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26 Cards in this Set
- Front
- Back
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What are differentials for pruritis
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infectious
ectoparasites allergic |
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What are differentials for rash / pustules
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pyoderma
eosinophil pustulosis contact allergy/irritation trauma auto immune |
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What indicates high level of pruritis
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Scratching in the exam room
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what is diagnosis approach to pruritis
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Derm data base:
skin scraping trichogram impression smear fungal culture cytology of pustule |
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What are primary factors of pruritis
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-Allergic disease: atopy, food adversion, contact allergy, flea allergy
-Ectoparasites -Inflammatory disease: autoimmune, infectious -Disorders of cornification: seborrhea |
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What are predisposing factors to pruritis
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Breed
age endocrine disorder environment temp and humidity husbandry |
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What are perpetuating factors to pruritis
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Bacterial infection (staph)
Malassezia dermatophytes / fungus Inappropriate treatment - excessive bathing |
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What type of skin is itchy
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dry skin
heat |
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What is the threshold theory
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-every animal has a certain amount of normal itch
-When factors are added above the threshold it becomes clinical -Threshold is moveable |
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What causes CS to get worse
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problems accumulate
more blocks |
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How do you manage pruritis
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-Id and control perpetuating factors
-ID and treat primary factor |
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What are diagnostic keys
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-Organized diagnostic and therapeutic approach to ID:
perpetuating factors primary factors predisposing factors -good client ed -keep accurate records -Follow up exams are crucial |
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What do you do on intitial visit (Step 1)
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Signalment
History PE |
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What are keys to pick up in history
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-Chronology of condition, age of onset, seasonal or non seasonal, progressive or static
-Severity -effect of previous treatment |
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What do you look for on PE
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-Evidence of pruritis
Alopecia Excoriations saliva staining broken hairs -look for causes of pruritis: pyoderma ectoparasites -Inflammatory vs non inflammatory diseases |
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What are components of Derm data base
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Skin scraping
impression smear - yeast Trichogram Fungal evaluation - culture preferred |
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What is treatment strategy
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-ID perpetuating (2nd) factors
-Treat perpetuating (2nd) factors -ID underlying (1) factors |
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What are optional tests
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Fungal culture
fecal float ear cytology flea control (cats) hypoallergenic diet - takes time to work skin biopsy |
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What are possible perpetuating factors
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-Malassezia
-Bacterial dermatitis - Staph |
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What are superantigens
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Staph
activate CD4 T cells act as virulence factors not processed by APCs |
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What is the effect of SA in atopic dermatitis
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trigger ready response in atopic dermatitis animals
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What are key historical features for Malassezia
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-severe, progressive pruritis
-partial response to steroids -lick feet / rub face / perianal pruritis / otitis externa / wt loss -Hx of allergy patient that was managed well but now relapsing -Allergy patient that cannot be controlled |
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What are differentials for Intense pruritis
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Scabies
Malassezia dermatitis Flea allergy dermatitis Familial seborrhea combintions of severely mild-moderate pruritic conditions |
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What are PE findings with Malassezia
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-severe pruritis
-erythema / scale / crust dermatitis -progression to lichenified / hyperplastic / hyperpigmented skin -alopecia due to pruritis -lymphadenomegaly -yeast otitis (60-80% cases) |
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Where are the Malassezia problem areas
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-Interdigital - dorsal, ventral
-ventral neck -Perianal / perivulvar -axillary / inguinal -lip folds -base of claws |
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What are Malassezia diagnostics
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-Derm data base
-Cytology -Find underlying cause - alergy test, food trial |
