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Questions and Answers
What is the most likely cause of follicular distention with keratin in cats?
Which of the following treatments should be used with caution due to potential serious side effects?
What secondary invaders might be present in lesions of a cat with suspected acne?
What are some of the signs of severe cases of cat acne?
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Which of the following treatments may cause irritation when used on cat acne?
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Which parasites are indicated as primary agents in demodicosis in cats?
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What is the relationship between human medications and treatments indicated for cat acne?
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What type of dermatitis is most associated with feline acne?
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What is the primary initial treatment for swelling of the chin in severe cases?
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What should be monitored for in follow-up treatment of affected cats?
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Which factor is NOT commonly associated with the etiology of the condition described?
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What should be done during treatment after lesions have resolved?
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Which of the following is a cause of pain related to the condition?
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What is indicated for recurrent episodes of the condition?
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What type of testing may be included in the diagnosis process?
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Which medication is explicitly noted as contraindicated for breeding animals?
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What is the most effective topical treatment for acne that has better penetration?
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In cases of resistant infections, what is a commonly used systemic antibiotic?
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Which diagnostic procedure is generally NOT necessary for acne, unless in selected cases?
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Which of the following antiseborrheic agents is used for treating Malassezia infection?
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Which topical medication is suggested for reducing scar tissue formation during severe inflammatory episodes?
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Which culture type would be performed to identify dermatophytosis?
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What is a common cleansing agent for the treatment of acne?
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Which antibiotic ointment is used specifically for treating infected skin lesions?
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What is the primary characteristic of acne in dogs, which differentiates it from human acne?
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Which diagnostic procedure is specifically helpful for determining the presence of bacteria or yeast in the lesions of affected dogs?
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What is the recommended initial dosage for the tapering of oral corticosteroids in treating significant inflammation associated with canine acne?
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What risk is associated with the long-term use of gentamicin/steroid-containing ointments in treating dog acne?
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Which factor is NOT typically considered a contributing element to canine acne?
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In cases of resistant infections in dogs, which systemic antibiotic could be indicated?
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What is the main purpose of performing a bacterial culture and sensitivity test in cases of dog acne?
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What are the clinical signs most often associated with acne in dogs?
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What is the main purpose of adding oral antibiotics in the treatment of acne when topical treatments are insufficient?
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Which approach should not be taken when dealing with lesions to avoid exacerbating the inflammation?
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Which breed characteristic is noted as a potential risk factor for the development of acne?
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When evaluating for allergic diseases in relation to acne, what should be considered as a contributing factor?
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What effect may trauma from squeezing acne lesions have on the condition?
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Which associated condition is known to potentially exacerbate feline acne?
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What is the recommended cleaning method for managing acne lesions?
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Which type of dermatitis is relevant when considering differential diagnoses in cases of acne?
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What are the characteristics of lesions associated with the condition described?
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Why are bacterial cultures and sensitivities performed in cases of suspected folliculitis?
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What might the initial therapeutic approach involve when managing lesions on the chin?
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What is a potential outcome of long-term use of topical steroids?
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Which breeds are noted for being predisposed to this allergic skin condition?
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How might a dog's behavioral habits impact the condition of their chin?
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What change occurs as the disease progresses in the lesions?
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Which of the following best describes the expected course and prognosis of the condition if treated appropriately?
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What is a common factor that could initiate a lick–itch cycle in pets?
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Which of the following is a recommended method for monitoring the healing of lesions?
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Which condition is known to potentially exacerbate the effectiveness of treatments for feline acne?
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What underlying cause should be considered if lesions persist despite treatment for acne?
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Which treatment option is often considered when no underlying disease is detected?
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What should be performed to rule out secondary infections in persistent lesion cases?
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Which factor complicates the prognosis of lesions if underlying causes are not identified?
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What is considered a necessary part of the follow-up treatment process?
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What is the primary behavioral indicator of Acral Lick Dermatitis?
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Which diagnostic procedure is essential for differentiating between related conditions in cases of Acral Lick Dermatitis?
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What is a commonly observed histopathological finding in dogs with Acral Lick Dermatitis?
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What medication is advised to combine with caution due to possible interactions in the treatment of this condition?
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Which breed is most commonly affected by Acral Lick Dermatitis?
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What type of allergy testing is recommended for identifying potential food allergies in affected dogs?
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Which of the following is considered a rare but potentially useful treatment for alleviating symptoms?
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Which condition must be ruled out when examining a dog with symptoms of Acral Lick Dermatitis?
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Which diagnostic procedure is least likely to be necessary when diagnosing feline acne?
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What is the role of food elimination trials in the context of skin conditions?
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Which treatment could potentially lead to toxicity in cases of skin infections?
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Which of the following is a method for proving self-trauma due to pruritus in animals?
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In diagnosing skin conditions, which factor is least associated with systemic disease evaluation?
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What feature is typical in sphynx cats exhibiting alopecia universalis?
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Which feline breed is known for having autosomal recessive alopecia?
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What is a common characteristic of skin affected by Demodex gatoi mites?
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Which condition could result in folliculitis secondary to alopecia?
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What is another term for decreased secondary hairs in alopecia universalis?
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How might the skin of a cat affected by sebaceous glands malfunction appear?
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What is commonly observed in the fur of Siamese cats with hypotrichosis?
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Which type of skin lesion is more likely to occur with the presence of inflammation due to parasites?
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What is a main factor that can lead to telogen effluvium in cats?
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Which condition is characterized by hair regrowth over weeks following medication discontinuation?
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Which type of alopecia is most commonly associated with inflammatory injuries?
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What is a rare cause of alopecia mentioned that can occur at the site of application?
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Which of the following is NOT a known cause of hair follicle cycling disorders?
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What effect does parturition not have on hair follicle cycling?
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What is the primary visible symptom associated with auto-immune alopecia areata?
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Which of the following causes post traumatic alopecia in cats?
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Which condition is associated with scaly alopecia and may result in skin fragility in its advanced stages?
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What is a significant treatment associated with hyperadrenocorticism and can impact conditions like pemphigus foliaceus?
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What skin condition is characterized by nonpruritic alopecia with a rapid progression and bilateral symmetry?
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Which type of dermatitis is characterized by dramatic scaling that begins on the head and neck and is nonpruritic?
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Which treatment is suggested for managing Demodicosis in cats?
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In cases of Hyperthyroidism, what is a commonly observed symptom related to alopecia?
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Which condition is most commonly recognized as a risk factor for demodicosis in cats?
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What finding is commonly associated with paraneoplastic alopecia in cats?
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What secondary issue may arise in cats suffering from dermatological conditions like Hyperadrenocorticism?
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Which characteristic is typical for squamous cell carcinoma in situ in older cats?
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Which skin condition can potentially cause skin lesions in humans through zoonotic transmission?
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What symptom might indicate hyperadrenocorticism in a cat, potentially complicating treatment options?
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What is a primary characteristic of skin affected by Mural lymphocytic folliculitis?
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Which treatment option is typically indicated for resolving thymoma-associated exfoliative dermatitis?
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Which of the following treatments is indicated for secondary problems like hyperkeratosis?
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What is a common sign of allergic dermatitis in cats when compared to other conditions?
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Which condition is characterized by generalized truncal alopecia with scaling and intense erythema?
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What is a common feature of dermatophytosis in dogs?
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Which breed characteristic is associated with sebaceous adenitis?
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Chronic corticosteroid use in dogs is most likely to cause which of the following conditions?
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Which condition involves multifocal alopecia with signs of inflammation and crusting?
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What is often seen in pinnal alopecia or pattern baldness?
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Which factor is considered a secondary consequence of allergic dermatitis?
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What is a distinguishing feature of alopecia caused by demodicosis?
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What condition is likely indicated by symmetric alopecia of the flanks and perineal area in a female dog?
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Which breed is NOT commonly associated with congenital hypotrichosis?
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What is a common external cause of noninflammatory alopecia?
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Which condition is associated with symmetrical truncal alopecia and hyperpigmentation?
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Which breed is particularly noted for presenting breed-related alopecia?
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What might be indicated in a male dog with alopecia around the perineum and genital area?
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Which of the following is associated with infectious causes leading to alopecia?
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What is the primary indicator of follicular dysplasia in a dog?
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Which condition is characterized by symmetric alopecia of the pinnae, bridge of nose, tail, and feet in Yorkshire terriers?
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Which of the following is a trigger for vasculitis that can lead to hair loss and skin inflammation?
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What is a common cause of traction alopecia in dogs?
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Which type of alopecia is associated with failure to regrow hair after clipping?
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Which sign is commonly associated with hyperadrenocorticism in dogs?
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Which systemic sign is NOT typically associated with staphylococcal infection leading to alopecia?
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Which of the following specifics related to breed is seen in Portuguese water spaniels?
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What describes the alopecia pattern seen with staphylococcal folliculitis?
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What role does levothyroxine play in managing hypothyroidism?
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Which diagnostic test is specifically used to evaluate hyperadrenocorticism?
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What is the primary purpose of performing an ACTH response test?
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Which treatment is indicated for managing natural hyperadrenocorticism?
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What is a suggested approach for managing alopecia X and seasonal flank alopecia?
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Which laboratory test is vital for diagnosing hypothyroidism but shouldn't rely solely on total thyroxine levels?
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Which condition might be confused with hyperadrenocorticism due to overlapping symptoms?
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What is the impact of performing a low-dose dexamethasone suppression test (LDDST)?
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Which diagnostic procedure is considered particularly valuable for assessing epidermal changes associated with specific dermatological conditions?
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In the context of alopecia management, what approach should be considered when determining the treatment?
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Which factor is essential in the patient monitoring process after implementing treatment for skin lesions?
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What potential complication should be taken into account when treating dermatological conditions?
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When considering adjunctive therapies for dermatological conditions, which method is indicated as helpful?
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What role does age play in the treatment of dermatological issues according to diagnostic procedures?
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Which of the following is NOT typically deemed as a cause for complications when treating skin conditions?
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In diagnosing dermatophytosis, which culture type is most relevant?
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Which hormonal condition is most likely associated with an increase in male dog attraction due to alopecia?
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What is the probable consequence of secondary seborrhea in dogs with alopecia?
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Which breed is most commonly associated with inflammatory causes of alopecia?
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What is the expected clinical appearance of alopecia in cases related to hyperadrenocorticism?
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Which factor primarily affects hair follicle cycling in dogs?
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What symptom might be observed in conjunction with hyperestrogenism in male dogs experiencing alopecia?
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Which breed-specific alopecia is associated with unknown causes?
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What additional skin condition can be linked to the lack of normal hair follicle cycling?
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What is a rare condition associated with hyperandrogenism in male dogs?
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What is the primary role of estrogen in the hair follicle cycle?
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In diagnosing hyperestrogenism, what hormone concentration levels are sometimes elevated?
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What is the typical symptom seen in dogs with Alopecia X?
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Which of the following conditions may follow clipping of hair?
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Which type of tumor is not commonly associated with hyperestrogenism?
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Which systemic signs are typically absent in cases of hyperestrogenism?
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What is a known cause of abnormal alopecia patterns associated with hyperandrogenism?
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Which breeds are primarily affected by Alopecia X?
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In which breeds is the impact of alopecia X more commonly observed?
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What is a noted complication of interpreting serum estradiol concentrations?
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What common condition in male dogs could arise from exposure to human topical hormone replacement therapy?
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What is the typical time frame for hair regrowth following postclipping alopecia?
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Which condition is associated with normal-sized testicles in cases of hyperestrogenism?
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What approach is recommended for diagnosing Alopecia X?
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What is one characteristic of alopecia that can complicate diagnosis in affected dogs?
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What is a likely histologic change associated with endocrine dermatoses?
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Which condition is primarily classified as an inflammatory cause of alopecia?
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What treatment for alopecia requires caution in diabetic dogs due to the risk of insulin resistance?
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In the context of noninflammatory alopecias, which histopathological feature may also be observed?
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What outcome is expected with effective treatment of alopecia in approximately 40-50% of cases?
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Which of the following is NOT a sign of noninflammatory alopecia?
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What condition can develop as a long-term side effect of medroxyprogesterone acetate use?
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Which hormonal imbalance is associated with alopecia in dogs?
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What is a notable effect of neutering intact animals with regards to alopecia X?
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Which of the following treatments for hyperandrogenism may lead to an Addisonian crisis?
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What is a possible consequence of hyperestrogenism in dogs?
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What is the expected time frame for hair regrowth to become evident after treatment with trilostane?
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Which alternative drug mentioned is utilized for the treatment of Cushing’s syndrome?
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What does Alopecia X primarily result in?
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What condition may be treated through castration as mentioned?
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What should be monitored when using mitotane for treatment?
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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
-
Infectious causes:
- 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.
Breed-Related Alopecia
- 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
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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.
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Breed Predispositions:
- Alopecia X: Miniature poodle and plush-coated breeds.
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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.
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Hyperestrogenism:
- Enlarged nipples, mammary glands, vulva, and prepuce.
- Macular melanosis and linear preputial dermatitis.
- Abnormal-sized testicles or different-sized testicles.
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Hyperandrogenism:
- Tail gland hyperplasia and perianal gland hyperplasia.
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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.
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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.
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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.
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Melatonin:
-
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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