European Society of Veterinary Dermatology
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1 European Society of Veterinary Dermatology
2 Keratinisation disorders Robert Cikota DVM AniCura Vastra Djursjukhuset, Gothenburg, Sweden
3 Keratinisation disorders Cutaneous scaling is a common clinical presentation Is the scaling? Primary keratinisation defect Secondary to an underlying dermatosis Excess scaling can occur due to a variety reasons
4 Causes of Secondary scaling Parasites Infections Allergy Metabolic diseases Endocrine diseases Autoimmune diseases Neoplasia Nutritional Enviromental Sarcoptes, cheyletiella, fleas.. Staphylococcus, malassezia.. Atopy, cutaneus food reactions. Zn-responsive Hypothyroidism, Cushing Pemphigus, lupus. Cutaneous lymphoma. Malnutrition.. Low humidity
5 Primary keratinisation disorders Disorder Primary idiophatic seborrhoea Ichthyosis Vitamin A responsive dermatosis Zinc responsive dermatosis Sebaceous adenitis Nasodigital hyperkeratosis Schnauzer comedo syndrome Ear margin dermatosis Hereditary lupoid dermatosis Some predisposed breeds Cocker spaniel, Basset, Springer spaniel, Irish setter, Dachshund Golden retriever, Jack russel, Yorkshire terrier, American bulldog Cocker spaniel, Labrador retriever Siberian Husky, Alaskan Malamute Standard poodle, Akita, Vizla, Lhasa apso, Springer spaniel, Samoyed Labrador retriever, Springer spaniel Miniature schnautzer Dachshund German shorthaired pointer
6 Investigation of scaling Signalement Age Breed History Physical examination Dermatological examination Diagnostic tests Other tests Gives us useful clues Primary keratinisation disorder < 2 years of age Middle age- older animals- endocrine, neoplasia Dachshund, German pointer A good history- general health, life style, environment, therapy, parasite controle, seasonal pattern Performed in all cases- endocrine or metabolic diseases Where did the lesions start, distribution, progression, type of lesions Skin scraping- parasites, cytology, tape stripping, hair plucking, bacterial and fungal culture Blood samples, endocrine functional tests, allergy tests, skin biopsy
7 Case Elite Rottweiler, 8 years, intact male Scaling, alopecia, mild pruritus since 5-6 months Referral clinic- Stronghold 2X, Thyroid status Emma Åström
8 History Dry and dull haircoat Scaling, alopecia, mild pruritus Started 5-6 months ago Cats in the household Referral clinic- Stronghold 2X, Thyroid status normal Cortisol / crea ratio normal Emma Åström
9 Emma Åström Emma Åström
10 Examination General examination- within normal limits Dermatological examination: Extensive almost general alopecia affecting dorsum/lateral trunk Very dry haircoat and skin- wire wool Extensive scaling small scales Focal areas- with mild- moderate erythema Occasional crusts
11 Emma Åström
12 Emma Åström
13 Emma Åström
14 Very dry haircoat Extensive scaling Problem list Almost general alopecia affecting dorsum/lateral trunk
15 Differential diagnosis Demodicosis Vitamin A responsive dermatosis Dermatophytosis Sebaceaous adenitis Leishmaniosis Follicular alopecia
16 Diagnostic tests Skin scrapings Parasite - unremarkable Cytology - mild bacterial overgrowth Trichogram - follicular casts Biopsy
17 Trichogram Emma Åström
18 Dermatohistopathology Variable in intensity and relate to stage of lesions Inflammatory destruction of sebaceous glands cellmediated pathogenesis Early lesions - characterized by variable degrees of sebaceous adenitisgranulomatous to pyogranulomatous K. Varjonen Later lesions diffuse absence of sebaceuos glands
19 Treatment Sebaceaous adenitis Cyclosporine 5 mg / kg Keratolytic schampoos 1-2 X weekly Propylene glycol 50 % topically Omega- 6 and omega-3 fatty acid supplementation Reexamination in 4-6 weeks
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