Transcript Pyodermas - Dr. Roberta Dev Anand

ATTITUDE IS
EVERYTHING
“A BAD ATTITUDE IS LIKE A FLAT
TIRE, YOU CAN’T GET TOO FAR
UNTIL YOU CHANGE IT.”
Definitions
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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
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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
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Superficial
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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
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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
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Rash: wide spread eruption of lesions
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Hyperpigmentation: increased pigmentation of skin
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Cyst: Fluctuant nodule; walled off, fluid filled nodule
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Papule: small, circumscribed, solid elevated lesion of the skin.
<1cm
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Pustule: a small, elevated, circumscribed, pus-containing lesion
of the skin.
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Definitions
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Rash: wide spread eruption of lesions
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Hyperpigmentation: increased pigmentation of skin
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Cyst: Fluctuant nodule; walled off, fluid filled nodule
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Papule: small, circumscribed, solid elevated lesion of the skin.
<1cm
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Pustule: a small, elevated, circumscribed, pus-containing lesion
of the skin.
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Abscess: localized collection of pus; larger than a pustule
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Cellulitis: swollen, tender area of skin with bacterial infection;
can develop into an abscess
Definitions
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Granulation tissue: new tissue in a healing wound;
consists of fibrous tissue and capillaries
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Erosion: loss of skin surface; shallow, moist, crusted
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Ulcer: loss of the epidermis resulting in exposure of
dermis
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Comedone: dilated hair follicle blocked with
sebum and other cellular debris
Pyodermas
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PYODERMA Definition: Bacterial infection of skin, superficial or
deep; Primary or secondary
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Pyoderma occurs when:
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skin surface broken
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skin macerated(thin, soft) by chronic exposure to moisture
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Normal bacteria altered
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Circulation impaired
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Immunocompetence impaired (aka immunosuppressed)
Superficial pyoderma- Lesion usually involve superficial epidermis
and heals w/o scarring, short duration
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Dogs - Staph intermedius
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Cats – Pasteurella multocida
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Common locations: the trunk
Pyoderma
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Deep pyodermas – gram-negative organisms (E. coli, proteus sp,
pseudomonas sp)
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Common locations: chin, nose, pressure points, feet, generalized,
skin folds
Risk factors
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Allergies
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Fungal infections
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Endocrine diseases
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Immune system incompetence
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Seborrhea
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Conformation – ex: skin folds
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Trauma
Pyoderma
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Physical Exam may show:
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papules
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pustules
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crusts
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epidermal collarettes
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circular erythematous or hyperpigmented spots
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alopecia
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scaling
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lichenification
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abscess, cellulitis, etc..
Pyoderma
EPIDERMAL COLLARETTES
PYODERMA
ERYTHEMA, PUSTULES
CASE #11
Superficial Pyoderma: “Hot spot”
Superficial Pyoderma:
“Hot Spot”
Superfical Pyodermas
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Acute Moist Dermatitis, Superficial pyotraumatic dermatitis
(“Hot Spots”)
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Clinical Signs:
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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
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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
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Dx: visual inspection of affected area
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TX
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Clip hair around lesion until skin normal
Cleanse skin with medicated shampoo
Topical Antibiotics/steroid creams or sprays
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(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
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CASE #12
Superficial Pyodermas
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Impetigo (aka superficial pustular dermatitis)
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Signalment: young dogs secondary to malnourishment and poor
hygiene
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Strep and Staph occasionally cultured from lesions
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Clinical Signs: non-pruritic, non-painful pustules and papules on
abdomen
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Diagnosis: Physical signs
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Treatment: Systemic Antibiotics, medicated shampoo
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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)
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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
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Treatment: Relieve symptoms by cleaning and drying
lesion
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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
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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
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Common in young short-haired dog breeds and
cats - can be chronic
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Clinical Signs:
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Chin swollen and painful to touch, dark spots => black
heads (comedones)
Dx: Appearance, r/o bite wounds, abscesses
ACNE
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Rx:
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clip hair on chin
clean daily with human acne product (helps with
follicular flushing)
systemic antibiotics
Topical Mupirocin ointment or cream
Client Info:
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May become chronic
Daily cleaning of chin
Use only ceramic or stainless steel bowls – NO PLASTIC
Deep Pyoderma
DEEP PYODERMA
Deep Pyodermas
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More difficult to treat than Superficial Pyodermas
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Often chronic
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Patients are often resistant to treatment or
immunosuppressed
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Frequently involves Staph intermedius, Proteus,
Pseudomonas, e. Coli
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Clinical Signs
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Papules and pustules,
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+/- fever
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Draining fistulas
Deep Pyodermas
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Dx: clinical signs
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Tx:
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Thorough cleaning
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Systemic Antibioics (clavamox, baytril, cephalexin)
Client Info
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Causative organism often drug resistant
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Treatment may be prolonged and expensive in large
breed dogs
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Some animals will never fully recovery