Derm1- Pyoderma

  1. Pyodermas are considered a(n) ____________ of a(n) ___________.
    secondary clinical manifestation; primary problem
  2. Any _____________ can cause a pyoderma.
    predisposing condition that alters the normal cutaneous defense mechanisms
  3. What are the cutaneous defense mechanisms against pathogenic bacteria? (8)
    hair cot, epidermal turnover, stratum corneum, epidermal lipids,sebum, immunoglobulins, interferon, normal non-pathogenic flora
  4. What are common predisposing conditions to pyoderma? (8)
    environment (temperature and humidity), allergic dermatitis, endocrinopathies, immunologic incompetence (neoplasia), idiopathic keratinization defects, ectoparasites, poor nutrition, long term glucocorticoid therapy
  5. What are common lesions associated with pyoderma? (3)
    pustules, epidermal collarettes, papules
  6. What is the main cutaneous pathogen in canine pyoderma? What is a less common primary pathogen?
    Staphylococcus pseudintermedius; less commonly Staph aureus
  7. What are secondary pathogens that are often involved in canine pyoderma? (5)
    Proteus, Corynebacterium, Bacillus, E. coli, ad Pseudomonas
  8. What drugs are ineffective against Staph pseudintermedius and aureus? Why? (5)
    penicillin, amoxicillin, and ampicillin- these bacteria produce beta-lactamase, which destroys these antibiotics; additionally, they usually have inherent resistance to tetracycline and stroptomycin
  9. What are the 2 types of surface pyodermas?
    acute moist dermatitis (hot spots), skin fold pyoderma
  10. What is the etiology of acute moist dermatitis? What are 5 common underlying causes?
    • self-inflicted: underlying problem causes licking, chewing, scratching--> trauma--> secondary infection
    • Underlying problems: allergic skin disease, ectoparasites, otitis externa, dirty matted coat, foreign body
  11. What are clinical signs/lesions associated with acute moist dermatitis? (4)
    erythema, edema, seropurulent exudate (yellow crust), painful
  12. How do you diagnose acute moist dermatitis? (3)
    history and clinical signs, try to ID underlying disease, skin cytology shows cocci and degenerate neutrophils
  13. How do you treat acute moist dermatitis? (6)
    control underlying disease process, clip hair around lesion, clean area, [if mild] topical steroid, [if severe] oral prednisone, [if generalized or multiple lesions] oral antibiotic
  14. Exudative, odiferous, and erythematous lesions within the skin folds.
    skin fold pyoderma
  15. What anatomic defects in certain breeds predispose them to maceration of the stratum corneum? (3)
    constant skin friction, poor air circulation, accumulation of moisture (tears, sebum, saliva, urine)
  16. What breeds are predisposed to lip fold pyoderma? (3)
    cock and springer spaniels, St. Bernards, bulldogs
  17. What is commonly the clients complaint with lip fold pyoderma?
  18. In what breeds is facial fold pyoderma most common? What are common concurrent conditions?
    Brachycepalics; traumatic corneal abrasions or ulcerations (due to scratching at face)
  19. What are common client complaints with vulvar fold pyoderma? (4)
    frequent licking at vulva, foul odor, painful urination, +/- secondary ascending UTI
  20. What breeds are predisposed to tail fold pyoderma? (3)
    English bulldog, boston terrier, pugs
  21. How do you treat skin fold pyoderma?
    • palliative therapy: clip hair, gentle daily cleansing, +/- topical steroid and antibiotics
    • Surgical ablation of defect: if owner wants permanent cure
  22. What are the most common locations for skin fold dermatitis? (4)
    nose, lips, vulva, tail
  23. Puppy pyoderma, superficial pyoderma occurring in puppies less than 1 year old.
  24. Describe the presentation of impetigo.
    subcorneal pustules that affect sparsely haired skin of the groin, abdomen, and axillae
  25. Impetigo may be associated with... (4)
    parasitism, poor nutrition, dirty environment, and viral infections
  26. Describe the treatment for impetigo. (4)
    none if mild, antibacterial shampoo or ointment, eliminate underlying cause, [severe/persistent] systemic antibiotics
  27. Bacterial infection involving the hair follicle and adjacent epidermis, but not beyond the hair follicle.
    superficial bacterial folliculitis
  28. Clinical signs/lesions of superficial bacterial folliculitis. (7)
    papules, pustules, erythema, epidermal colarettes, focal areas of alopecia; [short coated breeds only] moth-eaten alopecia, small tufts of hair stand up
  29. Superficial bacterial folliculitis RARELY affects what locations? (3)
    face, pinnae, distal extremities
  30. What are common pruritic underlying causes of superficial bacterial folliculitis? (4)
    atopic dermatitis, food allergy, flea allergy, scabies/chyeletiella
  31. What are common non-pruritic underlying causes of superficial bacterial folliculitis? (4)
    hypothyroidism, hyperadrenocorticism, idiopathic seborrhea, demodicosis
  32. How do you diagnose superficial bacterial folliculitis? (4)
    history/clinical signs, skin scrape to rule out demodex, skin scraping shows cocci and degenerate neutrophils, negative dermatophyte culture
  33. How do you treat superficial bacterial folliculitis?
    identify and treat underlying disease, systemic antibiotic 1 week past resolution of lesions, +/- antimicrobial shampoo
  34. What types of deep pyodermas present in SA medicine? (5)
    canine acne, nasal pyoderma, interdigital pyoderma, generalized deep pyoderma, pyotraumatic folliculitis (deep hot spot)
  35. What is the usual distribution of canine acne?
    chin +/- lips of short-haired breeds [young animals]
  36. Canine acne involves what two pathologic processes?
    folliculitis and furunculosis
  37. What types of lesions are associated with canine acne? (6)
    • Primary: papules, nodules, pustules
    • Secondary: ulcerations, draining tracts, purulent exudate
  38. How do you diagnose canine acne? (3)
    history/clinical signs, skin scraping to rule out Demodex, skin cytology usually shows pyogranulmatous, eosinophils
  39. Describe the txt of canine acne. (6)
    none if mild, Benzoyl peroxide shampoo periodic bathing, antiseptic wipes, topical steroids, mupirocin ointment, [if severe] systemic antibiotics
  40. What breeds are more commonly affected with painful nasal pyoderma? (4)
    GSD, Bull terrier, Collies, Pointers
  41. What lesions are associated with nasal pyoderma? (6)
    papules, pustules, crusting, folliculitis and furunculosis with draining tracts [all on dorsal aspect of muzzle]
  42. How do you diagnose nasal pyoderma? (4)
    history/clinical signs, skin scraping to rule out demodex, biopsy to rule out pemphigus and eosinophilic furunculosis, fungal culture to rule out dermatophytosis
  43. How do you treat nasal pyoderma? (3)
    gentle soak, antibacterial shampoo, systemic antibiotic
  44. What are 2 focal and 3 systemic causes of interdigital pyoderma?
    • focal: foreign body, local trauma
    • systemic: allergic dermatitis, psychogenic dermatitis, hypothyroidism
  45. What is the most common cause of interdigital pyoderma?
  46. What lesions are associated with interdigital pyoderma? (5)
    papules, nodules, bullae, ulcers, draining tracts
  47. How do you diagnose interdigital pyoderma? (5)
    history/clinical signs, skin scraping to rule out parasites, cytology consistent with deep pyoderma, fungal culture if suspect fungal deep infection, [more chronic cases] skin biopsy
  48. How do you treat interdigital pyoderma? (4)
    systemic antibiotics 8-12 weeks, topical soaks, surgery if formed dermal granulomas, try to ID underlying problem
  49. What breed is predisposed to generalized deep pyoderma?
  50. What lesions are associated with generalized deep pyoderma? (6)
    pustules, crusts, erosions, ulcers, draining tracts, pain
  51. What areas are most commonly affected by local deep pyoderma? (4)
    rump, lateral thighs, chest, legs
  52. ____________ is important to rule out with ANY deep pyoderma.
  53. How do you diagnose generalized deep pyoderma?
    deep skin scraping to rule out demodex, cytology, bacterial culture and susceptibility, +/- biopsy, fungal cultures to rule out deep fungal infection
  54. How do you treat generalized deep pyoderma? (3)
    antibiotic therapy based on culture and sensitivity, antibacterial baths, topical antibacterial medications/chlorhex spray
  55. What breed commonly gets deep hot spots?
    Golden Retrievers
  56. What are big rule-outs to diagnose deep hot spots?
    true hot spot (superficial), deep fungal infection
  57. What is important for management of deep hot spots?
    find an underlying cause
  58. How do you treat deep hot spots? (5)
    ID and treat underlying disease, systemic antibiotic based on culture and sensitivity, clip and remove hair in the area, antibacterial soaks, +/- oral prednisone
  59. What is a major difference between treating superficial and deep pyoderma?
    • uncomplicated superficial pyoderma- it is acceptable to try empirical therapy
    • deep- always culture and sensitivity
  60. What drugs should NOT be used as empirical treatment for pyoderma?
    penicillin, ampicilin, amoxicillin, tetracycline, streptomycin
  61. What drugs are acceptable to use as empirical therapy for pyoderma? (9)
    • Cephalosporins- first choice
    • Clindamycin

    • Lincomycin
    • Eryhtromycin (has to be given every 8 hours...low client compliance)
    • Oxacillin (injectable, expensive, every 8 hrs)
    • Trimethoprim sulfas (severe side effects)
    • Chloramphenicol (dangerous to human exposure- aplastic anemia; severe side effects; every 8 hrs)
    • Clavamox (good but has broader spectrum)
    • Enrofloxacin
  62. __________ is almost always used as adjunctive therapy for treatment of pyoderma.
    Topical therapy (wet soaks, antibacterial shampoos, antibacterial ointments and wipes)
  63. What is the most common cause of treatment failure for pyoderma?
    insufficient duration of therapy
  64. How long should you treat superficial vs deep pyoderma?
    • superficial- 7-10 days past clinical cure
    • deep- 14-20 days past clinical cure
  65. Methicillin resistance is conferred by ________.
    mecA gene
  66. Multi-Drug Resistant (MDR) staph is an organism that is...
    resistant to 3 or more classes of antimicrobial agents.
  67. What are risk factors for MRSP? (2)
    treated with antimicrobials in 30d prior to onset, have been hospitalized
  68. How can you prevent spread/colonization with MRSP? (4)
    prevent infection, diagnose and treat infection effectively, use antimicrobials wisely, prevent transmission
  69. When is staphage lysate used?
    important to control the infection with recurrent idiopathic resistant staph infection; concurrent antibiotic therapy; for life
Card Set
Derm1- Pyoderma
vetmed derm1