Dermatology

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In my multi-specialty, referral-based veterinary hospital in the heart of San Francisco, with all our many bells and whistles, including access to numerous specialists within our clinic (internal medicine, surgeon, radiologist, dentistry, holistic, oncologist, acupuncturist and ophthalmologist), I still continue to feel very frustrated with a common skin disease: canine pyoderma.

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Previously, differentials of feline facial pruritus were discussed to include ectoparasites such as flea allergy, otodectes, Notoedres and cheyletiella, food allergy, atopy including possible food storage mite allergy and demodicosis. Less common differentials include infections such as dermatophytosis, viral, and bacterial pyoderma, Malassezia dermatitis, Pemphigus foliaceus (PF) and idiopathic facial dermatitis of the Persian cat. Clinically, many of these diseases appear similar including Pemphigus foliaceus and bacterial pyoderma which can be difficult to differentiate both clinically and histopathologically.

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We have pretty much resolved ourselves to pigeonholing our pruritic dogs into the categories of atopy, food allergy and ectoparasites as a reason for their itching.

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For those nonseasonal pruritic patients where food elimination trials haven't been helpful and steroids seem to help or those patients with nonseasonal recurrent otitis or pyoderma, an allergy to house dust mites or food storage mites should be considered. Dust mites are the leading cause of allergy/asthma in humans. In dogs, it appears to exceed flea allergy as the most common intradermal skin test reaction. An estimated 30-80 percent of atopic dogs and cats skin test positive to dust mites (Photo 1). Of the two types of dust mites, Dermatophagoides farinae and Dermatophagoides pteronyssinus, cats tend to be allergic to

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Test your dermatology skills on the following cases. What would you do first? Which diagnostics would yield the most information yet not break your client's wallet? Are you seeing an unusual disease or more commonly, an unusual manifestation of a common disease?

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"Why does my dog have dry skin? Didn't I wash off all the shampoo? Am I bathing him too much? Does he need a conditioner?" We have all been asked these questions many times. With the winter months upon us for those in the colder areas of the country, the low humidity often causes humans to have "dry skin". This may be true for our canine patients as well, however dry skin in dogs may be the result of several underlying diseases (Photo 1).

When clients bring in their pets to have growths removed or wounds examined, we have the clients mark the problem spots on an anatomy chart. The chart makes it easy for us to locate all the lumps and lesions and is a great alternative to drawing on the animals with a marker. --Sage Olson, receptionist Kensington, Conn.