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Dermatology
Intro & CAD
90
Veterinary Medicine
Professional
03/18/2012

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Cards

Term
What % of non-routine presentations to SA practitioners involve dermatological conditions?
Definition
35%
Term
Is Cheyletiella zoonotic?
Definition
Yes
Term
Is Scabies zoonotic?
Definition
Yes
Term
Primary, secondary, or both? Macule
Definition
Primary
Term
Primary, secondary, or both? Patch
Definition
Primary
Term
Primary, secondary, or both? Papule
Definition
Primary
Term
Primary, secondary, or both? Plaque
Definition
Primary
Term
Primary, secondary, or both? Pustule
Definition
Primary
Term
Primary, secondary, or both? Vesicle
Definition
Primary
Term
Primary, secondary, or both? Bulla
Definition
Primary
Term
Primary, secondary, or both? Wheal
Definition
Primary
Term
Primary, secondary, or both? Nodule
Definition
Primary
Term
Primary, secondary, or both? Tumor
Definition
Primary
Term
Primary, secondary, or both? Cyst
Definition
Primary
Term
Primary, secondary, or both? Alopecia
Definition
Both
Term
Primary, secondary, or both? Scale
Definition
Both
Term
Primary, secondary, or both? Crust
Definition
Both
Term
Primary, secondary, or both? Follicular cast
Definition
Both
Term
Primary, secondary, or both? Comedo
Definition
Both
Term
Primary, secondary, or both? Hyperpigmentation
Definition
Both
Term
Primary, secondary, or both? Hypopigmentation
Definition
Both
Term
Primary, secondary, or both? Epidermal collarette
Definition
Secondary
Term
Primary, secondary, or both? Erosion
Definition
Secondary
Term
Primary, secondary, or both? Ulcer
Definition
Secondary
Term
Primary, secondary, or both? Scar
Definition
Secondary
Term
Primary, secondary, or both? Fissure
Definition
Secondary
Term
Primary, secondary, or both? Lichenification
Definition
Secondary
Term
What are other names for Canine Atopic Dermatitis?
Definition
Canine atopy, Canine atopic dz, CAD
Term
What is CAD?
Definition
A genetically predisposed inflammatory & pruritic skin dz w/ characteristic clinical features associated w/ IgE Abs most commonly to environmental allergens
Term
What are the most common allergens involved in CAD? Give examples.
Definition
House dust mites; Dermatophagoides farinae, D. pteronyssinus, Bloomia tropicalis
Term
What are some less common allergens involved in CAD?
Definition
Food storage mites, Pollens of grasses/weeds/trees, Human & Feline dander, Mold allergens
Term
There is significant cross-reactivity btw house dust mites & _____.
Definition
Food storage mites
Term
What are 2 food storage mites involved in CAD?
Definition
Acaris siro & Tyrophagus putrescentiae
Term
What is the main route of access of allergens in CAD?
Definition
Through the skin, aided by Langerhans cells w/i the epidermis armed w/ IgE Ab
Term
What are less common routes of access of allergens in CAD?
Definition
Ingestion; Inhalation
Term
In CAD, IgE attaches to _____ & _____ via high affinity _____.
Definition
Mast cells & blood basophils; Fc receptors
Term
What preformed mediators are released upon access of allergens in CAD?
Definition
Histamine, Heparin. Serotonin, Proteinases
Term
What newly generated mediators are released upon access of allergens in CAD?
Definition
Plt activating facor; PGs; Thromboxanes; Leukotrienes
Term
What breeds appear to be protected against CAD, w/ lower than expected incidence?
Definition
Poodles & mixed breed dogs
Term
When does the age of onset of CAD peak?
Definition
1-2y
Term
_____% of CAD commences prior to 1yo
Definition
16%
Term
CAD almost never commences below _____ (age) and rarely before _____ or after _____.
Definition
3m; 6m, 7y
Term
CAD is primarily a _____ dz, although _____ signs may be noted.
Definition
Dermatological; Hay-fever
Term
_____ is the cardinal sign of CAD, and can be seen in _____% of cases.
Definition
Pruritis; 99%
Term
What is the predominant distribution of CAD?
Definition
Facial, Ventral, Pedal
Term
What type of lesions are seen in most cases of CAD?
Definition
Macules & Papules
Term
What is the main site of otitis externa in CAD cases?
Definition
Inner surface of ear flap & vertical canal
Term
_____ cells of atopic dogs adhere more readily to Staph.
Definition
Stratum corneum
Term
What occurs in CAD with bacterial overgrowth w/o epidermal invasion?
Definition
Exotoxin superAg release +/- Anti-Staph IgE
Term
What bacteria is commonly involved in the secondary complications of CAD?
Definition
Staphylococcus
Term
What yeast is commonly involved in the secondary complications of CAD?
Definition
Malassezia
Term
What are some chronic skin changes associated w/ CAD?
Definition
Seborrhea, Hair loss, generalized erythema, hyperpigmentation, lichenification
Term
What are some important rule outs for CAD?
Definition
Parasitic dz, Food allergy, Contact allergy
Term
Contact allergy is always a _____ and restricted to the _____.
Definition
Macular/papular eruption; Hairless areas
Term
_____% of cases seem to have classical AD but no evidence of allergen-specific IgE.
Definition
5-10%
Term
What are 2 possible ways to demonstrate allergen-specific IgE? (Which is preferred?)*
Definition
Intradermal skin test; Serological tests*
Term
What are disadvantages of IDT?
Definition
Pt is off antihistamines for 10d & off corticosteroids for at least a week for every month of Tx
Term
_____ does not inhibit IDT.
Definition
Atopica (cyclosporin)
Term
What is the best type of serological test for Dx of CAD?
Definition
ELISA
Term
T/F: Presence of (+) skin test or (+) serological test justifies Dx of CAD.
Definition
F
Term
What is usually the time course for Tx of CAD?
Definition
Life-long
Term
What % of CAD cases cure spontaneously or are cured w/ immunotherapy?
Definition
10-20%
Term
What is generally the cornerstone of the therapeutic approach to CAD?
Definition
Hyposensitization (Immunotherapy)
Term
In what cases of CAD is immunotherapy not indicated?
Definition
Short Season; Older pt
Term
With hyposensitization, most dermatologists limit the mixture to _____ allergens.
Definition
10
Term
What types of preparations are available for hyposensitization?
Definition
Aqueous extracts & Alum precipitates
Term
What are 2 possible SE of hyposensitization? (Which is more common?)*
Definition
Anaphylaxis & Exacerbation of pruritis*
Term
What is the incidence of anaphylaxis w/ hyposensitization?
Definition
~1/200-1/500
Term
If anaphylaxis results from hyposensitization, what is the Tx?
Definition
Epinephrine & IV corticosteroids; abandon immunotherapy
Term
What should be done if hyposensitization results in exacerbation of pruritis?
Definition
Give corticosteroids; Lower dose of Ag
Term
With what response to hyposensitization should a CAD patient be reassessed?
Definition
Little/no improvement after 9 months
Term
What are some possible ways to evict house dust mites?
Definition
Parasiticides & insect growth regulators (Virbac Knockout/Indorex)
Term
In the case of medical Tx of CAD, what type of parenteral corticosteroids should be avoided?
Definition
Long-acting injectables
Term
What parenteral corticosteroids can be used in the Tx of CAD?
Definition
Prednisolone, Methylprednisolone
Term
What topical corticosteroids can be used in the Tx of CAD?
Definition
Triamcinolone (Genesis), Hydrocortisone aceponate (Cortevance), Hydrocortisone shampoo
Term
How is topical hydrocortisone aceponate metabolized?
Definition
In the skin (not systemically absorbed)
Term
In what % of CAD cases are antihistamines effective?
Definition
20-30%
Term
Give examples of antihistamines used to treat CAD.
Definition
Hydroxyzine HCl, Diphenhydramine HCl, Chlorpheniramine HCl, Clemestine, Astemizole, Doxepin HCl, Trimeprazine
Term
What essential fatty acids can be given PO as part of the CAD Tx?
Definition
Linoleic acid; Linolenic acid; Gamma-linolenic acid; Eicosapentanoic acid
Term
_____ days of FA therapy are required before one can accurately assess the response.
Definition
30-60
Term
What PGE analog has shown >50% improvement in ~50% of CAD cases?
Definition
Misoprostol
Term
In Tx of CAD, how does Cyclosporin compare to corticosteroids wrt efficacy & onset of action?
Definition
As effective; Slower onset
Term
What type of SE are common w/ cyclosporin?
Definition
GI
Term
In CAD, what can be used to assist barrier function?
Definition
Ceramide-containing shampoos; Phytosphingosine; +/- oral EFAs
Term
What shampoos have anti-seborrheic effects?
Definition
coal tar, sulphur, salicylic acid
Term
What shampoos have antipruritic effects?
Definition
Colloidal oatmeal
Term
What shampoos remove allergen from the skin?
Definition
any and all
Term
What shampoos have anti-inflammatory effects?
Definition
Corticosteroid or antihistamine
Term
What shampoos have antibacterial effects?
Definition
benzoyl peroxide, CHX, monosaccharides (anti-adherance)
Term
What type of shampoos have anti-yeast effects?
Definition
CHX (>2%), Miconazole, Ketoconazole
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