European Society of Veterinary Dermatology

European Society of Veterinary Dermatology

Keratinisation disorders Robert Cikota DVM AniCura Vastra Djursjukhuset, Gothenburg, Sweden

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

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

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

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

Case Elite Rottweiler, 8 years, intact male Scaling, alopecia, mild pruritus since 5-6 months Referral clinic- Stronghold 2X, Thyroid status Emma Åström

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

Emma Åström Emma Åström

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

Emma Åström

Emma Åström

Emma Åström

Very dry haircoat Extensive scaling Problem list Almost general alopecia affecting dorsum/lateral trunk

Differential diagnosis Demodicosis Vitamin A responsive dermatosis Dermatophytosis Sebaceaous adenitis Leishmaniosis Follicular alopecia

Diagnostic tests Skin scrapings Parasite - unremarkable Cytology - mild bacterial overgrowth Trichogram - follicular casts Biopsy

Trichogram Emma Åström

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

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