1887

Skin problems: a clinical approach

image of Skin problems: a clinical approach
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Abstract

The main presenting signs of skin disease are: pruritus; alopecia (symmetrical, localized, diffuse, patchy); scaling and crusting; erosions and ulceration; papules, pustules and vesicles; lumps and nodules; and pigmentation disorders. This chapter looks at history, physical examination, diagnostic techniques, pruritic conditions and non-pruritic conditions. : Skin scraping for parasites; Skin cytology; Obtaining a trichogram; Skin biopsy.

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Figures

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27.1 Examples of dermatological lesions. Papule: a solid elevated lesion, <1 cm diameter (arrowed). Pustule: a circumscribed elevation of the skin, which contains pus (arrowed). Hypopigmentation: (i) <1 cm macule; (ii) >1 cm patch. Scale: an accumulation of loose fragments of the cornified layer of the skin (arrowed). Crusts: accumulation of dried exudate, serum, pus, blood, cells or scales (arrowed). Epidermal collarette: circular arrangement of scale. Alopecia: loss of hair. Comedones: dilated hair follicles filled with cornified cells and sebaceous material (arrowed). Nodule: a circumscribed solid elevation, >1 cm in diameter). Lichenification: thickening and hardening of the skin.
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27.3 An approach to the dog with pruritus. Prior to embarking on using the chart, a thorough clinical history should be taken and a physical examination carried out.
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27.4 Comma-shaped flea faeces (f), along with white flea eggs (e) are visible in these haircoat combings on an examination table.
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27.5 Alopecia, erythema and papules on the eyelids in an early case of atopic dermatitis in a young Staffordshire Bull Terrier.
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27.7 Acute moist dermatitis in a cross-bred dog, with an exudative lesion behind the axilla.
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27.8 Scaling and crusting lesions on the pinna of a dog with sarcoptic mange.
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27.9 Orange mites are visible on the ventral abdomen of this terrier.
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27.10 An approach to the dog with non-pruritic skin disease. Prior to embarking on using the chart, a thorough clinical history should be taken and physical examination carried out.
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27.12 A middle-aged hypothyroid Dobermann bitch with hair loss, brittle hairs and hyperpigmentation.
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27.13 Colour dilution alopecia. This Dobermann has hair loss in the darker-haired regions but not in the lighter coloured hair regions. Note the clear demarcation between the areas.
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27.16 American Hairless Terrier. Note the lack of hair on the body that is normal for this breed.
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27.17 Patchy alopecia and associated self-trauma on the head of a 12-week-old Pug with localized demodicosis.
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27.18 Dermatophytosis with the usual presentation of alopecia and scaling in a cross-bred dog. Circular lesions (epidermal collarettes) on a terrier with pyoderma. These are commonly mistakenly thought to be due to dermatophyte ‘ringworm lesions’, but nearly always represent a post pustular lesion.
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27.20 Follicular casts. Adherent keratin and follicular material on hair shafts (arrowed).
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27.21 Cross-bred dog with alopecia, depigmentation, erythema and epidermal thickening of the nasal philtrum due to epitheliotropic lymphoma.
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27.22 Crusting and scaling lesions on the eyelids of a young Siberian husky with zinc-responsive dermatosis.
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27.24 Pustules and crusting on the paw of a Cocker Spaniel with pemphigus foliaceus.
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27.26 A young Shar Pei with mucinosis undergoing excessive skin fold removal. Sticky tenacious fluid can be seen coming from the resection site.
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27.29 Vitiligo in a 5-year-old female Rottweiler, showing loss of pigmentation of the nasal planum, eyelids and oral mucosa.
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Image of Demodex canis mites: note the characteristic cigar shape of the adults. j = juvenile. (Original magnification X100)
Demodex canis mites: note the characteristic cigar shape of the adults. j = juvenile. (Original magnification X100) mites: note the characteristic cigar shape of the adults. j = juvenile. (Original magnification X100)
Image of Cheyletiella mite from a skin scrape. (Original magnification X200)
Cheyletiella mite from a skin scrape. (Original magnification X200) mite from a skin scrape. (Original magnification X200)
Image of Sarcoptes scabiei mite from a deep skin scrape. (Original magnification X200; examined using potassium hydroxide)
Sarcoptes scabiei mite from a deep skin scrape. (Original magnification X200; examined using potassium hydroxide) mite from a deep skin scrape. (Original magnification X200; examined using potassium hydroxide)
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Image of Cytology sample showing characteristic peanut-shaped Malassezia organisms (arrowed). (Diff-Quik; original magnification X1000, examined under oil emersion)
Cytology sample showing characteristic peanut-shaped Malassezia organisms (arrowed). (Diff-Quik; original magnification X1000, examined under oil emersion) Cytology sample showing characteristic peanut-shaped organisms (arrowed). (Diff-Quik; original magnification X1000, examined under oil emersion)
Image of Cytology sample from a pyoderma lesion showing bacterial cocci (c) and active phagocytosis by neutrophils (n). (Diff-Quik; original magnification X1000, examined under oil emersion)
Cytology sample from a pyoderma lesion showing bacterial cocci (c) and active phagocytosis by neutrophils (n). (Diff-Quik; original magnification X1000, examined under oil emersion) Cytology sample from a pyoderma lesion showing bacterial cocci (c) and active phagocytosis by neutrophils (n). (Diff-Quik; original magnification X1000, examined under oil emersion)
Image of Mast cells containing granules, including a dividing cell, in a sample from a mastocytoma. (Diff-Quik; original magnification X1000, examined under oil emersion)
Mast cells containing granules, including a dividing cell, in a sample from a mastocytoma. (Diff-Quik; original magnification X1000, examined under oil emersion) Mast cells containing granules, including a dividing cell, in a sample from a mastocytoma. (Diff-Quik; original magnification X1000, examined under oil emersion)
Image of Sample from a pustule in a case of pemphigus foliaceous showing epithelial cells (acantholytic (a) cells), that have lost their adhesion to adjacent cells, giving them a rounded appearance. Neutrophils (n) are also present. (Diff-Quik; original magnification X1000, examined under oil emersion)
Sample from a pustule in a case of pemphigus foliaceous showing epithelial cells (acantholytic (a) cells), that have lost their adhesion to adjacent cells, giving them a rounded appearance. Neutrophils (n) are also present. (Diff-Quik; original magnification X1000, examined under oil emersion) Sample from a pustule in a case of pemphigus foliaceous showing epithelial cells (acantholytic (a) cells), that have lost their adhesion to adjacent cells, giving them a rounded appearance. Neutrophils (n) are also present. (Diff-Quik; original magnification X1000, examined under oil emersion)
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Image of Anagen hairs, showing rounded bulb ends. (Original magnification X100)
Anagen hairs, showing rounded bulb ends. (Original magnification X100) Anagen hairs, showing rounded bulb ends. (Original magnification X100)
Image of Telogen hair showing a tapered end. (Original magnification X200)
Telogen hair showing a tapered end. (Original magnification X200) Telogen hair showing a tapered end. (Original magnification X200)
Image of Dermatophytosis: arthroconidia can be seen surrounding the hair shaft (arrowed). (Original magnification X400)
Dermatophytosis: arthroconidia can be seen surrounding the hair shaft (arrowed). (Original magnification X400) Dermatophytosis: arthroconidia can be seen surrounding the hair shaft (arrowed). (Original magnification X400)
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Image of An example of a questionnaire for a dog with a skin problem.
An example of a questionnaire for a dog with a skin problem. An example of a questionnaire for a dog with a skin problem.

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