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Download Seborrhea - Dr. Roberta Dev Anand
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DERMATOLOGY MISCELLANEOUS TOPICS Seborrhea Normal skin cell turnover – 3 weeks Time period is shortened in seborrhea Accelerated (few days) => build up of keratin (dead cells) => flakes Altered sebaceous gland secretions Normal secretion of oil in or near hair follicles enriches skin Seborrhea Seborrhea Causes Primary: hereditary as in Amer. Cocker Spaniel, Eng. Springer Spaniel, Westies, Basset Hounds Secondary: causes: disease/injury to skin from other Allergies, parasites, nutritional disorders, immunemediated, endocrine disorders (hypothyroidism) Types Seborrhea sicca: dry, only scaliness Seborrhea oleosa: oily + scales Seborrhea sicca DRY and SCALY Seborrhea oleosa Seborrhea – Treatment Medicated shampoos Reduce scaling – sulfur and salicylic acid (keratolytic, keratoplastic), selenium sulphide (keratoplastic, keratolytic, antifungal, degreasing) Conditioners Clip hair so shampoo can penetrate If secondary, treat underlying cause Antifungal and/or antibacterial meds Omega-3 fatty acid supplements Anti-inflammatory, anti-pruritic properties Seborrheic Fungal Dermatitis Malassezia species Cause infection when skin surface altered/abnormal or immunosuppressed Diagnosed by cytology (stained slides) Normal in small amounts on the skin Samples can be obtained via tape prep or impression smear Tx: 2% miconazole/2% chlorhexidine shampoo Selenium sulphide Other Antifungals: ketoconazole, clotrimazole, miconazole Oral ketoconazole Seborrheic Fungal Dermatitis Atopy (Atopic dermatitis) Defintion: Allergy to inhaled environmental substances and manifested through irritation of skin and ears, usually starting at 1-2 yrs of age Allergens: Dust mites Pollens Feathers Molds Animal and human dander Tobacco smoke Clinical Signs: Pruritus Self-trauma to skin +/- secondary bacterial infection Staining of hair from saliva Licking/chewing feet Alopecia, scaling, hyperpigmentation Atopy Dx Accurate hx critical R/o food allergies, flea allergy dermatitis, sarcoptic mange, contact dermatitis BEFORE diagnosis of atopy can be made Intradermal skin testing – most accurate to identify offending allergen Tx: No cure ID and eliminate cause best treatment ATOPICA – contains cyclosporin A (immunosuppressor), Antiinflammatory and antipruritic Treat any bacterial or fungal infections before using immune suppressive drugs Medication (steroids, Abs) and allergy shots (desensitization) Omega 3 fatty acids Antihistamines-more effective if given before symptoms occur Atopy Alopecia and erythema of the periocular skin and alopecia, erythema, and hyperpigmentation of the muzzle. Alopecia and hyperpigmentation of the muzzle. Appearance Skin Testing Skin testing is performed to identify the allergens involved in allergic disease. Under profound sedation an area of hair on the chest is shaved and small injections of substances known to be possible allergens made. After 15-20 minutes the reactions are recorded Food Allergies 10% of all allergies Usually starts between 2-6 yrs Processed foods increase likelihood of reaction Fillers, artificial colors, preservatives Food allergies in dogs Food Allergies Dx and Tx Elimination diets: new source of protein for 3 mo. If improves, reintroduce original protein to see if symptoms recur – confirmation of dx Use new diet. May develop allergies to new diet later Treatment Food allergies Treatment Foods can be obtained based on venision and potato, fish and potato, egg and rice, duck and pea, and even kangaroo. Generally recommends duck and potato based foods for dogs How do you diagnose food intolerance (food allergy)? The patient is fed a hypoallergenic diet for 60-90 days. This allows the body to become desensitized to the offending allergens. When the previous diet is fed back to the pet, an acute hypersensitivity reaction may occur. This helps to identify that a food was the source of the allergic signs Evaluating Feline Pruritus Feline Food Allergy Year round pruritus Variable response to steroids 10-30% with concurrent GI symptoms Common offending proteins -Dairy, fish, beef, pork, chicken, rabbit, horse, lamb, eggs, clams, "commercial diets" Managing Feline Pruritus Diagnosing food allergy 10 week food trial Royal Canin Green pea & duck/rabbit Hills Z/D Allergies
