Equine Dermatology Quiz
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Questions and Answers

What is a key aspect to consider when diagnosing skin lesions in horses?

  • The age of the horse is the only relevant factor.
  • Only the history of the lesion's growth.
  • The possible presence of other lesions and their locations. (correct)
  • All lesions are likely sarcoids.

    • Which of the following is NOT commonly used to describe a skin lesion?

  • Hyperkeratotic
  • Neoplastic (correct)
  • Alopecic
  • Verrucous

    • What would be an important question to ask an owner regarding a skin lesion?

  • Is the lesion painful to touch? (correct)
  • Is the horse receiving regular exercise?
  • How many horses are in the area?
  • Has the horse recently changed its diet?

    • Which condition involves a thickening of the epidermis as a potential diagnosis for skin lesions?

    <p>Exuberant granulation tissue</p> Signup and view all the answers

    What is an important factor in the assessment of skin lesions in horses?

    <p>The duration and pattern of growth of the lesion.</p> Signup and view all the answers

    What might a thickened, verrucous central area of a lesion suggest?

    <p>Hyperkeratosis.</p> Signup and view all the answers

    The slow and gradual growth of a skin lesion in horses may indicate what?

    <p>A benign condition.</p> Signup and view all the answers

    What is a common misconception about skin lesions in horses?

    <p>Sarcoids are the only type of skin tumor in horses.</p> Signup and view all the answers

    What is the primary aim of using lime sulphur spray/dip?

    <p>To manage and control dermatological issues</p> Signup and view all the answers

    Which of the following is NOT a potential cause of pastern dermatitis?

    <p>Fungal infections</p> Signup and view all the answers

    What is the treatment of choice for melanoma when lesions are small?

    <p>Surgical removal</p> Signup and view all the answers

    What is an important caution regarding melanomas?

    <p>They can become malignant over time.</p> Signup and view all the answers

    Which diagnostic method is used to assess atypical melanocytes in suspected melanoma cases?

    <p>FNA (fine needle aspiration)</p> Signup and view all the answers

    What type of organism is dermatophytosis (ringworm)?

    <p>Fungus</p> Signup and view all the answers

    Which of the following is an example of a neoplasm that should be considered when diagnosing skin masses?

    <p>Sarcoid</p> Signup and view all the answers

    What common misconception is associated with benign neglect regarding melanomas?

    <p>They can remain benign indefinitely.</p> Signup and view all the answers

    What is the primary differential diagnosis for the pony's intense pruritus?

    <p>Culicoides hypersensitivity</p> Signup and view all the answers

    Which of the following environmental factors should be evaluated for their role in the pony's condition?

    <p>Stagnant water for breeding of Culicoides midge</p> Signup and view all the answers

    What treatment is suggested to reduce exposure to the inciting cause of pruritus in the pony?

    <p>Fly rugs and masks</p> Signup and view all the answers

    Which anti-inflammatory medication is mentioned for use in treatment?

    <p>Prednisolone</p> Signup and view all the answers

    What precaution should be considered when using steroid therapy in treatment?

    <p>Risk of laminitis</p> Signup and view all the answers

    When is the optimal time to start control measures for midges?

    <p>Before midge season begins</p> Signup and view all the answers

    What diagnostic method is used to check for other potential allergens affecting the pony?

    <p>Intradermal skin test</p> Signup and view all the answers

    What is a possible indicator of an ongoing louse infestation in the pony?

    <p>Self-induced alopecia</p> Signup and view all the answers

    What is a disadvantage of laser surgery mentioned?

    <p>Requires prolonged healing by secondary intention</p> Signup and view all the answers

    Which treatment is considered the best option for peri-ocular sarcoids?

    <p>Radiotherapy</p> Signup and view all the answers

    What is a potential risk when using intralesional chemotherapy?

    <p>Local effects such as swelling</p> Signup and view all the answers

    What characteristic of cryotherapy is highlighted in the content?

    <p>Painful and high recurrence rate if used alone</p> Signup and view all the answers

    What type of reaction is associated with the efficacy of topical therapeutic agents?

    <p>Variable local reaction depending on drug choice</p> Signup and view all the answers

    What should be considered about the cost of radiotherapy?

    <p>It is expensive and poses a radioactive hazard</p> Signup and view all the answers

    Which question would be least relevant to ask the owner of the pony concerning pruritus?

    <p>What is her favorite treat?</p> Signup and view all the answers

    What might be a consequence of the pony's prolonged scratching?

    <p>Self-induced alopecia and skin excoriations</p> Signup and view all the answers

    Which treatment option is considered suitable for nodular sarcoids without a root?

    <p>Ligation/banding</p> Signup and view all the answers

    What is a major benefit of chemotherapy or electrochemotherapy in treating sarcoids?

    <p>Increases cytotoxicity significantly with electrical impulses</p> Signup and view all the answers

    What is a downside of performing sharp surgery on sarcoids?

    <p>High risk of recurrence if used as the sole therapy</p> Signup and view all the answers

    Which treatment option can be very effective when used intradermally but is difficult to acquire?

    <p>BCG</p> Signup and view all the answers

    What does 'benign neglect' imply in the treatment of sarcoids?

    <p>Non-painful management with possible future risks</p> Signup and view all the answers

    What is a common complication associated with cryotherapy?

    <p>Possibility of scarring or skin damage</p> Signup and view all the answers

    Which of the following statements about periocular sarcoids is true?

    <p>Skin expanders can assist in reconstructing the eyelid.</p> Signup and view all the answers

    What is a limitation of using ligation as a treatment for sarcoids?

    <p>It is unsuitable for all types of sarcoids.</p> Signup and view all the answers

    What is the primary diagnostic method that offers rapid results for identifying Trichophyton equinum and Trichophyton mentagrophytes?

    <p>Fungal qPCR</p> Signup and view all the answers

    What should be done before applying Enilconazole washes for treating a horse with fungal infections?

    <p>Remove crusts first</p> Signup and view all the answers

    What is a significant characteristic of exuberant granulation tissue in horses?

    <p>It leads to poor skin mobility and movement.</p> Signup and view all the answers

    Which treatment method is NOT typically associated with the management of proud flesh?

    <p>Bacterial infection therapy</p> Signup and view all the answers

    What is a key benefit of maintaining effective record keeping during dermatological exams in horses?

    <p>It aids in surgical planning and tracking changes.</p> Signup and view all the answers

    Which condition must be differentiated from proud flesh during diagnosis?

    <p>Papillomatosis</p> Signup and view all the answers

    What is the recommended interval for applying Enilconazole washes on horses?

    <p>Every three days for four repeats</p> Signup and view all the answers

    What common misconception exists regarding the treatment of exuberant granulation tissue?

    <p>Topical treatments are always sufficient.</p> Signup and view all the answers

    Study Notes

    Equine Dermatology Engagement Session

    • Dr Alissa Cooper led the session
    • She has a BSc, BVetMed, PGCertVetEd, FHEA, and MRCVS qualifications
    • She is a lecturer in equine clinical practice at the University of Surrey

    Learning Objectives

    • Discuss the presentation, diagnosis, and treatment for sarcoids in horses
    • Discuss the presentation, diagnosis, and treatment for dermatitis in horses
    • Discuss the presentation, diagnosis, and treatment for melanoma in horses
    • Discuss the pathogenesis, diagnosis, and treatment for exuberant granulation tissue in horses

    Case Study 1

    • A 12-year-old Haflinger gelding presented with a skin lesion on its right caudal abdomen
    • The lesion had been present for two years, showing slow and gradual growth
    • The lesion's diameter increased gradually, and recently developed more thickening in the center
    • Questions to ask the owner include whether the lesion is itchy, location of additional lesions, if other horses are affected, previous treatments, known causes, recent changes, and general health/preventative health
    • The lesion is well-circumscribed, alopecic, and has epidermal thickening, hyperkeratosis, verrucous change centrally, pigment change, and lichenification
    • Differential diagnoses include sarcoid (occult/verrucous-mixed), dermatophytosis, scar, chronic skin irritation/rubbing, and autoimmune disease
    • Diagnostics to consider are skin scrape/hair pluck to rule out other differentials, skin biopsy (incisional or excisional), and awareness of potential risks of making the condition worse
    • A treatment plan must be developed
    • Treatment options for sarcoid include topical therapy (AW5 cream, imiquimod, 5-fluorouracil), surgery (ligation/banding, laser surgery, sharp resection), chemotherapy/electrochemotherapy, radiotherapy, cryotherapy, immune modulation, photodynamic therapy, and benign neglect
    • Periocular sarcoids may require topical/surgical treatment, with skin expanders potentially necessary for reconstruction of the lid
    • Intralesional therapy using BCG can be effective but can be difficult to acquire
    • Radiation is also possible
    • Owners should be warned that treatment may be a long and difficult process, with some cases showing surprising success. Invasive fibroblastic lesions on the muzzle may be targeted with cryotherapy and intralesional 5FU
    • Note that surgical removal is usually the best treatment if lesions are still small

    Case Study 2

    • A 10-year-old Welsh pony mare presented with intense pruritus during the summer, increasingly severe over three seasons
    • The pony scratches its rump, tail, and mane, resulting in self-induced alopecia and excoriations
    • Similar lesions are noted on the mane
    • Questions to ask the owner include how long they've owned the horse, its current management (stabled/turned out), turnout conditions, rug use, topical shampoos, diet, parasite control history, and previous treatments
    • Differential diagnoses include Culicoides hypersensitivity (sweet itch), dermatophilosis (rain scald), dermatophytosis (ringworm), contact hypersensitivity, hypersensitivity to other flies/insects, and louse infestation
    • Diagnostics include clinical presentation evaluation, environment evaluation (stagnant water for midge breeding), hair plucks, skin scrapes, scurf examination, rule out of ectoparasites, intradermal skin test, checks for/rule out other allergens, and a biopsy
    • Management involves management changes to control or reduce exposure to the inciting cause (fly rugs/masks, fly repellent), moving field during summer, stabling during dawn and dusk, fans in stable, starting control measures before midge season, and other options such as SSS/lotions/baths
    • Treatment may include medications to reduce pruritus severity like anti-inflammatories (prednisolone/dexamethasone), avoiding long-term steroid use, and considering laminitis risk. Antihistamines also may be helpful
    • Desensitization therapy and nutritional supplements may also be considered

    Case Study 3

    • A 6-year-old cob gelding presented with pruritus to distal limbs
    • The signs developed after a move to new yards in September
    • The horse stamps its feet, rubs its legs, and bites its pasterns
    • No previous history of skin conditions
    • Questions to ask the owner include details about the timing, symptoms progression, history of skin conditions/past treatments, and other animals/environment that may be in contact with the horse
    • Lesions are described as diffuse, alopecic, erythematous, with scurfy scales and exudate, skin thickening, and pruritic.
    • Diagnostic approach involves a skin scrape, sticky tape impression, hair plucks for fungal rule out, and biopsy.
    • Preliminary diagnosis includes chorioptic mange (Chorioptes bovis), skin dwelling/scurf feeding mite, and more prevalent in house horses; consideration that the outbreak can be caused by shared equipment
    • Management advice includes clipping hair, removing bedding, cleaning and disinfecting the stable daily, treating contact animals, a pig oil/white mineral oil and yellow sulfur patch test, and stopping sharing equipment.
    • Treatment includes thorough cleaning with appropriate shampoo (keratolytic or selenium sulfide). Historically, Doramectin (Dectomax injection) may be given, and topical treatments such as Fipronil spray (effective if clipped) and Ivermectin/moxidectin
    • Further management may also involve lime sulfur spray, repeated every 7-14 days

    Case Study 4

    • A 12-year-old grey Connemara mare presented with several nodular masses in the perineal region, gradually increasing in size over 6-8 months.
    • Clinical examination revealed additional nodules in the right groin region and a swelling in the left parotid region.
    • Differential diagnoses include melanomas, sarcoids, and mast cell tumors
    • Diagnostics involve fine needle aspiration (FNA) to identify pleomorphic and atypical melanocytes, and biopsy to confirm atypical melanocytes
    • Melanoma treatment options include surgical removal (easier when lesions are small), diode laser, chemo/electrochemotherapy, cryosurgery, Oncept vaccine + Tyrosinase inhibitor, and autologous vaccine. Cimetidine treatment can be given for possible treatment. It is important to not neglect it as melanomas should not be underestimated
    • Benign neglect should not be a treatment option and should be avoided because they can lead to malignant issues.

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    Equine Dermatology Engagement Session PDF

    Description

    This quiz focuses on key aspects of diagnosing skin lesions in horses, covering definitions, assessments, and potential treatments. It explores common misconceptions and important questions for horse owners regarding dermatological conditions. Test your knowledge on equine skin health!

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