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What are the three layers of the skin?
- Epidermis
- dermis
- subcutaneous
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What are the functions of the skin?
- Barrier
- temperature regulation
- sensory
- motion and shape
- secretion
- adnexa (hair, nails, hooves)
- storage
- excretion
- pigmentation
- vitamin D production
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What are the different types of skin diseases?
- Pyoderma
- malassezia
- anal sac
- lick granuloma
- injection reactions
- tumors
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What are pyodermas?
Bacterial infection of the skin
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Are pyodermas primary or secondary conditions?
Can be either
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Are pyodermas superficial or deep infections?
Can be either
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What do superficial pyodermas involve?
Only superficial epidermis and hair follicles
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For superficial pyodermas, healing occurs without ______.
Scarring
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Does superficial pyoderma usually last a long time?
No, short duration
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What are the different types of superficial pyodermas?
- Acute moist dermatitis
- skin fold pyoderma
- impetigo
- feline acne
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What are the clinical signs of superficial pyodermas?
- Papules/pustules
- epidermal collarettes
- alopecia
- +- pruritis
- erythema
- crusts
- often staphylococcus spp.
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What is epidermal collarette?
A circular lesion with a circular rim of scale and/or a peeling edge
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What is the treatment for superficial pyodermas?
- Systemic antibiotics
- topical antibiotics
- antibacterial shampoos
- identify and treat underlying disease if present
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What do deep pyodermas tend to become?
Chronic
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Do deep pyodermas resist treatments?
Yes
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What are deep pyodermas usually associated with?
Immunosuppression
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What are deep pyodermas sometimes secondary to?
Allergies
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How does staphylococcus intermedius cause deep pyodermas?
Releases enzymes and toxins that produce severe tissue damage
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What are the clinical signs of deep pyodermas?
- Same as for superficial
- Dogs often febrile
- may produce draining tracts
- specific conditions: juvenile cellulitis, interdigital pyoderma, generalized pyoderma
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How do we treat deep pyodermas?
- Do culture and sensitivity
- biopsy
- systemic antibiotics
- prolonged antibiotics therapy as long as three months
- topical treatment
- staphylococcal bacterin - bacterial vaccine
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How do we educate our clients on deep pyodermas?
- There may be drug resistance
- long treatment
- expensive for large breed dogs
- need to investigate underlying cause
- some animals may never be cured
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What is another term for acute moist dermatitis?
Hot spot
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What are hot spots usually secondary to? How does trauma usually happen?
- Secondary to trauma
- trauma usually self inflicted
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What do hot spots usually look like?
- Red, moist, hot, painful
- alopecia, pruritits
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How do we treat hot spots?
- Clip hair from regions, exposing the edge of the lesion
- cleanse with a medicated shampoo
- topical medication - gentocin spray
- antibiotics, glucocorticoids
- treat underlying condition (fleas, atopy)
- may need to sedate because lesions can be painful
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How do we educate clients about hot spots?
- Gentle cleansing daily will help speed recovery
- ecollar as needed
- owner should wash hands after treatment
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Where do we usually see skin fold pyoderma?
where the skin is plentiful - lips, facial folds, vulvar folds, tail folds
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How do dogs get skin fold pyoderma?
- trap moisture and heat
- constant rubbing and trauma
- secondary infection
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What are the clinical signs of a skin fold pyoderma?
- foul odor
- discharge
- red, moist, ulcerated
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Are skin fold pyodermas a chronic problem?
yes, require long term treatment
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How do we treat skin fold pyoderma?
- clip and cleanse areas
- dry the lesions - cornstartch
- systemic antibiotics
- surgical removal of excess skin
- weight reduction
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How do we educate clients about skin fold pyoderma?
- long term and maintenance medical treatment
- keep hair away from the eyes
- monitor cornea for damage
- weight reduction
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What is another term for impetigo?
puppy pyoderma
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What age does impetigo usually occur?
under 1 years old
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What is impetigo?
superficial pyoderma
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What are the clinical signs of impetigo?
- occurs on sparsely haired areas - abdomen, axillae
- pustules, collarettes
- usually non-prurtic
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What is the bacteria that usually causes impetigo?
staphylococcus spp.
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What is the treatment for impetigo?
- many resolve spontaneously
- many resolve once neutered
- antibacterial cleansing
- topical antibiotics
- systemic antibiotics
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What is feline acne?
- blackheads
- pustules
- fistulas
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Can feline acne be chronic?
yes
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At what age does feline acne occur?
can occur at any age
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What are the clinical signs of feline acne?
- pustules, comedones
- black grandular debris on chin hair
- draining tracts
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What is the treatment for feline acne?
- clip hair on chin and cleanse
- extract large comedones - may require sedation
- cleanse daily with benzoyl peroxide - human acne pads
- topical, systemic antibiotics
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How do we educate clients on feline acne?
- may be a chronic problem
- maintenance treatment is needed
- may be helpful to change from plastic or ceramic food and water dishes to glass of stainless steal
- wash dishes weekly
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What are other names for juvenile cellulitis?
- juvenile pyoderma
- puppy strangles
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What is juvenile cellulitis?
skin lesions progressing to systemic disease - fever, anorexia, enlarged and abscessing lymph nodes
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What are the clinical signs of juvenile cellulitis?
- age range: 3 - 16 weeks
- acute swelling of face
- eyelids, lups, muzzle
- submandibular lymphadenopathy
- papules, pustules, fistulas
- painful, febrile, joint pain
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What is the treatment for juvenile cellulitis?
- aggressive therapy with corticosteroids
- antibioitcs
- topical thearpy
- relapse is uncommon
- use aggressive therapy to prevent scarring
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What is Malassezia dermatitis?
lipophilic yeast
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Where do we normally find malassezia?
normal flora of ear canal, skin, and mucosal surfaces
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What does Malassezia have a symbiotic relationship with?
staphylococcus
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What factors enhance the growth of malassezia dermatitis?
- increased humidity
- yeast is a secondary invader to primary skin disease
- allergies, skin folds
- immune suppression - disease or iatrogenic
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What are the clinical signs of malassezia dermatitis?
- malodorous - can smell from the next room if severe
- intense pruritis
- erythema, scales, pyoderma
- greasy exudate
- possible hyperpigmentation and lichenification
- otitis
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How do we diagnose malassezia?
- cytology - impression smear, ear swab
- round to oval budding yeast - peanut, shoe print, snowman
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How do we treat malassezia?
- local - topical antifungals
- generalized - topical antifungal shampoos, systemic antifungals if needed, antibiotics
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What are some examples of antifungal shampoos?
- chlorhexidine
- miconazole
- ketoconazole
- selenium sulfide
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Where are the anal glands located?
located between muscle layers of the anus, at 4 and 8 o'clock
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What kind of fluid do anal sacs produce?
oily, brown fluid
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How are anal glands naturally expressed?
defectaion compresses sacs, expelling fluid onto surface of feces
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What can anal sacs result in?
- impaction, infection
- may abcess and rupture
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What are the clinical signs of something being wrong with the anal sacs?
- scooting on rear end, "sit and spin", reluctance to sit
- tenesmus/pain on defecation
- redness or abscess in anal area
- excessive licking
- foul odor
- stares at rear end
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What is the treatment for anal sacs?
- drain sacs by internal compression
- if secretions dry, may need to add saline or mineral oil to soften
- flush sacs with antiseptic or antibiotic solution
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What is the treatment for an abscessed anal gland?
- warm compresses or hydrotherapy
- systemic antibiotics
- anal sacculectomy
- may need to sedate or anesthetize for initial treatment
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What is another term for a lick granuloma?
canine acral lick granuloma
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What does acral mean?
of or affecting a peripheral part, such as limbs or ears
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What are the clinical signs of a lick granuloma?
- thickened plaque on distal extremity
- perpetuated by self trauma
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What are the causes of a lick granuloma?
- boredom, anxiety, frustration
- allergy, skin disease - bacterial, fungal
- hypothyroidism, neoplasia, foreign body, neuropathy
- OCD - obsessive compulsive disorder
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What is the treatment for a lick granuloma?
- treat underlying cause
- antibiotics - 8+ weeks
- e-collar
- topical antibiotic +/- antiinflammatory
- topical spray with analgesic
- laser, cryosurgery, radiation
- intralesional steroid injections
- medications - antidepressants, anti-anxiety, behavior modification
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How do we educate clients on lick granulomas?
- long term therapy required
- recurrence are common
- lesion is often refractory to treat
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When do injection reactions occur?
can occur 2 - 4 months after injection
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Is treatment usually required for injection reactions?
no
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What can injection reactions do to the hair of the animal?
- hair regrowth may take months to years
- color change to hair
- alopecia could be permanent
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What are some benign skin tumors?
- histiocytoma
- lipoma
- sebaceous cyst
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What kind of dogs usually get histiocytomas?
yound dogs
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What do histiocytomas look like?
- small button-like nodule
- hairless
- may be ulcerated
- face, legs, lips, abdomen
- hair grows rapidly
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What is the treatment for a histiocytoma?
- usually regresses spontaneously
- surgical excision
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How do we educated clients about histiocytomas?
- not malignant, no metastasis
- not seen in cats
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What are lipomas?
neoplasia of liopcytes - adipose cells
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Are lipomas common in cats?
no
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What are some common locations for lipomas?
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What causes lipomas?
cause unknown
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What are the clinical signs of a lipoma?
- round or oval subcutaneous masses
- encapsulated, slow growing
- lesions are soft to firm
- many are freely movable
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How do we diagnose a lipoma?
- clinical signs
- fine needle aspirate
- biopsy
- surgical excision and biopsy
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What is the treatment for a lipoma?
- surgical excision
- remove rapidly growing tumors
- remove if causing locomotion problems
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How do we educate clients of lipomas?
- benign tumors even though they may grow large
- rarely malignant
- may recur after removal
- change in diet will usually not affect existing lipomas
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What are the clinical signs of sebaceous cysts?
- dogs of any age or sex
- encapsulated, round, fluctuant
- contain gray, cheesy material
- may spontaneously rupture
- usually on back, legs, chest, and neck
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How do we treat sebaceous cysts?
- may never need treatment
- surgical removal
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How do we educate clients on sebaceous cysts?
- formed by changes in the sebaceous gland surrounding the hair follicle
- benign, slow growing
- cure - surgical removal
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What are some malignant skin tumors?
- basal cell carcinoma
- fibrosarcoma (not vaccine induced, vaccine induced)
- mast cell tumor
- melanoma - benign or malignant
- squamous cell carcinoma
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What are the clinical signs of basal cell carcinomas?
- common tumor of adult animals
- single, discrete lesion
- round, firm, ulcerated
- commonly found on the head
- slow growing
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What is the treatment for basal cell carcinoma?
wide surgical excision
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How do we educate clients on basal cell carcinoma?
- rarely metastasize
- recurrence possible at surgical site
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Where do we typically find fibrosarcomas in older dogs that is not vaccine induced?
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What are the clinical signs of a fibrosarcoma that is not vaccine induced?
- firm, rubbery texture
- not encapsulated
- adheres to underlying tissue
- very invasive, readily metastasize
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How do we treat fibrosarcomas that are not vaccine induced?
- wide surgical excision
- recurrence is common
- prognosis is poor
- may require amputation of a limb to get a wide surgical margin
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Describe a fibrosarcoma that is vaccine induced.
- tumor of fibroblasts
- develop rapidly
- very invasive
- malignant
- occur at vaccine site within 4 - 6 weeks post vaccination
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What are the clinical signs of a fibrosarcoma that is vaccine induced?
- solitary
- infilatrative
- poorly circumscribed
- nodular to irregular
- dermal/subcutaneous
- may ulcerate
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How do we diagnose a fibrosarcoma that is vaccine induced?
- biopsy
- fine needle aspiration
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How do we treat a fibrosarcoma that is vaccine induced?
- wide surgical excision
- amputation of affected limb
- radiation pre or post-op
- chemotherapy
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How do we educated clients on fibrosarcomas that are vaccine induced?
- if inflammatory lump from vaccination does not resolve in 1 - 2 weeks then recheck
- variable to poor prognosis - especially if not detected and treated early and aggressively
- recurrence common
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What are the vaccine associated sarcoma task force guidelines?
- use single dose vaccine
- use intranasal vaccine if available
- do not vaccinate between shoulder blades
- any swelling not resolved by 6 weeks should be excised by radical excision
- use vaccine without adjuvants
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Where should we give the rabies vaccine?
low on right rear leg
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Where should we give the FeLV vaccine?
low on left rear leg
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Where should we give the FVR-CP vaccine?
right shoulder
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What do mast cell tumors arise from?
mast cells
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What are the clinical signs of a mast cell tumor?
- isolated, firm nodules in skin
- 50% on rear legs, perineum, or external genitalia
- may be ulcerated
- cats may have crusts over ulcerated tumor surfaces
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How do we diagnose mast cell tumors?
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How do we treat mast cell tumors?
- wide surgical excision
- radiation
- chemotherapy
- cryosurgery
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How do we educated clients on mast cell tumors?
- 30% of cases metastasize
- recurrence is possible
- cats - lesions usually benign
- prognosis variable
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What do benign melanomas look like?
small, slow growing, hairless, have dark pigmentation
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What do malignant melanomas look like?
large, dome-shaped, attached, varying pigment
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Where are melanomas common?
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How do we diagnose a melanoma?
biopsy
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How do we treat melanoma?
- radical surgical excision
- radiation
- chemotherapy
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How do we educated clients on melanomas?
- metastasize readily
- prognosis usually poor
- recurrence common
- life span small lesions - 12 months
- life span large lesions - 4 months
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Where do squamous cell carcinomas occur?
in thinly haired, non-pigmented, sun-damaged skin
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Where on cats do we usually see squamous cell carcinomas?
pinnae, eyelids, nose
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Where on dogs do we usually see squamous cell carcinomas?
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What do squamous cell carcinomas look like?
lesions raised, ulcerated, cauliflower - like, necrotic odor
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How do we diagnose squamous cell carcinomas?
biopsy
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How do we treat squamous cell carcinomas?
- complete surgical excision
- laser
- cryosurgery
- radiation
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How do we educated clients on squamous cell carcinomas?
- tumors most common in sun-damaged skin
- recurrence is common
- prevent chronic exposure to the sun
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