Derm - work in progress

macule/patch

primary

What lesion is this? Is it primary or secondary?

papule

primary

What lesion is this? Is it primary or secondary?

pustule

Papules eventuate into __________ (other lesion)

pustule

primary

What lesion is this? Is it primary or secondary?

plaque

primary

What lesion is this? Is it primary or secondary?

vesicle/bulla

primary

What lesion is this? Is it primary or secondary?

Nodule

primary

What lesion is this? Is it primary or secondary?

Wheal/Urticaria

primary

What lesion is this? Is it primary or secondary?

Epidermal collarette

secondary

What lesion is this? Is it primary or secondary?

Erosion/ulcer

secondary

What lesion is this? Is it primary or secondary?

a vescicle/bulla!

Knowing that an erosion and ulceration are both secondary lesions - what is their corresponding primary lesion that preceded them?

Lichenification

secondary

What lesion is this? Is it primary or secondary?

Excoriation

secondary

What lesion is this? Is it primary or secondary?

Scale

it can be primary or secondary

What lesion is this? Is it primary or secondary?

Crust

it can be primary or secondary

What lesion is this? Is it primary or secondary?

a pustule!

Knowing that a crust can be either primary or secondary - if it is in fact a secondary lesion, what would be the most probable primary lesion that proceeded the crust?

Follicular casts

it can be primary or secondary

What lesion is this? Is it primary or secondary?

Comedo/comedones

it can be primary or secondary

What lesion is this? Is it primary or secondary?

Hyperpigmentation

it can be primary or secondary

What lesion is this? Is it primary or secondary?

Hypopigmentation/Depigmentation

It can be primary or secondary

What lesion is this? Is it primary or secondary?

Alopecia

it can be primary or secondary

What lesion is this? Is it primary or secondary?

macule

scales

lichenification

excoriation

erosion

epidermal collarette

plaque

What sort of lesions are best for acetate tape cytology?

papule

pustules

lichenification

crust

erosion

epidermal collarette

plaques

What sort of lesions are best for direct impression slide cytology?

difficult to reach, sensitive places

interdigital spaces

lip/skin folds

Where on the body would you prefer to collect a sample using tape?

yeast

bacteria

What sort of etiological agents might you pick up on tape cytology?

yeast

bacteria

What sort of etiological agents might you pick up on direct impression cytology?

papule

callus

lichenification

crust

scale

epidermal collarette

erosion

excoration

suspected mites

What sort of lesions would lead you to pursue superficial skin scraping on your patient?

demodex

What sort of lesions would lead you to pursue deep skin scraping on your patient?

it has a rounded edge, which decreases the chance of laceration

What are some benefits to using a laboratory spatula as opposed to a scalpel blade for skin scraping?

mites - sarcoptes

lice

otodectes

fleas (flea dirt)

What parasites would you expect to identify from a superficial skin scraping?

mites - demodex

Which parasites would you expect to identify from a deep skin scraping?

potentially any lesion

What sort of lesions on the patient may indicate a need for biopsy?

NO!

because then you've lost your diagnostic sample

Should the surface of the skin be scrubbed/prepped prior to biopsy of a superficial lesion?

newer

________ lesions are more helpful for obtaining a meaningful biopsy

punch biopsy!

For a papule, would you take a punch biopsy or an FNA to get a diagnostic sample?

FNA!

For a pustule, would you take a punch biopsy or an FNA to get a diagnostic sample?

You'll want to lift up the crust with a scalpel blade and do an impression cytology of what's underneath

If ya got a crusty crust lesion - how/where would you get your diagnostic sample?

Alopecia

papules

scale

crust

hyperkeratosis

What kind of lesions would you attain a skin scraping of?

1) To support a suspicion of dermatophytosis caused by M. canis

2) Used to select fluorescent hairs for fungal/DTM culture and trichoscopy

Why would you even whip out a Wood's lamp to scan a patient?

will help us narrow down our diff. diagnoses because certain conditions/diseases are more common in certain ages and they also have will different chronicity

Why would knowing the age of your patient and the age of onset of a certain derm problem be useful?

parasites

genetic things

What are some derm. conditions we think of as common in neonate to 1month old patients?

allergies

autoimmune conditions

What are some derm. conditions we think of as common in our adult animals?

endocrine/metabolic

neoplasia

degenerative

What are some derm. conditions we think of as common in our senior animals?

certain infectious diseases have specific geographic distribution or a certain seasonality. This is also to help also narrow our diff. diagnoses

Why would we ask in a derm history about where a pet was from or their travel history?

This is a major factor in ruling in or out certain conditions/causes

Why would we ask the owner in a derm history about if their animal is itchy?

licking

chewing

biting

rubbing

scratching

head shake

booty scoot

What are specific behaviors that would would ask the owner if they've observed them in order to determine if the pet is itchy?

again - we ask in order to narrow down our differential diagnoses.

this might suggest the cause is infectious or environmental or their diet/food (if fed same thing) or potential toxicities

Why would we ask an owner if they have any other animals in their pet's environment that have similar skin problems? What skin conditions/diseases would be considered if the owner reports other animals have similar skin issues?

US

Complete the word for itch: prurit___