Feline Acne Overview and Clinical Presentation
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Feline Acne Overview and Clinical Presentation

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Questions and Answers

What is the most likely cause of follicular distention with keratin in cats?

  • Demodicosis
  • Bacterial infections
  • Allergic dermatitis (correct)
  • Malassezia infection

    • Which of the following treatments should be used with caution due to potential serious side effects?

  • Benzoyl peroxide
  • Cyclosporine
  • Systemic isotretinoin (correct)
  • Salicylic acid

    • What secondary invaders might be present in lesions of a cat with suspected acne?

  • Fungi
  • Bacteria and Malassezia (correct)
  • Yeast
  • Demodex mites

    • What are some of the signs of severe cases of cat acne?

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

    Which of the following treatments may cause irritation when used on cat acne?

    <p>Benzoyl peroxide and salicylic acid</p> Signup and view all the answers

    Which parasites are indicated as primary agents in demodicosis in cats?

    <p>Demodex mites</p> Signup and view all the answers

    What is the relationship between human medications and treatments indicated for cat acne?

    <p>They should be avoided due to potential drug interactions</p> Signup and view all the answers

    What type of dermatitis is most associated with feline acne?

    <p>Allergic dermatitis</p> Signup and view all the answers

    What is the primary initial treatment for swelling of the chin in severe cases?

    <p>Gentle clipping and soakings</p> Signup and view all the answers

    What should be monitored for in follow-up treatment of affected cats?

    <p>Relapses of the condition</p> Signup and view all the answers

    Which factor is NOT commonly associated with the etiology of the condition described?

    <p>Hormonal imbalances</p> Signup and view all the answers

    What should be done during treatment after lesions have resolved?

    <p>Taper off medication over a 2- to 3-week period</p> Signup and view all the answers

    Which of the following is a cause of pain related to the condition?

    <p>Bacterial furunculosis</p> Signup and view all the answers

    What is indicated for recurrent episodes of the condition?

    <p>Life-long maintenance treatment</p> Signup and view all the answers

    What type of testing may be included in the diagnosis process?

    <p>Intradermal allergy testing</p> Signup and view all the answers

    Which medication is explicitly noted as contraindicated for breeding animals?

    <p>Systemic isotretinoin</p> Signup and view all the answers

    What is the most effective topical treatment for acne that has better penetration?

    <p>Tretinoin gel</p> Signup and view all the answers

    In cases of resistant infections, what is a commonly used systemic antibiotic?

    <p>Amoxicillin with clavulanate</p> Signup and view all the answers

    Which diagnostic procedure is generally NOT necessary for acne, unless in selected cases?

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

    Which of the following antiseborrheic agents is used for treating Malassezia infection?

    <p>All of the above</p> Signup and view all the answers

    Which topical medication is suggested for reducing scar tissue formation during severe inflammatory episodes?

    <p>Oral prednisolone</p> Signup and view all the answers

    Which culture type would be performed to identify dermatophytosis?

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

    What is a common cleansing agent for the treatment of acne?

    <p>Benzoyl peroxide</p> Signup and view all the answers

    Which antibiotic ointment is used specifically for treating infected skin lesions?

    <p>Mupirocin 2%</p> Signup and view all the answers

    What is the primary characteristic of acne in dogs, which differentiates it from human acne?

    <p>It is associated with folliculitis and furunculosis.</p> Signup and view all the answers

    Which diagnostic procedure is specifically helpful for determining the presence of bacteria or yeast in the lesions of affected dogs?

    <p>Impression cytology.</p> Signup and view all the answers

    What is the recommended initial dosage for the tapering of oral corticosteroids in treating significant inflammation associated with canine acne?

    <p>0.5 mg/kg/day.</p> Signup and view all the answers

    What risk is associated with the long-term use of gentamicin/steroid-containing ointments in treating dog acne?

    <p>Alopecia and cutaneous atrophy.</p> Signup and view all the answers

    Which factor is NOT typically considered a contributing element to canine acne?

    <p>Nutritional deficiencies.</p> Signup and view all the answers

    In cases of resistant infections in dogs, which systemic antibiotic could be indicated?

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

    What is the main purpose of performing a bacterial culture and sensitivity test in cases of dog acne?

    <p>To select appropriate antibiotics for treatment.</p> Signup and view all the answers

    What are the clinical signs most often associated with acne in dogs?

    <p>Localized swelling and redness.</p> Signup and view all the answers

    What is the main purpose of adding oral antibiotics in the treatment of acne when topical treatments are insufficient?

    <p>To prevent chronic scarring</p> Signup and view all the answers

    Which approach should not be taken when dealing with lesions to avoid exacerbating the inflammation?

    <p>Scrub the areas vigorously for cleanliness</p> Signup and view all the answers

    Which breed characteristic is noted as a potential risk factor for the development of acne?

    <p>Short-coated breeds may be genetically predisposed</p> Signup and view all the answers

    When evaluating for allergic diseases in relation to acne, what should be considered as a contributing factor?

    <p>Underlying allergic or atopic diseases</p> Signup and view all the answers

    What effect may trauma from squeezing acne lesions have on the condition?

    <p>It can cause further inflammation</p> Signup and view all the answers

    Which associated condition is known to potentially exacerbate feline acne?

    <p>Allergic or atopic disease</p> Signup and view all the answers

    What is the recommended cleaning method for managing acne lesions?

    <p>Daily cleaning with chlorhexidine-containing products</p> Signup and view all the answers

    Which type of dermatitis is relevant when considering differential diagnoses in cases of acne?

    <p>Contact dermatitis</p> Signup and view all the answers

    What are the characteristics of lesions associated with the condition described?

    <p>Lesions may contain pus or blood in advanced stages.</p> Signup and view all the answers

    Why are bacterial cultures and sensitivities performed in cases of suspected folliculitis?

    <p>To isolate bacteria that may not be present in early stages.</p> Signup and view all the answers

    What might the initial therapeutic approach involve when managing lesions on the chin?

    <p>Frequent cleaning with antimicrobial solutions.</p> Signup and view all the answers

    What is a potential outcome of long-term use of topical steroids?

    <p>Adrenal suppression and skin thinning.</p> Signup and view all the answers

    Which breeds are noted for being predisposed to this allergic skin condition?

    <p>Boxer, Doberman pinscher, and Rottweiler.</p> Signup and view all the answers

    How might a dog's behavioral habits impact the condition of their chin?

    <p>Rubbing on surfaces may exacerbate the lesions.</p> Signup and view all the answers

    What change occurs as the disease progresses in the lesions?

    <p>Erythematous papules enlarge and may rupture.</p> Signup and view all the answers

    Which of the following best describes the expected course and prognosis of the condition if treated appropriately?

    <p>Successful management but may require long-term topical treatment.</p> Signup and view all the answers

    What is a common factor that could initiate a lick–itch cycle in pets?

    <p>Local irritation or lesion</p> Signup and view all the answers

    Which of the following is a recommended method for monitoring the healing of lesions?

    <p>Monitoring the level of licking and chewing</p> Signup and view all the answers

    Which condition is known to potentially exacerbate the effectiveness of treatments for feline acne?

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

    What underlying cause should be considered if lesions persist despite treatment for acne?

    <p>Psychogenic causes</p> Signup and view all the answers

    Which treatment option is often considered when no underlying disease is detected?

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

    What should be performed to rule out secondary infections in persistent lesion cases?

    <p>Bacterial, fungal, or ectoparasitic testing</p> Signup and view all the answers

    Which factor complicates the prognosis of lesions if underlying causes are not identified?

    <p>Guarded nature of the prognosis</p> Signup and view all the answers

    What is considered a necessary part of the follow-up treatment process?

    <p>Physical restraints to prevent licking</p> Signup and view all the answers

    What is the primary behavioral indicator of Acral Lick Dermatitis?

    <p>Compulsion to lick the limb</p> Signup and view all the answers

    Which diagnostic procedure is essential for differentiating between related conditions in cases of Acral Lick Dermatitis?

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

    What is a commonly observed histopathological finding in dogs with Acral Lick Dermatitis?

    <p>Epidermal hyperplasia</p> Signup and view all the answers

    What medication is advised to combine with caution due to possible interactions in the treatment of this condition?

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

    Which breed is most commonly affected by Acral Lick Dermatitis?

    <p>Great Dane</p> Signup and view all the answers

    What type of allergy testing is recommended for identifying potential food allergies in affected dogs?

    <p>Intradermal allergy testing</p> Signup and view all the answers

    Which of the following is considered a rare but potentially useful treatment for alleviating symptoms?

    <p>Intralesional corticosteroids</p> Signup and view all the answers

    Which condition must be ruled out when examining a dog with symptoms of Acral Lick Dermatitis?

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

    Which diagnostic procedure is least likely to be necessary when diagnosing feline acne?

    <p>CT scan</p> Signup and view all the answers

    What is the role of food elimination trials in the context of skin conditions?

    <p>To identify allergic reactions to food</p> Signup and view all the answers

    Which treatment could potentially lead to toxicity in cases of skin infections?

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

    Which of the following is a method for proving self-trauma due to pruritus in animals?

    <p>Shirts/collar</p> Signup and view all the answers

    In diagnosing skin conditions, which factor is least associated with systemic disease evaluation?

    <p>Skin biopsy analysis</p> Signup and view all the answers

    What feature is typical in sphynx cats exhibiting alopecia universalis?

    <p>Hereditary complete absence of primary hairs</p> Signup and view all the answers

    Which feline breed is known for having autosomal recessive alopecia?

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

    What is a common characteristic of skin affected by Demodex gatoi mites?

    <p>Pruritic and scaly patches on the skin</p> Signup and view all the answers

    Which condition could result in folliculitis secondary to alopecia?

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

    What is another term for decreased secondary hairs in alopecia universalis?

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

    How might the skin of a cat affected by sebaceous glands malfunction appear?

    <p>Oily with a noticeable shine</p> Signup and view all the answers

    What is commonly observed in the fur of Siamese cats with hypotrichosis?

    <p>Typically thin and sparse coat</p> Signup and view all the answers

    Which type of skin lesion is more likely to occur with the presence of inflammation due to parasites?

    <p>Scaly and potentially pruritic lesions</p> Signup and view all the answers

    What is a main factor that can lead to telogen effluvium in cats?

    <p>Sudden hormonal changes</p> Signup and view all the answers

    Which condition is characterized by hair regrowth over weeks following medication discontinuation?

    <p>Telogen effluvium</p> Signup and view all the answers

    Which type of alopecia is most commonly associated with inflammatory injuries?

    <p>Post traumatic alopecia</p> Signup and view all the answers

    What is a rare cause of alopecia mentioned that can occur at the site of application?

    <p>Topical medication application</p> Signup and view all the answers

    Which of the following is NOT a known cause of hair follicle cycling disorders?

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

    What effect does parturition not have on hair follicle cycling?

    <p>Does not impact hair regrowth</p> Signup and view all the answers

    What is the primary visible symptom associated with auto-immune alopecia areata?

    <p>Symmetric areas of hair loss</p> Signup and view all the answers

    Which of the following causes post traumatic alopecia in cats?

    <p>Direct damage to skin and follicles</p> Signup and view all the answers

    Which condition is associated with scaly alopecia and may result in skin fragility in its advanced stages?

    <p>Epitheliotropic lymphoma</p> Signup and view all the answers

    What is a significant treatment associated with hyperadrenocorticism and can impact conditions like pemphigus foliaceus?

    <p>Megestrol acetate</p> Signup and view all the answers

    What skin condition is characterized by nonpruritic alopecia with a rapid progression and bilateral symmetry?

    <p>Mural lymphocytic folliculitis</p> Signup and view all the answers

    Which type of dermatitis is characterized by dramatic scaling that begins on the head and neck and is nonpruritic?

    <p>Thymoma-associated exfoliative dermatitis</p> Signup and view all the answers

    Which treatment is suggested for managing Demodicosis in cats?

    <p>Fluralaner topically</p> Signup and view all the answers

    In cases of Hyperthyroidism, what is a commonly observed symptom related to alopecia?

    <p>Self-barbering due to discomfort</p> Signup and view all the answers

    Which condition is most commonly recognized as a risk factor for demodicosis in cats?

    <p>Feline leukemia virus (FeLV)</p> Signup and view all the answers

    What finding is commonly associated with paraneoplastic alopecia in cats?

    <p>Often related to pancreatic adenocarcinomas</p> Signup and view all the answers

    What secondary issue may arise in cats suffering from dermatological conditions like Hyperadrenocorticism?

    <p>Severe skin fragility</p> Signup and view all the answers

    Which characteristic is typical for squamous cell carcinoma in situ in older cats?

    <p>Papillomatous plaques and scaly crusts</p> Signup and view all the answers

    Which skin condition can potentially cause skin lesions in humans through zoonotic transmission?

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

    What symptom might indicate hyperadrenocorticism in a cat, potentially complicating treatment options?

    <p>Thin skin with vulnerability to tearing</p> Signup and view all the answers

    What is a primary characteristic of skin affected by Mural lymphocytic folliculitis?

    <p>Thinning and waxy texture</p> Signup and view all the answers

    Which treatment option is typically indicated for resolving thymoma-associated exfoliative dermatitis?

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

    Which of the following treatments is indicated for secondary problems like hyperkeratosis?

    <p>Shampoo and topical therapy</p> Signup and view all the answers

    What is a common sign of allergic dermatitis in cats when compared to other conditions?

    <p>Ineffectiveness of antihistamines</p> Signup and view all the answers

    Which condition is characterized by generalized truncal alopecia with scaling and intense erythema?

    <p>Epitheliotropic lymphoma</p> Signup and view all the answers

    What is a common feature of dermatophytosis in dogs?

    <p>Partial to complete alopecia with scaling</p> Signup and view all the answers

    Which breed characteristic is associated with sebaceous adenitis?

    <p>Hair straightening and thinning</p> Signup and view all the answers

    Chronic corticosteroid use in dogs is most likely to cause which of the following conditions?

    <p>Iatrogenic Cushing's syndrome</p> Signup and view all the answers

    Which condition involves multifocal alopecia with signs of inflammation and crusting?

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

    What is often seen in pinnal alopecia or pattern baldness?

    <p>Miniaturization of hairs</p> Signup and view all the answers

    Which factor is considered a secondary consequence of allergic dermatitis?

    <p>Self-trauma due to pruritus</p> Signup and view all the answers

    What is a distinguishing feature of alopecia caused by demodicosis?

    <p>Presence of comedones and scaling</p> Signup and view all the answers

    What condition is likely indicated by symmetric alopecia of the flanks and perineal area in a female dog?

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

    Which breed is NOT commonly associated with congenital hypotrichosis?

    <p>German shepherd</p> Signup and view all the answers

    What is a common external cause of noninflammatory alopecia?

    <p>Infectious dermatophytosis</p> Signup and view all the answers

    Which condition is associated with symmetrical truncal alopecia and hyperpigmentation?

    <p>Alopecia X</p> Signup and view all the answers

    Which breed is particularly noted for presenting breed-related alopecia?

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

    What might be indicated in a male dog with alopecia around the perineum and genital area?

    <p>Sertoli cell tumor</p> Signup and view all the answers

    Which of the following is associated with infectious causes leading to alopecia?

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

    What is the primary indicator of follicular dysplasia in a dog?

    <p>Alopecia with pigmentation changes</p> Signup and view all the answers

    Which condition is characterized by symmetric alopecia of the pinnae, bridge of nose, tail, and feet in Yorkshire terriers?

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

    Which of the following is a trigger for vasculitis that can lead to hair loss and skin inflammation?

    <p>Vaccine reactions</p> Signup and view all the answers

    What is a common cause of traction alopecia in dogs?

    <p>Prolonged tight matting of the hair</p> Signup and view all the answers

    Which type of alopecia is associated with failure to regrow hair after clipping?

    <p>Post-clipping alopecia</p> Signup and view all the answers

    Which sign is commonly associated with hyperadrenocorticism in dogs?

    <p>Truncal alopecia with atrophic skin</p> Signup and view all the answers

    Which systemic sign is NOT typically associated with staphylococcal infection leading to alopecia?

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

    Which of the following specifics related to breed is seen in Portuguese water spaniels?

    <p>Higher susceptibility to endocrine abnormalities</p> Signup and view all the answers

    What describes the alopecia pattern seen with staphylococcal folliculitis?

    <p>Annular to polycyclic areas of alopecia</p> Signup and view all the answers

    What role does levothyroxine play in managing hypothyroidism?

    <p>It supplements the deficient thyroid hormone.</p> Signup and view all the answers

    Which diagnostic test is specifically used to evaluate hyperadrenocorticism?

    <p>High-dose dexamethasone suppression test (HDDST)</p> Signup and view all the answers

    What is the primary purpose of performing an ACTH response test?

    <p>To assess adrenal gland function.</p> Signup and view all the answers

    Which treatment is indicated for managing natural hyperadrenocorticism?

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

    What is a suggested approach for managing alopecia X and seasonal flank alopecia?

    <p>Using melatonin supplementation</p> Signup and view all the answers

    Which laboratory test is vital for diagnosing hypothyroidism but shouldn't rely solely on total thyroxine levels?

    <p>Thyroid panel</p> Signup and view all the answers

    Which condition might be confused with hyperadrenocorticism due to overlapping symptoms?

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

    What is the impact of performing a low-dose dexamethasone suppression test (LDDST)?

    <p>It assesses the body's response to glucocorticoids.</p> Signup and view all the answers

    Which diagnostic procedure is considered particularly valuable for assessing epidermal changes associated with specific dermatological conditions?

    <p>Skin biopsy</p> Signup and view all the answers

    In the context of alopecia management, what approach should be considered when determining the treatment?

    <p>Tailor treatments based on the specific cause</p> Signup and view all the answers

    Which factor is essential in the patient monitoring process after implementing treatment for skin lesions?

    <p>Underlying cause of skin condition</p> Signup and view all the answers

    What potential complication should be taken into account when treating dermatological conditions?

    <p>Ischemic dermatopathies</p> Signup and view all the answers

    When considering adjunctive therapies for dermatological conditions, which method is indicated as helpful?

    <p>Regular bathing of the affected area</p> Signup and view all the answers

    What role does age play in the treatment of dermatological issues according to diagnostic procedures?

    <p>Certain conditions are more prevalent in older animals</p> Signup and view all the answers

    Which of the following is NOT typically deemed as a cause for complications when treating skin conditions?

    <p>Owner's financial status for treatment</p> Signup and view all the answers

    In diagnosing dermatophytosis, which culture type is most relevant?

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

    Which hormonal condition is most likely associated with an increase in male dog attraction due to alopecia?

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

    What is the probable consequence of secondary seborrhea in dogs with alopecia?

    <p>Development of pyoderma</p> Signup and view all the answers

    Which breed is most commonly associated with inflammatory causes of alopecia?

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

    What is the expected clinical appearance of alopecia in cases related to hyperadrenocorticism?

    <p>Symmetrical truncal alopecia with head sparing</p> Signup and view all the answers

    Which factor primarily affects hair follicle cycling in dogs?

    <p>Both hormonal and nonhormonal factors</p> Signup and view all the answers

    What symptom might be observed in conjunction with hyperestrogenism in male dogs experiencing alopecia?

    <p>Enlargement of nipples</p> Signup and view all the answers

    Which breed-specific alopecia is associated with unknown causes?

    <p>Boston Terrier alopecia</p> Signup and view all the answers

    What additional skin condition can be linked to the lack of normal hair follicle cycling?

    <p>Ceruminous otitis externa</p> Signup and view all the answers

    What is a rare condition associated with hyperandrogenism in male dogs?

    <p>Male pseudohermaphroditism</p> Signup and view all the answers

    What is the primary role of estrogen in the hair follicle cycle?

    <p>Inhibiting the growth phase</p> Signup and view all the answers

    In diagnosing hyperestrogenism, what hormone concentration levels are sometimes elevated?

    <p>Serum estradiol</p> Signup and view all the answers

    What is the typical symptom seen in dogs with Alopecia X?

    <p>Hairs fail to cycle</p> Signup and view all the answers

    Which of the following conditions may follow clipping of hair?

    <p>Telogen defluxion</p> Signup and view all the answers

    Which type of tumor is not commonly associated with hyperestrogenism?

    <p>Squamous cell carcinoma</p> Signup and view all the answers

    Which systemic signs are typically absent in cases of hyperestrogenism?

    <p>Polyuria/polydipsia</p> Signup and view all the answers

    What is a known cause of abnormal alopecia patterns associated with hyperandrogenism?

    <p>Cystic ovaries</p> Signup and view all the answers

    Which breeds are primarily affected by Alopecia X?

    <p>Miniature Poodle and plush-coated breeds</p> Signup and view all the answers

    In which breeds is the impact of alopecia X more commonly observed?

    <p>Boxers and English Bulldogs</p> Signup and view all the answers

    What is a noted complication of interpreting serum estradiol concentrations?

    <p>Normal fluctuation occurs throughout the day</p> Signup and view all the answers

    What common condition in male dogs could arise from exposure to human topical hormone replacement therapy?

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

    What is the typical time frame for hair regrowth following postclipping alopecia?

    <p>Within one year</p> Signup and view all the answers

    Which condition is associated with normal-sized testicles in cases of hyperestrogenism?

    <p>Hormonal imbalance</p> Signup and view all the answers

    What approach is recommended for diagnosing Alopecia X?

    <p>Clinical signs and ruling out other disorders</p> Signup and view all the answers

    What is one characteristic of alopecia that can complicate diagnosis in affected dogs?

    <p>Recurrence seasonally</p> Signup and view all the answers

    What is a likely histologic change associated with endocrine dermatoses?

    <p>Follicular keratosis</p> Signup and view all the answers

    Which condition is primarily classified as an inflammatory cause of alopecia?

    <p>Sebaceous adenitis</p> Signup and view all the answers

    What treatment for alopecia requires caution in diabetic dogs due to the risk of insulin resistance?

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

    In the context of noninflammatory alopecias, which histopathological feature may also be observed?

    <p>Flame follicles</p> Signup and view all the answers

    What outcome is expected with effective treatment of alopecia in approximately 40-50% of cases?

    <p>Hair regrowth within 6 months</p> Signup and view all the answers

    Which of the following is NOT a sign of noninflammatory alopecia?

    <p>Fluctuating hair loss</p> Signup and view all the answers

    What condition can develop as a long-term side effect of medroxyprogesterone acetate use?

    <p>Mammary nodules</p> Signup and view all the answers

    Which hormonal imbalance is associated with alopecia in dogs?

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

    What is a notable effect of neutering intact animals with regards to alopecia X?

    <p>It may result in a portion of dogs regrowing hair after up to 3 months.</p> Signup and view all the answers

    Which of the following treatments for hyperandrogenism may lead to an Addisonian crisis?

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

    What is a possible consequence of hyperestrogenism in dogs?

    <p>Behavioral changes</p> Signup and view all the answers

    What is the expected time frame for hair regrowth to become evident after treatment with trilostane?

    <p>Up to 3 months</p> Signup and view all the answers

    Which alternative drug mentioned is utilized for the treatment of Cushing’s syndrome?

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

    What does Alopecia X primarily result in?

    <p>Cosmetic hair loss with no definitive cure</p> Signup and view all the answers

    What condition may be treated through castration as mentioned?

    <p>Testicular tumors</p> Signup and view all the answers

    What should be monitored when using mitotane for treatment?

    <p>Signs of Addisonian crisis</p> Signup and view all the answers

    Study Notes

    Feline Acne Overview

    • Inflammatory dermatosis affecting the chin and lips.
    • May be recurrent or persistent.

    Clinical Presentation

    • Cats may have a single episode, a chronic recurring problem, or continual disease.
    • Frequency and severity varies.
    • Comedones, mild erythematous papules, serous crusts, and dark keratin debris develop on the chin and less commonly on the lips.
    • Swelling of the chin.
    • Severe cases may present with nodules, hemorrhagic crusts, pustules, cysts, fistulae, severe erythema, alopecia, and pain.

    Causative Factors/Risk Factors

    • Precise etiology unknown.
    • Often associated with allergic skin diseases.
    • May be a disorder of keratinization, poor grooming, abnormal sebum production, immunosuppression, viral infection, or stress.

    Pathologic Findings

    • Mild disease - follicular distention with keratin (comedones), hyperkeratosis, and follicular plugging, most often associated with allergic dermatitis.
    • Severe disease - mild to severe folliculitis and perifolliculitis with follicular pustule formation leading to furunculosis and pyogranulomatous dermatitis.

    Diagnosis

    • Skin scrapings - for demodicosis.
    • Bacterial culture—for resistant infections.
    • Fungal culture — for dermatophytosis.
    • Cytology—for bacteria and Malassezia.
    • Biopsy—rarely needed; necessary in selected cases to characterize changes such as cystic follicles, to differentiate acne from other diseases.

    Treatment

    • Initial treatment—gentle clipping and soakings to soften crusts.
    • Food elimination diet.
    • Topical - shampoo, cleansing agents, medicated wipes, antibiotic ointment, other topicals, combination topicals, topical retinoids.
    • Systemic - antibiotics, oral prednisolone, isotretinoin (Accutane), cyclosporine.

    Follow-Up

    • Monitor for relapses.
    • Discontinue treatment by tapering medication over a 2- to 3-week period.
    • Maintenance cleansing programs can be used to reduce relapses.

    Miscellaneous

    • Systemic isotretinoin should not be used on breeding animals.

    Differential Diagnosis

    • Hypersensitivity (atopy, flea bite, food, contact).
    • Bacterial folliculitis.
    • Demodicosis.
    • Malassezia infection.
    • Dermatophytosis.
    • Neoplasia of sebaceous or apocrine glands.
    • Eosinophilic granuloma.

    Canine Acne

    • Also known as muzzle folliculitis and furunculosis
    • Mostly seen in young dogs
    • Characterized by inflammation of hair follicles and boils
    • Rarely resembles human acne
    • Occurs almost exclusively in short-coated breeds
    • Genetic predisposition, trauma, and allergies are potential contributing factors

    Predisposed Breeds

    • Boxer
    • Doberman Pinscher
    • English Bulldog
    • Great Dane
    • Weimaraner
    • Mastiff
    • Rottweiler
    • German Shorthaired Pointer
    • Pit Bull Terrier

    Clinical Signs

    • Erythematous papules and sometimes bullae on the ventral chin and lip margins
    • Papules coalesce to form plaques
    • Lesions may contain pus or blood
    • Lesions may be pruritic or painful to the touch
    • Chronic lesions may become hyperpigmented, thickened, scarred, or alopecic

    Diagnosis

    • Impression cytology can identify bacteria or yeast
    • Skin scrape can rule out demodicosis
    • Dermatophyte culture can rule out ringworm (dermatophytosis)
    • Bacterial culture and sensitivity testing are needed for infections unresponsive to initial treatment options
    • Biopsy can be used for histologic confirmation

    Treatment

    • Frequent cleaning with chlorhexidine solutions, shampoos, or pads
    • Gentamicin/steroid-containing topical ointments for localized lesions twice daily
    • Systemic antibiotics based on culture and sensitivity testing (cephalexin 22-30mg/kg PO every 12 hours for 2-4 weeks is common)
    • Oral corticosteroids (prednisolone 0.5mg/kg/day) for inflammation, but not for long-term use
    • Reduce behavioral trauma to the chin

    Considerations

    • Limit long-term use of topical steroids due to potential adrenal suppression and skin thinning
    • Evaluate and manage concurrent allergic/atopic skin disease as it may worsen acne
    • Avoid squeezing lesions as it can increase inflammation
    • Monitor closely for improvement and repeat culture/sensitivity testing if lesions worsen
    • Early and aggressive therapy can prevent chronic scarring
    • Severe cases may require short courses of oral steroids

    Acral Lick Dermatitis

    • Compulsive licking of the limbs resulting in plaque formation
    • Affects skin and exocrine glands
    • Most common in large dog breeds: Labrador Retrievers, Doberman Pinschers, Great Danes, Irish Setters, Golden Retrievers, German Shepherd Dogs, Boxers, and Weimaraners
    • Median age of onset is 4 years, with a range of 1–12 years
    • No sex predilection
    • Excessive licking of the affected area
    • Alopecic, eroded/ulcerated, thickened, and raised firm plaques with scabs and exudation
    • Lesions are usually located on the dorsal aspect of the carpus, metacarpus, tarsus, or metatarsus
    • Lesions can be single or multiple

    Causes and Risk Factors

    • Any local irritation or lesion can initiate a lick-itch cycle
    • Associated diseases: staphylococcal furunculosis, hypersensitivity, endocrinopathy, demodicosis, dermatophytosis, foreign body reaction, neoplasia, underlying joint disease or arthritis, trauma, neuropathy, psychogenic, or sensory nerve dysfunction

    Diagnosis

    • Rule out bacterial, fungal, ectoparasitic, and endocrine causes and treat accordingly
    • Perform tissue cultures to differentiate from surface cultures, as results may differ
    • Consider biopsy to rule out neoplasia and other infections
    • Perform intradermal allergy testing to assess for atopy
    • Consider neurologic and orthopedic evaluation
    • Perform histopathology to identify epidermal hyperplasia, plasmacytic dermal inflammation, folliculitis, furunculosis, perihidradenitis, hidradenitis, epitrichial gland dilation/rupture, and vertical streaking fibrosis

    Treatment

    • Control pruritus
    • If infection resolves but pruritus and/or lesions persist, consider biopsy, allergy workup, neurologic/orthopedic exam, radiographs, behavioral modification
    • Treat the underlying disease to prevent recurrence
    • Physical restraints to allow healing
    • Consider radiation, acupuncture, CO2 laser, cryosurgery, or standard surgery

    Medications

    • Combine or withdraw administration of medications carefully
    • Fluoxetine, amitriptyline, clomipramine, and trazodone may be beneficial.
    • Topical treatment options include flunixin meglumine and fluocinolone in dimethyl sulfoxide, topical capsaicin products, and intralesional corticosteroids
    • Food elimination diet to determine food allergies
    • Doxepin should be used with caution due to possible interactions with monoamine oxidase inhibitors, clonidine, anticonvulsants, oral anticoagulants, steroid hormones, antihistamines, or aspirin
    • Antihistamines may cause sedation
    • Psychotropic medications should be combined and/or withdrawn carefully
    • Cardiotoxicity and hepatoxicity are rare in animals on TCAs
    • Routine monitoring is recommended

    Follow-up

    • Monitor the level of licking and chewing closely
    • If no underlying disease is detected, psychogenic causes (compulsive or self-mutilation disorder) are possible.
    • Prognosis is guarded.
    • Treatment can be difficult, especially if an underlying cause is not found.
    • Owners should be informed that patience and time are necessary.

    Miscellaneous

    • Age-related factors:
      • Dogs
    • The text does not specify any age-related factors.

    Alopecia in Cats

    • Alopecia in cats is defined as the abnormal lack of hair coat.
    • This is a very common issue.
    • Alopecia can be triggered by a variety of different causes including infection, parasites, allergies, endocrine disorders, and medication reactions.
    • The following factors can contribute to alopecia: infection, parasites, allergies, endocrine disorders, medications, congenital conditions, environmental damage, and autoimmune diseases.
    • Alopecia can be caused by the following:
      • Infectious causes:
        • Dermatophytes (fungal infections)
      • Parasitic causes:
        • Demodex mites
        • Cheyletiella mites
        • Notoedres mites
        • Fleas
      • Hypersensitivities:
        • Atopic dermatitis (allergy)
        • Oral medication reactions
        • Topical medication reaction
      • Disorders of hair follicle cycling:
        • Telogen effluvium (hair loss due to stress)
        • Cushing's syndrome (hyperadrenocorticism)
        • Hypothyroidism
      • Congenital causes:
        • Hair follicle dystrophy
        • Alopecia universalis (normal in Sphynx cats)
        • Feline hypotrichosis (Siamese and Devon Rex cats)
        • Pinnal hypotrichosis
      • Environmental causes:
        • Solar damage
        • Burns
        • Frostbite
        • Scarring
      • Ischemic causes:
        • Post-matting alopecia
        • Post-traumatic alopecia
      • Autoimmune causes:
        • Alopecia areata
        • Pemphigus foliaceus
      • Neoplastic causes:
        • Epitheliotropic lymphoma
        • Mastocytosis
        • Squamous cell carcinoma in situ
      • Manifestation of internal disease:
        • Sebaceous adenitis (thymoma-associated)
        • Paraneoplastic alopecia
        • Mural lymphocytic folliculitis
        • Hyperthyroidism
        • Hyperadrenocorticism
        • Diabetes mellitus
        • Hypothyroidism
      • Psychogenic causes:
        • Compulsive disorder
    • Alopecia can be treated with a variety of medications, depending on the underlying cause, including:
      • Antibiotics
      • Antifungal medications
      • Antiparasitic treatments
      • Antihistamines
      • Corticosteroids
      • Thyroid hormone replacement therapy
      • Immunosuppressants
    • Alopecia can have a variety of complications, depending on the underlying cause, but can include:
      • Skin infections
      • Pruritus (itching)
      • Hair loss
      • Skin lesions
    • It is important to see a veterinarian for diagnosis and treatment.

    Expected Course and Prognosis

    • The expected course and prognosis of alopecia in cats varies depending on the underlying cause.
    • Some cases can be easily treated with medication, while others may be more challenging.
    • In some cases, alopecia may be irreversible.

    Zoonotic Potential

    • Certain causes of alopecia can be zoonotic, meaning they can be transmitted from animals to humans.
    • Dermatophytosis (fungal infection) can cause skin lesions in humans.
    • Cheyletiellosis (mite infestation) can cause skin irritation in humans.
    • It is important to take precautions to prevent the spread of zoonotic diseases.

    Alopecia - Dogs

    • Definition: Alopecia is a common disorder resulting in complete or partial hair loss in regions where hair typically grows.
    • Causes: Multiple factors contribute to alopecia, including hypersensitivity, infections, genetic abnormalities, trauma, autoimmune reactions, mechanical issues, endocrine imbalances, neoplasia, drug reactions, and follicle growth cycle disruptions.
    • Systems Affected: Alopecia can involve multiple systems, including:
      • Endocrine/metabolic system
      • Hemic/lymphatic/immune system
      • Skin/exocrine system
    • Age, Sex, and Breed: Specific age, breed, and sex predilections are associated with different causative factors.
    • Clinical Signs: The pattern and degree of hair loss, along with the presence or absence of itching, are crucial factors in diagnosing alopecia.
    • Diagnosis: Various diagnostic procedures are employed, including:
      • Cytology
      • Fungal culture
      • Skin biopsy
    • Treatment: Treatment options vary depending on the underlying cause of alopecia.
    • Follow-Up: Follow-up monitoring is crucial and depends on the specific cause.
    • Miscellaneous:
      • Bathing can be beneficial as an adjunctive therapy for many alopecic conditions.
      • The text makes no mention of specific associated conditions.

    Multifocal Alopecia

    • Demodicosis: Partial to complete alopecia with erythema, comedones, and mild scaling. Lesions can become inflamed and crusted.
    • Dermatophytosis: Partial to complete alopecia with scaling, with or without erythema; not typically ring-like.
    • Staphylococcal Folliculitis: Alopecia in circular patterns with epidermal collarettes, erythema, crusting, and hyperpigmented macules.
    • Injection/Topical Medication Reactions: Inflammation with alopecia and/or cutaneous atrophy from scarring.
    • Rabies Vaccine Vasculitis: Occurs 1–3 months after vaccination, resulting in a well-demarcated patch of alopecia. Small-breed dogs are more predisposed.
    • Traction Alopecia: Hair loss caused by applying tight barrettes, rubber bands, or prolonged matting.

    Specific Locations (Alopecia)

    • Pinnal Alopecia/Pattern Baldness:
      • Miniaturization of hairs and progressive alopecia.
      • Breeds predisposed: Dachshund, greyhound, American water spaniel, Portuguese water spaniel, Boston terrier, Manchester terrier, whippet, Italian greyhound, Chihuahua.
    • Pinnal Alopecia with Crusting or Necrosis: Consider vasculitis as a potential underlying cause.
    • Post-Clipping Alopecia: Failure to regrow hair after clipping, associated with slow or arrested hair cycles.
    • Melanoderma (alopecia of Yorkshire Terriers): Symmetric alopecia of pinnae, bridge of nose, tail, and feet.
    • Seasonal/Cyclic/Canine Flank Alopecia: Serpiginous flank alopecia with hyperpigmentation; Boxer, English bulldog, Airedale terrier.
    • Black Hair Follicular Dysplasia: Alopecia in black-haired areas only.
    • Dermatomyositis: Alopecia of face, tip of ears, tail, and digits, associated with scale, crusting, and scarring.
    • Alopecic Breeds: Chinese crested, Mexican hairless, Inca hairless, Peruvian Inca orchid, American hairless terrier.
    • Congenital Hypotrichosis: Cocker spaniel, Belgian shepherd, poodle, whippet, beagle, French bulldog, Yorkshire terrier, Labrador retriever, bichon frise, Lhasa apso, basset hound.
    • Color Dilution Alopecia: Affects blue or fawn dogs.

    Symmetric Alopecia

    • Hyperadrenocorticism: Truncal alopecia associated with atrophic skin, comedones, and pyoderma, as well as other systemic signs.
    • Hypothyroidism: Thinning of truncal hair coat, generalized alopecia is uncommon.
    • Noninflammatory Alopecia (Alopecia X): Symmetric truncal alopecia with hyperpigmentation; alopecia often starts along the collar area of the neck. Breeds predisposed: Pomeranian, chow chow, Akita, Samoyed, Keeshonden, Alaskan Malamute, and Siberian husky.
    • Hyperestrogenism (Females): Symmetric alopecia of flanks and perineal/inguinal regions with enlarged vulva and mammary glands. Can be caused by exogenous hormone exposure.
    • Male Feminization from Sertoli Cell Tumor: Alopecia of perineum and genital region with gynecomastia.

    Laboratory Testing

    • CBC/BIOCHEMISTRY/URINALYSIS:
      • Rule out metabolic causes such as hyperadrenocorticism.
      • Assess for hypothyroidism.
    • Thyroid Panel: Do not solely rely on low total thyroxine (T4) alone. Diagnose hypothyroidism.
    • Adrenocorticotropic Hormone (ACTH) Response Test, Low-Dose Dexamethasone Suppression Test (LDDST), and High-Dose Dexamethasone Suppression Test (HDDST): Evaluate for hyperadrenocorticism.
    • Sex Hormone Profiles: Often not useful for diagnosis or therapy.
    • Ultrasonography: Evaluate adrenal glands for evidence of hyperadrenocorticism.

    Treatment Considerations

    • Hyperadrenocorticism: Trilostane, mitotane, surgical removal of tumor.
    • Hypothyroidism: Levothyroxine supplementation.
    • Follicular Dysplasia: Control concurrent allergies and infections.
    • Alopecia X and Seasonal Flank Alopecia: Melatonin may be helpful in some cases.
    • Ischemic Lesions: Pentoxifylline may be considered.
    • Lymphoma, Cutaneous Epitheliotropic: Treat as appropriate for lymphoma.
    • Pemphigus: Treat as appropriate for pemphigus.
    • Sebaceous Adenitis, Granulomatous: Treat as appropriate for sebaceous adenitis.
    • Sertoli Cell Tumor: Treat as appropriate for the tumor.

    Contraindications & Interactions

    • Contraindications: N/A
    • Interactions: None mentioned.

    Alopecia (Noninflammatory) in Dogs

    • Definition: Alopecic disorders that are uncommon and associated with abnormal hair follicle cycling.
    • Causes: Hormonal and nonhormonal
    • Common Causes:
      • Hyperestrogenism: Males - Estrogen excess due to Sertoli cell tumor (most common), seminoma, or interstitial cell tumor (rare), or exposure to human topical hormone replacement.
      • Hyperestrogenism: Females - Estrogen excess associated with cystic ovaries, ovarian tumors (rare), exogenous estrogen supplementation, or exposure to human topical hormone replacement.
      • Hyperandrogenism (Males): Androgen-producing testicular tumors (especially interstitial cell tumors).
      • Alopecia X: Hairs fail to cycle. The underlying endocrine cause has not been identified.
    • Breed Predispositions:
      • Alopecia X: Miniature poodle and plush-coated breeds.
    • Symptoms:
      • Alopecia (Hair Loss): Usually diffuse and bilaterally symmetrical, sparing the head and distal extremities.
      • Coat: May be dry or bleached.
      • Secondary Conditions: Seborrhea, pruritus, pyoderma, comedones, ceruminous otitis externa, and hyperpigmentation.
      • Hyperestrogenism:
        • Enlarged nipples, mammary glands, vulva, and prepuce.
        • Macular melanosis and linear preputial dermatitis.
        • Abnormal-sized testicles or different-sized testicles.
      • Hyperandrogenism:
        • Tail gland hyperplasia and perianal gland hyperplasia.
    • Diagnosis:
      • Definitive diagnosis often requires ruling out the more common endocrine alopecias.
      • Histopathology: Helps rule out inflammatory causes of alopecia (pyoderma, demodicosis, dermatophytosis, sebaceous adenitis) and some other differentials listed above.
    • Treatment:
      • Hyperestrogenism/ Hyperandrogenism: Castration (scrotal testicular tumors, ovarian cysts and tumors, and abdominal testicular tumors).
      • Alopecia X: Neutering intact animals. Hair may regrow following neutering, taking up to 3 months.
      • Medications:
        • Melatonin:
          • Dosage: 0.1 mg/kg twice daily for 4 weeks.
          • Effective in approximately 40–50% of cases.
          • Hair regrowth can take up to 6 months.
        • Mitotane:
          • 15–25 mg/kg once daily as induction for 5–7 days, followed by twice weekly maintenance. Hair regrowth may occur in a portion of dogs treated and can take up to 3 months to become evident.
        • Trilostane:
          • Dosages as described for treatment of Cushing’s syndrome. Hair regrowth may occur in a portion of dogs treated and can take up to 3 months to become evident.
    • Client Education:
      • Alopecia X is a cosmetic condition with no definitive cure.
      • The risk of treatment should be emphasized.
      • Hair regrowth will only occur in a portion of dogs regardless of treatment chosen, and hair loss may recur months to years later in spite of continued treatment.

    Alopecia X

    • A growth hormone-responsive alopecia that occurs in plush-coated breeds.
    • The underlying endocrine cause has not been identified.

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    This quiz delves into feline acne, an inflammatory condition affecting the chin and lips of cats. It covers its clinical presentation, causative factors, and pathological findings, providing insights into both mild and severe cases. Perfect for veterinarians and pet owners interested in understanding this common dermatological issue in cats.

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