Pyoderma Flashcards

(31 cards)

1
Q

Staphylococcus pseudintermedius

A
  • found primarily on hair vs. skin in the anal region, nasal carriage.
  • Produces potent toxins/enzymes
    • B-lactamase- helps break down antibiotics such as penicillin and amoxicillin
    • Protein A : degranulates mast cells, fixes compliment
    • Proteases- irritates nerves and triggers pruritus
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2
Q

Pathogenesis of bacterial infections

A
  • increased adherence of S. pseudintermedius to skin cells in atopic animals
  • inflammatory mediators promote changes in microclimate
  • changes in permeability may allow serum leakage and increased humidity on the skin
  • Cutaneous temperature changes may also contribute to bacterial multiplication
  • Barrier dysfunction
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3
Q

Primary factors of Pyoderma

A

Allergic Skin diseases (Atopy**)

Ectoparasites

Disorders of cornification

Endocrine disease (hypothyroidism**)

Immunodeficiency

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4
Q

What are differential diagnoses for pustules

A
  • pyoderma
  • autoimmune disease
    • Pemphigus foliaceus : pustules
    • Panniculitis: draining tracts
  • Sterile eosinophilic pustulosis
  • Dermatophytosis
  • Sterile pyogranulomatous dermatitis
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5
Q

What are clinical features of Pyoderma?

A

pruritus

patchy alopecia to diffuse thinning of hair coat

Signs vary with depth of infection, duration of infection, primary factors, and severity of infection

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6
Q

What is the diagnostic approach for pyoderma

A

cytology is an absolute must

Physical and dermatological exams

Dermatology data base

CBC, biochemistry profile to look for primary causes

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7
Q

Acute Moist Dermatitis

A

“Hot Spots”

Secondary to trauma, flea infestations, environmental influences

Animals present with acute onset of lesions. Rapidly progressive

Intensive focal pruritus

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8
Q

How should you make a slide of a pyoderma case

A

cotton swab slide prep

roll prep

Pustule cytology

Papule cytology

Impression after lancing

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9
Q

In what situation would you utilize a shampoo therapy for a pyoderma case?

A

Useful for superficial infections

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10
Q

Why are whirlpools efficacious for pyoderma cases?

A

They remove surface debris, reduce pain, and increase blood flow to the skin

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11
Q

What are limitations of topical therapy for Pyoderma cases?

A
  • Client compliance
  • Exposure of clients to antiseptics
  • Delivery of active agent to the skin such as hair coat
  • Evidence of increasing bacterial resistance to antiseptics
  • Evidence of increasing bacterial resistance to antibiotics after exposure to biocides/antiseptics
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12
Q

What are effective antibiotic options to treat pyoderma cases?

A

fluoroquinolones, potentiated amoxicillin, synthetic penicillins, cephalexin

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13
Q

Waht are examples of Cephalosporins

A

Convenia

Simplicef

Cephalexin

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14
Q

Are cephalosporins a good choice for treating a pyoderma case?

A

yes this is the first tier of drugs to choose from

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15
Q

What are examples of Fluoroquinolones?

A

Zeniquin

Baytril

Ciprofloxacin

Orbax

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16
Q

What are limitations of systemic therapy

A

client compliance

adverse effects to the patient

general health of patient - may affect distribution or metabolism of drugs

concurrent medications

ANTIBIOTIC RESISTANCE

17
Q

What are classifications of pyoderma (4)

A
  • Surface- increased colonization, epidermis remains intact
  • Superficial: epidermal and/or hair follicles involved
  • Deep: extension of infection into dermis
  • Cellulitis: invasion of fascial planes and subcutis
18
Q

Acute moist dermatitis: Therapy

A

Clip, clean, and dry lesions

Antimicrobials vs Staph. (topical vs. systemic)

Glucocorticoids to reduce pain and pruritus

Prevention

  • control primary factors
  • topical antimicrobial/glucocorticoids early
19
Q

Impetigo

A

“Puppy pyoderma”

  • staphylococcal dermatitis in young dogs
  • Predisposing factors may include husbandry, parasitism, nutritional factors
  • Pruritus is absent to mild
  • Lesions are subcorneal pustules
20
Q

what are therapies for Impetigo

A

Lesions may resolve spontaneously

  • topical therapy
    • Mupirocin or BPO gel
    • BPO shampoos every 3-4 days
  • Systemic antimicrobial therapy
    • For more generalized cases
    • 21-30 day course of appropriate drug
21
Q

Canine Acne

A
  • Essentially folliculitis (and furunculosis) of the chin
  • Often seen in young dogs (rule-out demodicosis!!!)
  • May “Resolve” spontaneously at maturity
  • Therapy
    • Topical: BPO gel or mupirocin
    • Systemic: 21-30 days of appropriate drug
22
Q

Intertrigo

A

Skin Fold Dermatitis

  • skin folds provide an ideal environment for microbial proliferation
    • ​Bacteria (Staphylococci)
    • Yeast (Malassezia spp.)
  • Breed predisposition! Brachycephalic breeds
  • Management
    • clean and dry the lesion
    • Appropriate antimicrobials (generally topical)
    • Surgical correction
23
Q

Folliculitis

what is it and what are the major differentials

A

inflammation of the hair follicle superficial or deep. this is associated with patchy alopecia.

-papules, pustules, epidermal collarettes (lumpy-bumpy skin)

Common causes: Demodicosis, dermatophytosis, Staph. pseudintermedius

24
Q

therapy for folliculitis

A

topical is a good option if the owners are willling and able

  • Bathe every 3-7 days with antimicrobial shampoos
  • Mupirocin or BPO for focal lesions

Systemic

  • antimicrobials for 30 days
25
Furunculosis
progression of folliculitis Follicles rupture, releasing debris into the dermis -\> foreign body-type reactions **DRAINING TRACKS** Lesions include papules, nodules, pustules etc Destruction of the follicle results in permanent alopecia Pruritus is mild to moderate
26
therapy for Furunculosis
* Topical * Classically antibacterial shampoos are of little value * Whirlpools, US treatment are useful * Systemic therapy * Appropriate antibacterial therapy for 30-60 days or as needed * Choice of antimicrobial based on cytology or culture results
27
What is post-bathing Furunculosis
* Lesions develop with pain and pruritus 2-7 days after bathing * *Pseudomonas aeruginosa* * contaminated shampoo + trauma - if the shampoo has been sitting around for a while, it is usually a Pseudomonas bacteria present * Cytology Rod shaped Gram- bacteria * Culture and Sensitivity is recommended
28
paronychia
claw bed infection
29
Management of Deep Pyoderma
diagnostics: Database, bacterial culture, endocrine evaluations Systemic therapy with appropriate agents Whirlpool surgical intervention to open remove fistulous lesions Client education: long-term management, identify primary factors and predisposing factors
30
Methicillin Resistance
This is a zoonotic consideration for owners MRSP is rising in incidence. Antibiotics that remain our best choices such as Clindamycin, chloramphenicol. Topical therapy is used more frequently
31
Dermatologic Conditions that Mimic Pyoderma
* Juvenile cellulitis * Dermatophytosis (Trichophyton sp. ) * Autoimmune issues * Foreign body reactions * Sterile pyogranulomatous diseases.