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    Alterations in The Skin (Large Animal)

    Uploaded by

    Arkan Maulana Islami

    Copyright:

    © All Rights Reserved
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    Editor-in-Chief Bradford P. Smith, DVM, DACVIM Professor Emeritus Department of Medicine and Epidemiology School of Veterinary Medicine University of California, Davis Davis, California Large Animal Internal Medicine FIFTH EDITION ELSEVIER ce Sots No 308 {capyrght © 2015 by Sony an imprint of heir ie {Cope © 209, 3002196 19 by Nosy. nc anal Eve In Allright revered No prt ofthis puicain may bereproacd or uted ay rm any ea, ‘leon ar mecha incaing pois recorting. oa inematon spe and reel per ‘riot permis nit ro the pte Dataset ek pene, ate irate ot the Punters permis pols and our angen wih orgazatons Sch es the CaP Clean (Cee nd the Coppel LeatngAgvsh cat ned sour vata rueoriecrapomees ‘Ths ook athe nel ons conan in ae pected under copyright by the Plier thr "Notices ‘Knowiedge and best practice inthis eld are constant changing. Asnew research and experience Troaden our undentanding, changes in research methods, profession practices, or medial teatment may become necessary Practitioners and researchers must always rely on their own experience and knowledge in evaluating and wsing ay information, methods, compounds. or experiments described beri In sing such information or methods they shuld be minal of theron safety and te safety af thes, inladng parties for hom they have 4 professional esponsblt ‘With respect to any drug or pharmaceutical products iene readers are advised to check ‘he most caren inorsation provided ) cn procedures Featured oe (2) By the manafctree of tach product tobe administered, to verify the recommended dose or formal, the method and drut of edminitation, end containdatoe. isthe spony of prctiners, ecg, ‘on their own experience and knowledge oftheir patient. to make Glagnoses, Yo determine dlnages andthe bes treatment foreach individual patient and to tae ll appropriate suey prectutons "To tefulles extent of the aw nether the Publisher nor the autor, cotebuirs,o ens, assume any ably fr any injury andor damage to persons ox Peper asa matter of products dy nen or ter o uy op ay met pede rary of Congres Cataloging i-Pelicton Ds genial nero medicine ee le Be at Sth Fit ion ioetedesieaa eas PRE NSLS Caso soup el 6) ae Ye Preset an Pao Lnds Duncan Conon Sg Dir Py Rasp ‘Cnt Deepen Specs rant Gear Dubner Manager: Cater cso Pry Mane Roc ergo Dot Deco: Beas Slab Tmtdigeuthepeinmnbe 987-6 8 492 Wig Working ones Abi 0 grow libraries in Mf developing countries ° CHAPTER 11 Prarie, 158 ‘Scaling and crusting, 272 [Nodules, tumors, and ewelings, °°? Abnormal cout length aed density, 171 Urcerations and erovione 2" ‘Abnormal pigmentation, 7" General Approach to Diseases That Alter ‘the Skin Ie important wo remember dat de akin has a Uimied repertoire ‘wih egard to ie presentation: many caeses wih variu cee ‘nay manifest with simlar less. However, certain paras of response to disease are also recognized. In onder to manage skin Problems successfull, the veteravian mast use’ a systematic ‘approach by obtaining a complete history performing a thorough ‘Physical examination, and, when appropiate, using one oF more ‘Smple diagnostic techniques’ The following sections discuss the materials and methods necesary to perioem techniques commonhy ‘sed to diagnose lage animal skin disease History “Ta obsin 2 diferetal diagnosis lit, the questions lied on the ‘aiaple history fom (Fg. 11-1) should bevanswered. Ofea 1s ‘ipl to epeat the questions to the armas oa er Gite oto give them a history form fo complet atthe lesre, which allows them (grater opportunity to venenber dts lent tothe kin dear. ‘The goals should be to determine the inal features ofthe skin ‘seas, how the problem has progress, and what factors have Inuencd ts progression tothe present state Physical Examination “The diagrams and terms listed onthe sample form (Fig 11-2) may serve asa usefl gue for vcording the physical findings. The ani- imal overall contion shou be asses. anda general phil (Guininti sheald be perfoved to detract Be dines Limited t the sin or if systemic signs of disease are also present. The urtbtion, morphology (ep, papules, nodal, wheal, patches of Slope) and size of skin sont should be noted. The mcs ‘merabranes also shuld be examined, and the sk sueice palpate to determine features not redly noted visually (eg. crass Bobet the air drynes, bliy to epi haie, and presence of peripheral Iymphadenopathy) "The practtoners goal shuld be to describe accursely the ani rma inal appearance in writen record for fre reference Diagnostic Techniques For most of the techniques tht follow, a good-quality microscope ‘quipped with, 1,20, and 100 (ol immersion) objectives = recommended. “Conibations pts of hcg In pes eons By Anne G anwar scknwiged ‘SKIN SCRAPINGS. Skin scrapings are se primary t demon: strate microscopic ectoparasites speticly mite. Seep is a (gic, simple inespensie diagnostic technique that i more tefl ‘fruminants dan in horses Because equine mite iafeations ate relatively uncommon. The materials needed to perform a skin Scraping are aster container, mineral oa medial-gade spatala (Gsherbrand: Micrrputla with Fat-Ended Bade, catalogue 10, 21-401-20, Fsher Slate, Pitsburg wonetshersiniecom), as slides, and coverslips. Although a No 10 scalpel Blade may be ‘sed. a medal grade spatula wll ot cut the skin i asso sudden ‘movement ofthe animal ye jst ine enough to beable t serape ‘deep enough to ind Demo species mites finde I the hair ‘oats thik a small aca should be clipped before scraping. Malle opel scrapings tat cover lange tric areas dull be per formed as well as several scrapings covering a small area that ate hep enough tocretecpdryoenng. The lected eater shoud te placed ina contalne until can be examined mncroncopclly Sone ofthe ramplecan then be placed on a ghst ode nd Bey ‘ezine along the marge of the Gara debe wile the cian featches for indication of motion in the saline Ifthe characeie ‘whiplash movement of th paraie is noted, higher powered abe tive shouldbe used Ifthe preparation vesul Is negative 2 stall ‘mount of water i added Yo Pett dy, the last lide sete or {hwo wooden sticks above the wate, and he cover i replaced on the {ih The preparation shouldbe incubated fo several ours or oer ight an reexamined The Petr dish helps prevent the sample from drying ou BACTERIAL CULTURE, Tc metho of act cltare depends con the pe of Ison. All haired lesions should be gen shaved. [Nedules and tumors shoud be cultured by aseptically excising the Teton or by obtaining» generous edge of the Sasa. To prevent cute contamination by surface Bacteria, the nodules should be eal shaved, washed eth an antscpicsoap,and did wih stere {Buz pad A periesonal injection of 2 nicaine is used to apes (ttn the theae The stole pce ina tranepert medio eed Sent to a microbiology laboratory for culture. A papular eruption (Gab is bs catered by sbtainag «erie G-swm ponch Mopry of skin. Crust may belted up andthe underside cured va asterle future, Ucestive leone should not be cured becatse any tacteria oat are moe hkely to be opportunistic rather than Primary pathogens Ifthe sons are tua (vesicles, pustules, the ‘veiing skin canbe opened gently witha No. 1s ads and some of the contents ofthe lestontansfersed with the Bade tothe ip of a stele culture sya. Although some alder iterate recommends nat ‘sing ster culturetes diet on the skin surface, de to concerns that bompetlopene bactera frm Gh kin aurfce ny be cubed the author has wed this method of cling paps eroptions or teal when a Dapoy is fem [SUBCUTANEOUS AND DEEP FUNGAL CULTURE. Subcutane- ‘us and deep fungal cultures should e performed on nodes, tumors, and Swelings "The techie is hlenal to that descrbed forbacteril clare ofthese lesions Pruritus Definition rors i an unplentact senation that proves the desire to scratch, lis designated a primary cutaneous sensation. along with ‘eat, col, pain apd touch There ar wo broad categoria of rar tus Physologi or spontaneous itch sa sharp, welded, prurtic tcesaion tht ia suficenlly intenee to prompt scratching bt thet oes ot rest insignificant ition ofthe skis this frequent ‘Say occurrence in nora individual. Pathologic Wh i the lee ‘wol-defined prune that occurs ina vary of primary and escond- ary skin disorders and in systemic diseases. es an intense cutaneous ‘comfort tat provokes vigorous seratching™ Mechanisms of Pruritus “The investigation of the mechanism of ruts has ben primary in laboratory teal od human. is prefered that crac of tt Iw applicable other animal species: Pras inet seaocry pally tusnitied from an arborsog network of mere (Cdings stunted ter nar the derenopitercal ncn, The sees tion i earned to the spinal cord through sell unmyelinated © fiberThe Ser enter the dsl rot ofthe spinal cond and ascend Inthe ventrolateral spinothalamic act through the osteror rental nucleus ofthe thalamus tothe sensor cortex: Te pruritic seston ‘maybe modiied in the sensory cortex by behavioral fats amn- peiing stimal* ‘Many ical and chemical simi can evoke purus and many ‘absances have been implied as mediating prustus in humans Examples these medistor eich are seamed fave importance in domestic animal aswel nclade the allowing: 1 Histamine Hstrinc hs been regarded a the Cte nein of pruritus Hisamine is presen in mast cel inthe dermis and in {Uisedbatephle. An tnredernal npction of hsucineprodacet purus within 20 to 30 seconds, Because many prurc onde Teyood poorly to snttitamines given eiey Gerepedtcaly or prphactcally, histamine snot believed tobe the sle mediator et porien, “Enopeptass. Examples include trypsin, pupln, and kallkel, Poitgandins (E sores and endopercdates)” Prostaglandins Induce prustus by petentting the eleaseof proteases rom ker linoetes and eukoeytes and by lowering the threshold and Increasing the duration of hiktaminesnduced pri, Endogenous opioid peptides. Opiates may potentiate preexisting pruntus The opis antagonist naloxone nydochloride has fn atenuating eect on the hisamie-inéuced component of ponte ‘Stbstance Substance Psa newrotransmiterfoundin the central hd peripheral nesoas astm: When introduced sneaderaly, iteiet a prartie response Many aco can olen exiting prs, Neurologi cts such 3s boredam and fatigue can poteatiae a pathologie ch and portly trmform a paolo tch into a pathologie ach. Local ‘xonal eles can potemtate pruritus that by if second stimulus sapped oan area close to one that sprue secoad sts, Inespective of is type, perceived as an th In adaon skin with ‘ron dermats has hinted perception of simul and any stim Tusapplied tothe acted region may be percetvedas thera baring ‘sensation ofan tch This phenomenon 8 known "conversion ih Secondary bacterial infections, vasodilatation, and inflammation rest im local increase proteases that potentiate prurits Prats can be diminished by several nonpharmacologie mecha- nisms the most common being application of competing smal Protas 2 minor scnaon Compared wih the other prisary CHAPTER 12 Akeratoninthe stn QM 167 Most Common Causes of Pruritus in Horses ‘and Ruminants: Ectoparacites Clee specs eras) Peovoptoe cui otal Pevontes ov tert ‘Seeaotarseabe furan) (Chops eae ves anette Hypersensitivity (Horses) Infectious Staphylococcal yoseme hese Dermatoptes| ‘sensations of heat, cold touch and pin thus local application ofa ‘Gonptng tina to pouic wen cen eqppeac the pres “sition Scratching tan exampico! competing sina Seratch {Sgenry sieve pour by curbing the cys fiestnpulbes teraling ted thecal nerveus system, An ltematve hese a that scratching may cause trandent damage to nerve fibers that ‘convey the prc snstion, Unfortunatly the effec is shot lived ‘because the epidermal damage induced by scratching causes the reece of epidermal potese that may ater increate the Segre of Pruntus Centrally acung factors such as diversions or distractions Ean also diminish the percepon of prrtusby providing competing ‘Smal ety to the cortex rather than locally to the stn” ‘Approach to the Diagnosis of Pruritus Prius isthe most common sign of cutaneous disease. Most fen in large amas ta caed Uy ectoparaes ova hyperseeitly reaction, orboth (eg Cictdeshypesenstt), but may aoe ‘uted by extaectt bacterial ce aga nfclena (eg dermat Blines, Maluseeiaspedes) (Box 11-1) Becasse pruritus may be 8 Fenure ofa more generalized deat proces sie amportan o tke the pte enetl healt int acount Hypetenstityreactns, ‘whith are connmoely pent nny or ens tbe cated tothe dn For example anaphylnila lfethestening hypersensitive tin that may manifest as pruritus ints nly stages, Other pruntic ‘kin dlseaer include immune-mediated dese such estope et= Imats or pemphigus foliaceus; det iitaton by chemicals and hotoactvated dermatoses Is halpul to formulate a diferent ‘agnosis by considering each of ese broad categories of diseases sstang Moi infration, other colancots ag nd apprope ‘te lagnostc tests to narrow the bt of diferent diagnoses. Th ellwing hepa ee w guide tothe dingodia of posts in the horse and ruminant 1 "History and pisical examination (Fig. 1) 4 Determine ithe pris ts seasonal er yearrond problem ‘Aceasuoally ecuven proric deat ends to sugges Seasonal exposure to a paras (eg. ce in the Wine, Hes fn the summer) ora sewn environmental allergen (eg, pallens) as the cause. Determine the level a ly expose for {he anima thats pruicn the warmer months ' Dewemine ifthe pruritus is generalized or localized andi localized, what ares of the Boy are afeted. For example photoactvated dermatoses are limited to the white hard Fegions «Determine if contact animals ofthe same andlor diferent species are afected or unafectd. The presence of utile runic animals s suggestive of a contagious disease (68, rmatophytes, ectoparasites) ofa dase of commen exp sore (Clic) A single pruritic aninal song = group of tunafetd animals is more ikay tobe experiencing a hyper Sensivity reaction (drug or enone) 4 Determine what topical und stemlc medications wer given tothe animal both before abd ster the onstof the pole. Medications gven bore onset maybe the chur of the pra tus and thove pen aferonsct may interfere wth the resale of diagnostic es, Determine whether allthe cutaneous lesion an belted to selearauma or If primary cutaneous changes ae present (ega wheal nodules pigmentary changes). Determine whether, on close Inspection, the coat shows evidence of sal lt rosy vibe perites wach Lice ot thew exes 2. The soca wack dingottic tats are shin scrapings, sctte tape preparations dermatophyte culture plus KOH preparation, Dermatapis preparation, micoflral preparation. Dp for routine histopathologic examination, and Intaderal testing (sce Chapter 40), Nodules, Tumors, Definition ‘A nodule i 3 circumscribed, seid levation Lager than Tem in diameter dat does ot defor when pated. Noduls extend alo the decper layers ofthe sin ae ae usualy the reat of cellar Infrtesin the dermis or ubcuts: Tumors ew pce tera that ‘cull rls « neoplastic odalarenlarperceat of the dn or beulaneoas teste” The term tumor fe mest commonly used ¢2 swelngs suchas abscesses aid jt, 10 nodules and Wnoss, 1 rusts and to externa tauma must be diferetated. The bst of ‘ferent diagnos relevant to cach ofthese ros of primary Icio i then considered “The follwing steps area guide othe diagnosis of leratons and

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