An approach to superficial and deep pyoderma

image of An approach to superficial and deep pyoderma
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Recognizing the presence of pyoderma in a dog is one of the most essential skills necessary for the successful practice of small animal medicine. This chapter covers the clinical presentations of pyoderma and the clinical approach to it.

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21.1 Intertrigo. Note the deep perivulvar folds. When the skin is stretched to reveal the lesional area, erythema with exudation, and in some cases erosions, may be noted. Pruritus is common.
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21.2 Bacterial folliculitis in a dog. A large patch of alopecia reveals plugging of the follicular ostia (also known as comedones), crusted exudate and scale at the advancing edge of the lesion.
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21.3 Bacterial folliculitis in a dog. Patches of alopecia in a ‘moth-eaten’ pattern with minimal visible inflammation and lacking primary lesions (e.g. papules and pustules) characterize this presentation of ‘short coat pyoderma’. Only mild erythema and scale accompany the extensive alopecia. (Courtesy of Dr David Duclos)
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21.4 Large (up to 7 cm diameter) expanding epidermal collarettes are typical lesions associated with exfoliative superficial pyoderma. (Courtesy of Dr David Duclos)
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21.5 Large flaccid pustules (impetigo) and ‘footprint’ collarettes in an adult dog on long-term immunosuppressive therapy.
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21.6 Nasal folliculitis and furunculosis. Note the alopecia, purulent exudate and haemorrhage, and heavy crusting on the bridge of the nose. Note similarities to eosinophilic furunculosis of the face (see Figure 21.16 ).
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21.7 Folliculitis and furunculosis of the muzzle (also known as ‘canine acne’).
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21.8 Interdigital folliculitis and furunculosis. Note the marked tissue swelling, plugging of the follicular ostia (comedones) and loss of the normal footpad architecture. Tissue culture should be performed to confirm a bacterial aetiology and select an optimum antimicrobial therapy.
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21.9 Localized folliculitis and furunculosis over the carpus (also known as canine ‘acral lick granuloma’)
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21.10 Regional folliculitis, furunculosis and cellulitis in a German Shepherd Dog (also known as ‘German Shepherd pyoderma’).
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21.11 Mucocutaneous pyoderma. Note the erosions and crusting on the nasal planum extending on to the mucocutaneous junctions and continuing (as bacterial folliculitis) on to the haired skin of the muzzle. The primary differential diagnoses for this complex of lesions include autoimmune skin diseases and atypical dermatophytosis.
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21.12 Post-grooming furunculosis. (a) Note the pattern of lesions distributed down the dorsal midline, which is typical of this condition. (b) Note the haemorrhagic crusts resulting from follicular rupture. (Courtesy of Dr David Duclos)
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21.13 Feline bacterial folliculitis with crusting. Large patches of alopecia with exudation and serocellular crusts are formed by self-trauma and secondary bacterial folliculitis in this cat with facial pruritus due to a food-responsive dermatosis (also known as food allergy or adverse food reaction).
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21.14 Feline bacterial folliculitis. Small patches of alopecia with marked erythema are the only signs of bacterial folliculitis in this cat, for which the primary differential diagnoses should be dermatophytosis and demodicosis (caused by ).
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21.15 Juvenile cellulitis: this is a sterile disease. Note the swelling, alopecia, ulceration and exudation of the muzzle, which can easily be confused with folliculitis and furunculosis, especially if it occurs in an adult animal.
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21.16 Eosinophilic furunculosis of the face. Haemorrhage, ulceration and heavy crusting can be seen on the face of this dog, which had been stung/bitten by an unknown type of insect. Note the swelling of the muzzle due to inflammation and oedema. Multiple dogs in the kennel presented with similar lesions.
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