Patient with Nodules, Plaques, and Draining Tracts

Question 1

for nodular diseases, what is the first thing to consider/look for

Answer 1

is there one lesion or multiple?

Question 2

What does a single nodular lesion suggest?

Answer 2

neoplasia, foreign body, or fungus

Question 3

What do draining tracts suggest for disease?

Answer 3

foreign bodies

deep bacterial/fungal infection

Question 4

What is the diagnostic approach and tests for nodules, draining tracts and plaues

Answer 4

impression smear for tracts
aspirates if nodules?
cytology if plaques?

Question 5

what are examples of zoonotic diseases with these types of lesions?

Answer 5

Feline sporotrichosis
yersinia pestis
blasto

Question 6

What are the major DDx for plaques, nodules and draining tracts

Answer 6

eosinphilic granulma complex
skin tumors
bacterial infections
fungal infections

Question 7

how to make the specific diagnosis of skin tumors?

Answer 7

Cytology

Question 8

What skin tumor is monitorable?

Answer 8

histocytoma

Question 9

What skin tumor needs wide surgical argins?

Answer 9

Mast cell tumors

Question 10

what is the common lesion for eosinophilic granuloma complex?

Answer 10

skin, mucocutaneous junctions and oral cavity in cats.

Question 11

3 types of lesions noticed with EGC

Answer 11

indolent ulcer
eosinophilic plaque
eosinohpilic granuloma

Question 12

characteristics of the indolent rodent ulcer

Answer 12

unilateral on upper lip

not painful or itchy

Question 13

Characteristics of the eosinophilic plaque

Answer 13

ventral abdomen and inner thigh. usually ulcerated and pruritic

Question 14

characteristics of the eosinophilic granuloma

Answer 14

linear nodules on caudal thigh, lower lips, chin

not itchy

Question 15

cause of the EGC

Answer 15

pevious hypersensitivity to whatever it may be

some heritability

Question 16

Dx og EGC

Answer 16

Histopathology
AM tx then biospies
cytology to look at the secondaries

Question 17

Tx of EGC

Answer 17

try to manage the underlying hypersensitivity - flea/parasite control, diet trial,
ID or Serum allergy testing
or if atopy is the underlying cause, do immunotherapy

When cause unknown,
oral glucs, Ahist, EFAs, AM for secondary, Cyclosporine

Question 18

what is commonly cultures for bacterial infections causing these signs? causes?

Answer 18

pasteruella, staph, strep, anaerobes, mycobacterium**
Nocardia and Actinomyces - tracts esp

trauma or biting
Interdigial deep pyoderma in dogs can cause it too

Question 19

Where are mycobac granulomas often found in cats?

Answer 19

caudal abd

inguinal region

Question 20

Dx of mycobacterial granulomas in cas

Answer 20

acid-fast from smear, aspirate, and biopsy

Question 21

what if the bacterial draining tracts do not resovle?

Answer 21

go in with surgery to find out why. maybe awn or something

Question 22

What is a characteristic fungal lesion often found in dogs?

Answer 22

a fungal kerion – severely inflammatory, rapidly enlarging dermal nodule
Different from the usual erythema and alopecia

Question 23

what is a good way to dx sq mycoses

Answer 23

FNA and biopsies and request special staina
Maybe fungal culture
Wear gloves

Question 24

Blasto is found where

Answer 24

Mississippi and missouri

river valley areas

Question 25

Blast usually hits

Answer 25

young, active, large breeds

Question 26

Skin lesions of blasto include

Answer 26

firm papules, nodules, ulcers, abscesses

on the face, clawbeds, and nasal planum

Question 27

If we see lesions that could be blasto what is the worst thing to do?

Answer 27

treat as if it is IM disease.

Question 28

Clinical signs of cryptocooccus in cats

Answer 28

URT signs,
cutaneous, CNS, and ocular signs
a mass swelling in the nostril over the bridge of the nose

Question 29

Dx of fungal infections

Answer 29

cytology** alone can get it

Antigen testing for crypto and blasto (onl active infection)

Question 30

Other causes of nodules

Answer 30

papillomas
Cuterebra flies (late summer/fall)
Sterile panniculitis, granuloma/pyogranuloma, cutaneous histiocytosis, and calcinosus cutis

Question 31

In summary, what are the best methods to Dx nodules, plaques and draining tracts

Answer 31

Cytology and Histopath

maybe cultures