What are the 4 major presenting dermatology problems at vet clinics?
Pruritis (most common); otitis; alopecia; lumps and bumps (nodules, swellings and masses)
Summarise the problem oriented approach for dermatology cases
History, physical exam, problem list, differential diagnoses, diagnostic plan and tests, diagnosis, treatment
What specifics do you need for history in dermatology cases?
Background information, specific skin history, previous treatments, risk of heredity, infection or contagion, diet, environment and lifestyle, general health
Broadly, what history questions should you ask?
What's the problem, how long has it been present, has it changed over time? will cover most broad dermatology cases. Is it itchy? very important question
Is it itchy?
With pruritus, need to determine severity, affected areas, seasonality.
Why do a physical exam for a dermatology case?
Pathological changes are visible. Use vision, touch and smell. Include distance exam, look for lesions, critical to check distribution & examine whole animal. Look for parasites
What are the types of skin lesions?
Changes in skin colour, loss of hair, abnormal surface components, changes in skin thickness, defects in skin integrity, lumps and swellings
What causes erythema?
Redness, caused by vasodilation, inflamed skin, interchangeable with dermatitis. Non-specific sign. Causes: parasites, infections, allergies, environmental insults. Distribution map documents affected areas.
Why document or take note of lesion distribution?
Distribution is critical in dermatology, many conditions have specific distribution patterns
What are the different types of rashes?
Macule: little flat circle of different colour.
Papule: raised red pimple.
Pustule: like papule but with sack of pus in middle, can squeeze.
What is a staphylococcal ring?
A circular area of alopecia, with circular erythematous macule or ring, and a peripheral ring of scaling (epidermal collarette). Get multiple lesions, common in dogs. Caused by S. aureus, S intermedius, S pseudintermedius
What is hyperpigmentation?
Increased melanin in dermis. Causes: post-inflammatory (some breed disposition), endocrine disorders (adrenal, gonads, sometimes thyroid)
What is hypopigmentation?
Decreased melanin in dermis.
congenital or hereditary (albinism),
vitiligo (adult onset, melanocytes disappear),
environmental (freeze branding),
What is alopecia?
Loss of hair, can be partial or total including congenital.
Distribution: focal, multifocal, symmetrical or generalised, scar