dermatology

• stratum corneum
• keratin and melanin
• appendageal system-follicles,apocrine and sebaceous glands

• vascular plexi
• nervous tissue
• fibrous tissue

• fat
• vessels

• largest organ in body-protection
• barrier to traumatic insults
• barrier to disease
• barrier to fluid loss
• thermoregulation
• UV protection
• immunologic messenger

• raised lesions:
• papules-red bumps
• pustules-red bumps with pus-white heads, pimple, pyoderma are bacteria skin infection and they are famous for pustules when they rupture they form crusty circles, look like ringworms called epidermal coluret
• wheals/urticaria-flat, steep sided, hives, large raised "welt" (histamine) allergic respond
• nodules/tumors

• scales-flakes of stratum corneum
• crusts-dried remains of exudative lesions
• lichenification- bark like skin, liken scally layers, cronic irritation to skin, cronic allergic dog, it will get leathery thickened,crusty alligator skin looking, dogs with cushing disease will get on belly,raised thickening irregular suface of the skin usually cronic irritation/scratching
• alteration in pigmentation

• inflammation-edema(fluid build up), exudation(discharge), raised leasions, etc.
• acceleration of turnover of cells-scales, skin always turnsover possibly shedding
• increases mitotic activity-thickening
• increased melanocytes-pigmentation

• wood lamp-used for ringworms, base of broken hair shaft will turn candy apple green, flacky skin will turn green and will trick you
• DTM-dermatophyte test media-agar used to culture ring worms, pluck hair out on edge of lesion and press in agar and look for color change
• c/s-not done on skin much
• cytology- #1 diagnostic is the 3 slide tech. should be done on every skin case (otocytology, skin scrape, tape prep)
• impression-open ilceration mass,clean off first than take slide and press on lesion
• FNA- fine needle aspret, stick needle into it, material is going to be left in hub, blast on slide
• skin scraping
• biopsy-skin masses, skin lesions, tumors, auto immune disease like piphygus open vesicles on the edge of nose
• immune testing-ANA, coomb's,SLE

• antimicrobials-topical and systemic
• antiinflammatories-steriofd low dose
• antihistamines-burn, inflammorty, cascade
• nutraceuticals
• desensitization injections
• shampoos
• dips
• rinses

• food never been exposed to
• noval means new
• for food allergies
• can take several months
• no treat will ruin food trial

scapbies which are in elbow,edge of trunk and ears, rule out scabies with ivermectin make sure they are heartworm negative and not shelties or collies before despensing

• skin is the primary organ affected-GI tract and respiratory tract
• relaease of histamines, chemotactic factors in repsonse to a irritant-insects, plant material, fibers, food, others
• any lesion possible for reddness to severe trauma secondary to pruritis=excoriation which is self induced trauma

• allergies
• rarely find out what they are allergic to

• cyclosporine
• amino supressent dugs used a lot in allergic dogs
• suppresses the immune system

• allergic-immune reaction to antigen in contact
• rare in young
• chronic exposure
• irrirant-damage to keratinocytes from a substance-any age
• least common dermatitis seen
• easiest to diagnose and easiest to get rid of
• can be bedding or chemicals like laudry detergent
• ask if anything in their envt has changed
• localized

• generally has hairy skin-ventrum, chin,scrotum, between the toes
• distinct lesion line at hair line-hair coat great protection
• erthema to severe lesions

• biopsy
• patch testing

• avoidance
• steroids

• if know tge problem,px good for treatment
• if unknown, treatment may be lifelong

• IgE mediated (allergic reaction)(type 1) sensitivity to antigen
• histamine, cytokines, proteolytic, enzymese,etc.
• pollen, fibers, mold, dust, epithelium
• early onset 1-3 years may be seasonal
• allergic reaction to envt can be inhaled or dilivered transdermally

• pruitis to severe lesions
• axillary, facial, and pedal pruritis-inflammed ear
• recurrent pyoderma or otitis

• steroid trail-to rule it out see if it responds
• intradermal skin test
• serologic tests-RAST,ELISA-measure allergen specific IgE

• hyposensitization vaccines-allery shots, serum shots- start weak than go strong slowly exposing body to it to desenitize it
• steriods-prednazone
• antihistamines
• nutraceuticals-OFA essital fatty acid can block some steps of allergic reaction (omega 3 capsule) not enough by themself

• PATIENCE
• steriod side effects
• cariable success
• frequent rechecks esp. early on
• life long battle
• cushing disease-giving too much steriofd
• steriod play a role on stress

• allergic reaction to antigen in flea saliva
• worsens with age
• even 1 bite can have serious effects
• can be 1 flea something in the saliva
• found on base of tail
• hair lose on base of tail
• get rid of fast with capstar
• monthly version is confortis

• FLEAS-DUH
• dogs-christmas tree hair loss at tailhead
• cats-miliary dermatitis

• presence of flea
• IDST (serum test) and serologic test
• Bx-biopsy

• short term steriods
• flea control

flea control

atopy and food allergy because atopy clinical signs is facial rubbing and licking of paws and food allergies mimic that

• reaction to Ag in food
• most pets on food for over 2 years to sensitize
• poorly responsive to medication

• no set group signs
• lesions vary as always
• if less that 6 months or greater that 6 years most likely a food allergy than atopy

• food trail-take away what they are on and give them something noval, not treats, small amount work
• provocative exposure-ex. if allergic to liver give a lot to see what reaction they get
• Bx
• med trail

avoid what they are allergic to

• "life change" not food change
• PATIENCE
• its forever

• inflammatory reaction on the chin
• dogs-young, short coat breeds, probable genetic basis (bacteria infection around the face), DP, EBD, GD, Wm, Rot, GSHP,Mast
• cats-any age or breed, probable poor grooming called "feline acne" black heads

• dogs-folliculitis(molecules will get raised, plugged up follicles), furumculosis (recurring oil)
• cats-comedones(black head), pustules
• found on face can be food bowls if plastic

• clinical signs
• Bx
• C/S

• topical cleaning-bensoyle peroxide, Abx, shampoos
• topical meds-retinoids, mupirocin, other Abx
• steroids or Abx systemically

• cats-intermittent treatment
• dogs-long term treatment

• excessive licking leads to plaque
• boredom-lick grainuloles, thicken fibros, open, possible allergies, lost of sensation, hyoersensitivity
• local change in sensation
• possibly alergic disease
• large breed dogs, variable age

• thick, firm, ulcerated plaque
• usually dorsal/lateral carpus, tarsus, MC, MT

• lesion and location
• any indicated additional tests
• need to break the cycle

• increased activity
• covering
• you name it
• topical stuff
• entralesion
• steroids
• antihistamine
• antibiotics

• PATIENCE
• can be very rewarding or very poor response

• bacterial skin infection
• generally not a primary condition
• organisms include staph intermedia, and sometimes e.coli, proteus, and pseudomonas when complicated
• rarely if ever seen in cats
• secondary problem like to demodex and mostly allergies

• vary with depth of involvement
• superficial-papules, pustules, epid collarrettes
• deep-furunculosis, cellulitis, abscess
• often pruritic from the PD and the first condition

• presence of papules and pustules
• C/S-to rule out yeast
• SS-skin scrape-to run out mites
• Cytology

• Abx-based on C/S-longterm couple of week until skin clears
• ROT-10-14 days past clinical cure
• empirical-clavamox, first generation cephalexin
• seconday-baytril, advanced penicillins
• systemic antibiodics for skin use cyclosporine
• topical and antimicrobial shampoo

• steroids
• only short acting forms for initial pruritis like dexomethazone- to break cycle to make owner and animal happy
• long term use sets up for resistance

• need to find underlying cause and treat that
• use Abx as directed or can set up recurrence/resistance

• something stimulates intense licking and chewing
• trauma
• insect bite
• other localized inflammation
• trauma and moisture add to the irritation-cause irritation
• common in breeds with denser undercoat-GS, GR, LR, chow
• like acral lick dermatitis
• self induced
• something gets their attention and they start licking and chewing
• hot spot
• shave and clean, steroids, sedate topical antibacterial
• momedomax good for hot spot

• localized area of moist, ulcerated, inflamed skin
• acute onset-few hours

whatever is needed to find underlying cause

• corticosteroids-topical and/or systemic
• antibiotics
• correction of cause

• common in humid weather
• watch for fly strike in OD dogs
• can recur and be frustrating

• generally roaming male felines
• canine bites or penetrating trauma also
• contaminate bacteria "injected" in close space
• no area to drain out, build up pressure in the tissue layer, often e.coli, pseudomonas, staph, strept
• bacteria gets into tissue than there is a bacterial infection think of tom cat, fluid build up, usually need to drain it, side of face-anaerobic bacteria
• may or may not culture them
• WBC increase

• acute onset swelling
• area often very painful to the touch
• sometimes very thin area or has already ruptured
• pyrexia (fever) and malaise
• history of fighting

• by PE and history
• aspiration
• C/S or cytology

• lance and drain
• +/- Abx- clavamox, antirobe (clindamycin)

• generally recover well
• neutering and keeping in preventative

• grow in keratinized tissue
• carrier states in non symptomatic pets
• fibrosis masses
• fungal infection
• systemic fungal infection
• hard to treat
• topical fungal infection-ringworm

• dogs-lesions vary
• cats- more classic circular lesion

• wood lamp
• hair follicle examination
• DTM with mircoscopic identification of growth

• griseofulvin
• ketoconazole
• topical treatment after shaving-lime sulfur, miconazole shampoo

• drug side effects
• griseo-bone marrow suppression
• ketocon-hepatopathy
• quarentines sometimes needed-breeding facilities
• *potential zoonosis
• good hygiene usually preventative
• consult MD for treatment if contracted
• human RW (T.pedis, T. corpora) not transmissible to pets

• genus of mite living on the skin surface
• entire cycle is on the host-can live up to 10 days off host
• spread by contact
• walking dandruff
• easy to treat
• can burrow in humans but cant finish life cycle

dandruff and pruritis

• acetate tape exam
• SS

• topical pyrethrin based products over 3 weeks
• clean environment

• easily treated
• slight temporary zoonosis

• demodex canis mites live in the hair follicles
• *transmission from mom to pup at nursing
• normal fauna after that
• feline form exits but very rare
• normal inhabit of the skin
• exist in small numbers
• genetic predisposition
• deep scraping if no blood on microscope do again
• not a lot of false negative
• aka red mange
• can be localized on face or generalized-underlying immune disorder
• first seen in hair loss around the eyes
• symptoms are secondary to inflammation-unless mites in excess, no symptoms
• usually a dog that develops demodex has some underlying immune issue that's allowing the mites to take over
• localized demodex can cure themself
• demodecosis-mite has taken over (generalized state of mange)
• look like cigar with 8 legs when doing repetitive skin scraping looking for how many and if they are dead or alive

demodex can look like anything -hair loss

• SS from multiple sites
• easy to find on scraping
• generalized found in many sites, normal or not
• localized-only in affected skin
• SS used to evaluate response to treatment
• almost all cases of generalized demodex have secondary pyoderma so all are put on antibiotics

• only for generalized form
• amitraz (mitaban, tactic)- several protocols
• ivermectin and milbemycin
• treat until we see 2 negative skin scraping in a row
• don't treat localized forms
• if client ask can treat using ointment called gowanal

• drug effect-ivermectin in colles, dip
• DO NOT BREED patient with generalized Dz because genetic
• cure not always possible
• does not transmit to people or other pets

• sarcoptes scabei canis-dog
• cat-notedres cati
• lives on and burrows into the skin
• sensitivity to mite, feces, eggs, and dander
• transmission by direct contact-reservoir in wild canids-fox, wolf?
• scabies is zoonotic but cant complete its life cycle it will burrow under your skin and cause irritation
• most common pieces to find scabies is edge of ears, elbow and inguinal area
• ear scratch reflex test if positive will scratch when scratching pinna in pups 

• severe pruritis
• generally thin hair areas-ear tips and elbow
• secondary traumatic skin lesion
• aka excoriation cause self trauma from scratching
• scabies can have a lot of false negative
• treat with ivermectin to take off list

• skin scrape-a lot of false negative
• difficult to diagnose
• pinna response-consider 75-90% accurate-ear scratch reflex
• response to treatment

• ivermectin po or sq
• 1-2 weeks past cure
• topical dips-lime sulfure, paramiters
• don't use much anumore unless its sheltie or collie some if they have demodex

• very responsive to treatment
• does have a strong but short lived zoonotic potential
• can cause intense pruritis in people
• about a 10 day duration

• cause is unknown
• apocrine gland inflammation
• infection/impaction of anal sinuses
• anal sacculitis
• genetics suspected but not proven
• GS and IS most common breeds
• mean age 7 years- 7 months to 12 years
• draining tracts around the perional bacterial infection
• usually rupture demotological conditions

• dermatologic signs
• multiple chronic fistulas tracts and ulceration sinuses near the perianal region
• discharge and odor
• rectoanal signs
• tenesmus
• dyschezia
• licking and self mutilation
• a lot of irritation back there
• bloody

• slinical signs
• possible biopsy
• german shepard prone to it inflammatory infection anal gland
• fistulas tract-a draining tract that may not end
• unknown causes

• surgical treatment-no one technique-electrosurgery, cruosurgery, resection, laser, add anal sacculectomy
• medical treatment-promising results with cyclosporine-suppress inflammatory response

• keep area clean
• medication-consistent use
• results variable based on treatment and severity
• guarded in all but the minor causes
• not seen often 
• don't really know what causes it

• pemphigus foliaceus-think auto immune
• pemphigus vulgaris
• bullous pemphigoid
• discoid lupus erythematosis- effect skin and organs, kidney problems
• location in vesicles (bubbles), may rupture, or blisters
• effect different layers of skin on nose (black part)
• diagnose with biopsy
• generally an unknown cause
• alteration of the immune system to attack self-attacks layers of the skin-varies with disease, layers separate and fill with fluid, cause lesions
• generally very uncommon conditions

• mild signs similar to pyoderma
• classic signs include vesicles (bubbles) rupturing to erosions and ulcers
• location on the body differs with disease

• more generalized distribution including MM, MCJ
• more severe deep erosions
• secondary infections and other complication

• similar distribution to p vulgaris
• severity between foliaceus and vulgaris

• primarily around the head
• nasal planim, face, ear, mm
• lesion may be simple depigmentation at first
• progression to erosions and ulcerations

• biopsy- shoes depth/severity
• additional systemic testing-ANA, SLE, other

• steroids
• cytotoxis agents
• chrysotherapy-gold salts
• complication-Abx, fluiods, etc.
• comb test

• treatment can be lifelong
• rechecks very important
• vulgaris and bullous can be fatal
• discoid lupus can go into remission with treatment-progressive but not fatal without treatment