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Download Pyodermas - Dr. Roberta Dev Anand
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ATTITUDE IS EVERYTHING “A BAD ATTITUDE IS LIKE A FLAT TIRE, YOU CAN’T GET TOO FAR UNTIL YOU CHANGE IT.” Definitions • • • • • • • • Dermatology: study of diseases of the skin Dermatosis: skin disease Alopecia: hairloss Seborrhea: Excessive secretion of sebum (oily secretion of the sebaceous glands composed of fat and epithelial debris) Scale: Flakes of stratum corneum on the skin surface or hair coat; various colors Erythema: increased redness Collarette: circular arrangement of scale with central area of hyperpigmentation Crust: accumulation of dead cells and exudate on skin surface Definitions Ectoparasites: external parasites Skin Scraping: method of examining skin for parasites Dermatophyte: fungi that grow on the skin Dermatomycosis: fungal skin infection Dermatophytosis (ringworm): a skin infection with keratinophilic fungi Pyoderma: Bacterial infection of skin Superficial Deep Fungal culture – lab test used to grow dermatophytes for identification Bacterial culture and sensitivity: lab test used to grow and identify bacteria from lesions and determine antibiotic sensitivity Definitions Impetigo: Superficial bacterial skin infection seen in young dogs “puppy pyoderma” Acne: Pores clogged with oil forming “blackheads”, esp chin Lesion: area of altered skin Rash: wide spread eruption of lesions Hyperpigmentation: increased pigmentation of skin Cyst: Fluctuant nodule; walled off, fluid filled nodule Papule: small, circumscribed, solid elevated lesion of the skin. <1cm Pustule: a small, elevated, circumscribed, pus-containing lesion of the skin. Definitions Rash: wide spread eruption of lesions Hyperpigmentation: increased pigmentation of skin Cyst: Fluctuant nodule; walled off, fluid filled nodule Papule: small, circumscribed, solid elevated lesion of the skin. <1cm Pustule: a small, elevated, circumscribed, pus-containing lesion of the skin. Abscess: localized collection of pus; larger than a pustule Cellulitis: swollen, tender area of skin with bacterial infection; can develop into an abscess Definitions Granulation tissue: new tissue in a healing wound; consists of fibrous tissue and capillaries Erosion: loss of skin surface; shallow, moist, crusted Ulcer: loss of the epidermis resulting in exposure of dermis Comedone: dilated hair follicle blocked with sebum and other cellular debris Pyodermas PYODERMA Definition: Bacterial infection of skin, superficial or deep; Primary or secondary Pyoderma occurs when: skin surface broken skin macerated(thin, soft) by chronic exposure to moisture Normal bacteria altered Circulation impaired Immunocompetence impaired (aka immunosuppressed) Superficial pyoderma- Lesion usually involve superficial epidermis and heals w/o scarring, short duration Dogs - Staph intermedius Cats – Pasteurella multocida Common locations: the trunk Pyoderma Deep pyodermas – gram-negative organisms (E. coli, proteus sp, pseudomonas sp) Common locations: chin, nose, pressure points, feet, generalized, skin folds Risk factors Allergies Fungal infections Endocrine diseases Immune system incompetence Seborrhea Conformation – ex: skin folds Trauma Pyoderma Physical Exam may show: papules pustules crusts epidermal collarettes circular erythematous or hyperpigmented spots alopecia scaling lichenification abscess, cellulitis, etc.. Pyoderma EPIDERMAL COLLARETTES PYODERMA ERYTHEMA, PUSTULES CASE #11 Superficial Pyoderma: “Hot spot” Superficial Pyoderma: “Hot Spot” Superfical Pyodermas Acute Moist Dermatitis, Superficial pyotraumatic dermatitis (“Hot Spots”) Clinical Signs: red, moist, painful areas, oozing Common in thick coated dogs (Labs, Newfoundlands, Ger. Shepherds, Chows) Usually in hot moist summer months Hair loss, very pruritic Develops very fast Dx: visual inspection of affected area TX Clip hair around lesion until skin normal Cleanse skin with medicated shampoo Topical Ab’s/steroid creams or sprays (ex: Betagen Spray) Treat original disease (fleas, allergies) Systemic steroids, Abs Superficial Pyodermas Dx: visual inspection of affected area TX Clip hair around lesion until skin normal Cleanse skin with medicated shampoo Topical Antibiotics/steroid creams or sprays (ex: Betagen Spray) Treat original disease (fleas, allergies) Systemic steroids, Antibiotics Client Info Gentle cleansing BID Owner should wash hands after treatment E-collar may be necessary CASE #12 Superficial Pyodermas Impetigo (aka superficial pustular dermatitis) Signalment: young dogs secondary to malnourishment and poor hygiene Strep and Staph occasionally cultured from lesions Clinical Signs: non-pruritic, non-painful pustules and papules on abdomen Diagnosis: Physical signs Treatment: Systemic Antibiotics, medicated shampoo Client Info: Not contagious, usually clears by 6 months WE ARE ALL CONNECTED “I AM, BECAUSE WE ARE.” CASE #13 Skin Fold Pyoderma (aka Intertrigo) Occurs in breeds with abundant skin Facial folds, vulvar folds, tail folds Spaniels, Bulldogs, Pekingese, Pugs, Bostons, obese dogs Folds trap moisture, heat and bacteria Usually chronic Dx: Affected area moist, red, ulcerated Skin Fold Pyoderma Treatment: Relieve symptoms by cleaning and drying lesion Sx reduction of skin fold may be only permanent solution Weight loss in obese patients Antibiotics, chlorhexidine-containing pledgets Antibacterial and/or benzoyl peroxide shampoos Client Info Require long term medical management Keep area dry and clean Keep hair/folds away from eyes Skin Fold Pyoderma – Vaginal Folds Skin Fold Pyoderma – Lip Folds CASE #14 Acne Common in young short-haired dog breeds and cats - can be chronic Clinical Signs: Chin swollen and painful to touch, dark spots => black heads (comedones) Dx: Appearance, r/o bite wounds, abscesses ACNE Rx: clip hair on chin clean daily with human acne product (helps with follicular flushing) systemic antibiotics Topical Mupirocin ointment or cream Client Info: May become chronic Daily cleaning of chin Use only ceramic or stainless steel bowls – NO PLASTIC Deep Pyoderma DEEP PYODERMA Deep Pyodermas More difficult to treat than Superficial Pyodermas Often chronic Patients are often resistant to treatment or immunosuppressed Frequently involves Staph intermedius, Proteus, Pseudomonas, e. Coli Clinical Signs Papules and pustules, +/- fever Draining fistulas Deep Pyodermas Dx: clinical signs Tx: Thorough cleaning Systemic Antibioics (clavamox, baytril, cephalexin) Client Info Causative organism often drug resistant Treatment may be prolonged and expensive in large breed dogs Some animals will never fully recovery
