History, examination and initial evaluation

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A logical and thorough work-up is necessary for successful management of dermatology cases. This chapter covers the use of signalment, history and dermatological and general physical examinations to formulate a list of differential diagnoses.

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2.3 Dermatological history form for a dog.
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2.4 Dermatological history form for a cat.
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2.5 A visual analogue scale with descriptors for owner assessment of pruritus severity from 0–10 ( ). Owners are asked to place a mark on the vertical line at the level representing the animal’s degree of pruritus. This is then transformed by measurement into a score from 0–10. Owners should be reminded that rubbing, chewing or licking can be due to pruritus. For cat owners, it is important to include grooming behaviour as a sign of itching.
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2.6 To avoid nosocomial infections far-reaching hygiene routines need to be utilized: autoclaved and sterile packed (a) clipper blades , (b) cones for the otoscope and (c) skin scraping blades.
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2.7 A dermatoscope is a practical hand-held tool that allows a close-up examination of skin lesions, with good light and 10X magnification.
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2.9 Primary lesions. (a) Melanotic, perianal maculae in a dog with a testicular tumour. (b) Papules. (c) Alopecic, erythematous nodule (mast cell tumour). (d) Plaque-formed lesions in a Border Collie with ciclosporin-induced lichenoid psoriasiform dermatitis. (e) Vesicle and bulla (circled) on the lip of a Great Dane with epidermolysis bullosa aquisita. (f) Large pustule in a dog with pyoderma and hyperadrenocorticism. (g) Nodules and tumours in an English Bulldog with non-epitheliotrophic lymphoma. (h) Wheal formation in a Rhodesian Ridgeback with urticaria.
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2.10 Secondary lesions. (a) Collarette in a dog with pyoderma. (b) Scar formation after ulcerative lesion in a cat with fragile skin due to excessive corticosteroid treatment. (c) Erosion. (d) Ulcerations in the groin of a Great Dane with epidermolysis bullosa acquisita. (e) Fissure of the paw pad in a Kromfohrländer with digital hyperkeratosis. (f) Alopecia, lichenification and hyperpigmentation due to dermatitis. (g) Excoriation on the neck of a cat with food-responsive dermatosis.
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2.11 Lesions that can be either primary or secondary. (a) Alopecia: (i) Spontaneous alopecia (i.e. alopecia as a primary lesion) on the bridge of the nose in a hypothyroid dog. (ii) Secondary alopecia in a cat with self-inflicted ventral alopecia. (b) Scales in a dog with leishmaniosis. (c) Crusts. (d) Follicular casts on the ear pinna of a Howavart with sebaceous adenitis. (e) Comedone formation in a Lhasa Apso with demodicosis. (f) Alopecia, lichenification and hyperpigmentation on the shoulder of a dog infected with . (g) Nasal hypopigmentation in a dog with discoid lupus.
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2.12 By applying pressure to lesional skin with a glass slide it is possible to discriminate between inflammatory, vascular and haemorrhagic or non-vascular (nevus) lesions. Haemorrhagic and non-vascular related lesions do not blanche on pressure.

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