Integumentary Disease

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kris10leejmu
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209612
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Integumentary Disease
Updated:
2013-03-26 13:46:53
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Animal Diseases Four
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Animal Diseases
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  1. What are the three layers of the skin?
    • Epidermis
    • dermis
    • subcutaneous
  2. 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
  3. What are the different types of skin diseases?
    • Pyoderma
    • malassezia
    • anal sac
    • lick granuloma
    • injection reactions
    • tumors
  4. What are pyodermas?
    Bacterial infection of the skin
  5. Are pyodermas primary or secondary conditions?
    Can be either
  6. Are pyodermas superficial or deep infections?
    Can be either
  7. What do superficial pyodermas involve?
    Only superficial epidermis and hair follicles
  8. For superficial pyodermas, healing occurs without ______.
    Scarring
  9. Does superficial pyoderma usually last a long time?
    No, short duration
  10. What are the different types of superficial pyodermas?
    • Acute moist dermatitis
    • skin fold pyoderma
    • impetigo
    • feline acne
  11. What are the clinical signs of superficial pyodermas?
    • Papules/pustules
    • epidermal collarettes
    • alopecia
    • +- pruritis
    • erythema
    • crusts
    • often staphylococcus spp.
  12. What is epidermal collarette?
    A circular lesion with a circular rim of scale and/or a peeling edge
  13. What is the treatment for superficial pyodermas?
    • Systemic antibiotics
    • topical antibiotics
    • antibacterial shampoos
    • identify and treat underlying disease if present
  14. What do deep pyodermas tend to become?
    Chronic
  15. Do deep pyodermas resist treatments?
    Yes
  16. What are deep pyodermas usually associated with?
    Immunosuppression
  17. What are deep pyodermas sometimes secondary to?
    Allergies
  18. How does staphylococcus intermedius cause deep pyodermas?
    Releases enzymes and toxins that produce severe tissue damage
  19. 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
  20. 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
  21. 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
  22. What is another term for acute moist dermatitis?
    Hot spot
  23. What are hot spots usually secondary to?  How does trauma usually happen?
    • Secondary to trauma
    • trauma usually self inflicted
  24. What do hot spots usually look like?
    • Red, moist, hot, painful
    • alopecia, pruritits
  25. 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
  26. How do we educate clients about hot spots?
    • Gentle cleansing daily will help speed recovery
    • ecollar as needed
    • owner should wash hands after treatment
  27. Where do we usually see skin fold pyoderma?
    where the skin is plentiful - lips, facial folds, vulvar folds, tail folds
  28. How do dogs get skin fold pyoderma?
    • trap moisture and heat
    • constant rubbing and trauma
    • secondary infection
  29. What are the clinical signs of a skin fold pyoderma?
    • foul odor
    • discharge
    • red, moist, ulcerated
  30. Are skin fold pyodermas a chronic problem?
    yes, require long term treatment
  31. How do we treat skin fold pyoderma?
    • clip and cleanse areas
    • dry the lesions - cornstartch
    • systemic antibiotics
    • surgical removal of excess skin
    • weight reduction
  32. 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
  33. What is another term for impetigo?
    puppy pyoderma
  34. What age does impetigo usually occur?
    under 1 years old
  35. What is impetigo?
    superficial pyoderma
  36. What are the clinical signs of impetigo?
    • occurs on sparsely haired areas - abdomen, axillae
    • pustules, collarettes
    • usually non-prurtic
  37. What is the bacteria that usually causes impetigo?
    staphylococcus spp.
  38. What is the treatment for impetigo?
    • many resolve spontaneously
    • many resolve once neutered
    • antibacterial cleansing
    • topical antibiotics
    • systemic antibiotics
  39. What is feline acne?
    • blackheads
    • pustules
    • fistulas
  40. Can feline acne be chronic?
    yes
  41. At what age does feline acne occur?
    can occur at any age
  42. What are the clinical signs of feline acne?
    • pustules, comedones
    • black grandular debris on chin hair
    • draining tracts
  43. 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
  44. 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
  45. What are other names for juvenile cellulitis?
    • juvenile pyoderma
    • puppy strangles
  46. What is juvenile cellulitis?
    skin lesions progressing to systemic disease - fever, anorexia, enlarged and abscessing lymph nodes
  47. 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
  48. What is the treatment for juvenile cellulitis?
    • aggressive therapy with corticosteroids
    • antibioitcs
    • topical thearpy
    • relapse is uncommon
    • use aggressive therapy to prevent scarring
  49. What is Malassezia dermatitis?
    lipophilic yeast
  50. Where do we normally find malassezia?
    normal flora of ear canal, skin, and mucosal surfaces
  51. What does Malassezia have a symbiotic relationship with?
    staphylococcus
  52. 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
  53. 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
  54. How do we diagnose malassezia?
    • cytology - impression smear, ear swab
    • round to oval budding yeast - peanut, shoe print, snowman
  55. How do we treat malassezia?
    • local - topical antifungals
    • generalized - topical antifungal shampoos, systemic antifungals if needed, antibiotics
  56. What are some examples of antifungal shampoos?
    • chlorhexidine
    • miconazole
    • ketoconazole
    • selenium sulfide
  57. Where are the anal glands located?
    located between muscle layers of the anus, at 4 and 8 o'clock
  58. What kind of fluid do anal sacs produce?
    oily, brown fluid
  59. How are anal glands naturally expressed?
    defectaion compresses sacs, expelling fluid onto surface of feces
  60. What can anal sacs result in?
    • impaction, infection
    • may abcess and rupture
  61. 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
  62. 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
  63. 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
  64. What is another term for a lick granuloma?
    canine acral lick granuloma
  65. What does acral mean?
    of or affecting a peripheral part, such as limbs or ears
  66. What are the clinical signs of a lick granuloma?
    • thickened plaque on distal extremity
    • perpetuated by self trauma
  67. 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
  68. 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
  69. How do we educate clients on lick granulomas?
    • long term therapy required
    • recurrence are common
    • lesion is often refractory to treat
  70. When do injection reactions occur?
    can occur 2 - 4 months after injection
  71. Is treatment usually required for injection reactions?
    no
  72. 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
  73. What are some benign skin tumors?
    • histiocytoma
    • lipoma
    • sebaceous cyst
  74. What kind of dogs usually get histiocytomas?
    yound dogs
  75. What do histiocytomas look like?
    • small button-like nodule
    • hairless
    • may be ulcerated
    • face, legs, lips, abdomen
    • hair grows rapidly
  76. What is the treatment for a histiocytoma?
    • usually regresses spontaneously
    • surgical excision
  77. How do we educated clients about histiocytomas?
    • not malignant, no metastasis
    • not seen in cats
  78. What are lipomas?
    neoplasia of liopcytes - adipose cells
  79. Are lipomas common in cats?
    no
  80. What are some common locations for lipomas?
    • chest
    • abdomen
    • legs
  81. What causes lipomas?
    cause unknown
  82. 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
  83. How do we diagnose a lipoma?
    • clinical signs
    • fine needle aspirate
    • biopsy
    • surgical excision and biopsy
  84. What is the treatment for a lipoma?
    • surgical excision
    • remove rapidly growing tumors
    • remove if causing locomotion problems
  85. 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
  86. 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
  87. How do we treat sebaceous cysts?
    • may never need treatment
    • surgical removal
  88. 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
  89. 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
  90. 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
  91. What is the treatment for basal cell carcinoma?
    wide surgical excision
  92. How do we educate clients on basal cell carcinoma?
    • rarely metastasize
    • recurrence possible at surgical site
  93. Where do we typically find fibrosarcomas in older dogs that is not vaccine induced?
    • face
    • legs
    • mammary glands
  94. 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
  95. 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
  96. 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
  97. What are the clinical signs of a fibrosarcoma that is vaccine induced?
    • solitary
    • infilatrative
    • poorly circumscribed
    • nodular to irregular
    • dermal/subcutaneous
    • may ulcerate
  98. How do we diagnose a fibrosarcoma that is vaccine induced?
    • biopsy
    • fine needle aspiration
  99. How do we treat a fibrosarcoma that is vaccine induced?
    • wide surgical excision
    • amputation of affected limb
    • radiation pre or post-op
    • chemotherapy
  100. 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
  101. 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
  102. Where should we give the rabies vaccine?
    low on right rear leg
  103. Where should we give the FeLV vaccine?
    low on left rear leg
  104. Where should we give the FVR-CP vaccine?
    right shoulder
  105. What do mast cell tumors arise from?
    mast cells
  106. 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
  107. How do we diagnose mast cell tumors?
    • impression smears
    • biopsy
  108. How do we treat mast cell tumors?
    • wide surgical excision
    • radiation
    • chemotherapy
    • cryosurgery
  109. How do we educated clients on mast cell tumors?
    • 30% of cases metastasize
    • recurrence is possible
    • cats - lesions usually benign
    • prognosis variable
  110. What do benign melanomas look like?
    small, slow growing, hairless, have dark pigmentation
  111. What do malignant melanomas look like?
    large, dome-shaped, attached, varying pigment
  112. Where are melanomas common?
    • oral
    • skin
    • digits
  113. How do we diagnose a melanoma?
    biopsy
  114. How do we treat melanoma?
    • radical surgical excision
    • radiation
    • chemotherapy
  115. 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
  116. Where do squamous cell carcinomas occur?
    in thinly haired, non-pigmented, sun-damaged skin
  117. Where on cats do we usually see squamous cell carcinomas?
    pinnae, eyelids, nose
  118. Where on dogs do we usually see squamous cell carcinomas?
    • toes
    • trunk
    • scrotum
  119. What do squamous cell carcinomas look like?
    lesions raised, ulcerated, cauliflower - like, necrotic odor
  120. How do we diagnose squamous cell carcinomas?
    biopsy
  121. How do we treat squamous cell carcinomas?
    • complete surgical excision
    • laser
    • cryosurgery
    • radiation
  122. 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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