Lecture: Intro

Question 1

Approach to clinical cases

Answer 1

• Signalment
• History: Take good notes
• Physical examination
• List of problems and differential diagnoses
• Diagnostic tests
• Therapy

Question 2

History

Answer 2

• Onset
• Length of time of disease
• Seasonality
• Relatives
• Zoonosis

Question 3

History of Medications

Answer 3

• Antibiotics?
  
  • dose
  • duration
  • response
  • alone or with glucocorticoids
• flea control
• topical therapy
• special diet
• supplements

Question 4

Physical exam

Answer 4

• look for primary lesions
• may need to clip area
• Prurities (on a scale of 1-10)
• Look for fleas, flea dirt

Question 5

Primary lesions

Answer 5

• Macule
• Papule
• Plaque
• Pustule
• Vesicle
• Bulla
• Nodule
• Wheal
• Tumor

Question 6

Macule

Answer 6

• altered skin color, no elevation

Question 7

Answer 7

Macules

Can be dark spots as well

Question 8

Papule

Answer 8

• Solid raised lesion
• distinct borders
• less than 1 cm in diameter

Question 9

Answer 9

• Papule
• raised and itchy

Question 10

Plaque

Answer 10

• Elevated lesion with a flattened top greater than 10mm in size

Question 11

Answer 11

• Plaque

Question 12

Pustule

Answer 12

• Elevations villed with pus
• common in
  
  • bacterial infections
  • inflammatory skin diseases
• Follicular vs non follicular

Question 13

DDX for papular/pustular eruption

Follicular

Answer 13

• Demodex
• Dermatophytes
• Bacterial: Staphylococcus

Question 14

DDX for papular/pustular eruption

Non follicular

Answer 14

• Flea
• Food
• Contact
• Scabies
• Drug eruption
• Dermatomyositis
• Sterile pustular diseases
• Autoimmune

Question 15

Answer 15

Papular/pustular eruption

Question 16

Vesicle

Answer 16

• Small, clear fluid-filled blister
  
  • less than 1 mm in diameter
  • possible causes
    
    • acute contact dermatitis
    • some autoimmune skin diseases

Question 17

Answer 17

• Vesicle

Question 18

Bulla

Answer 18

• Clear fluid-filled blister > 10mm in diameter
• common causes
  
  • burns
  • contact dermatitis
  • drug reactions
  • autoimmune diseases

Question 19

Nodule

Answer 19

• Firm lesions that extend into the dermis or subcutaneous tissue

Question 20

Answer 20

• Nodule

Question 21

Tumor

Answer 21

• Swelling or enlargement
• Usually, not always neoplastic

Question 22

Answer 22

• Tumor

Question 23

Wheal (Hive)

Answer 23

• Sharply circumscribed skin elevation from superficial dermis edema
• typical of allergic reactions
• illustrates diascopy: lesion disappears when you press on it

Question 24

Secondary lesions

Answer 24

• epidermal collarettes
• scale
• crust
• scar
• ulcer
• excoriation
• lichenification
• hyperpigmentation
• hyperkeratosis

Question 25

Epidermal collarettes

Answer 25

* Secondary lesions developed from previous pustules

Question 26

Answer 26

Epidermal collarette

Question 27

Scale

Answer 27

* Flake of abnormal or compacted epithelial cells

Question 28

Crust

Answer 28

* Dried exudate (scab) * leukocytes * bacteria (common)

Question 29

Scar

Answer 29

* Fibrotic area resulting from healing of a wound or lesion (deep to dermis, I think) * Typically associated with * alopecia * depigmentation * thinner dermis

Question 30

Ulcer

Answer 30

* Loss of substance on a cutaneous surface exposing inner layers or tissues * May imply full thickness loss of epidermis

Question 31

Answer 31

* ulcer

Question 32

Excoriations

Answer 32

* Superficial erosion (doesn't get deep to dermis) * usually implies scratching or abrasion

Question 33

Lichenification

Answer 33

* Thickening of skin * secondary to trauma/inflammation * indicated chronicity * can be accompanied by hyperpigmentation

Question 34

Answer 34

Lichenification

Question 35

Hyperpigmentation

Answer 35

* Increased pigmentation * commonly associated wtih lichenification

Question 36

Hyperkeratosis

Answer 36

* Thickening of stratum corneum due to increased number of keratinized cells * Typically occurs in footpads

Question 37

Depigmentation

Answer 37

* Loss of pigmentation * typical of inflammatory/neoplastic processes affecting the basement membrane

Question 38

Answer 38

Salivary staining

Question 39

Skin scraping

Answer 39

* Superficial * Deep

Question 40

Direct microscopic exam

Answer 40

* Useful to detect arthrospores

Question 41

Cytology

Answer 41

* Useful to dx secondary infections * skin * tape * swab * ear * swab * Fine needle aspirates of masses

Question 42

Malassezia does not respond to

Answer 42

steroids