichthyosis

125
Q

Describe the histopathology for Non-Epidermolytic Ichthyosis:

A

Laminated (layer on the layer) Orthokeratotic hyperkeratosis
- Breeds: Jack Russell (Severe), Golden Retriever (Common, late-onset), American Bulldog (in between severeness), Great Dane

126
Q

Feline Acne

A

Feline Acne

127
Q
  • Uncommon idiopathic disorder of follicular keratinization
  • Any breed, gender
  • Not confined to adolescence
A

Feline Acne

128
Q
  • Comedones
  • Chin, lower lip, upper lip
  • May progress to papules and pustules
  • folliculitis, furunculosis, Cellulitis (infection in subcutaneous tissues)
  • Alopecia
  • Edematous, thickened
A

Feline Acne

Integumentary (Exam3) (3 decks)

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