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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