DERMATOLOGY. Dr. Khaled M. Al-Qudah. 4/24/2013 Dr. Khaled Al-Qudah 1
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1 DERMATOLOGY Dr. Khaled M. Al-Qudah 4/24/2013 Dr. Khaled Al-Qudah 1
2 Type of Skin Lesions I. primary lesions: 4/24/2013 Dr. Khaled Al-Qudah 2
3 primary lesions Macule: flat circumscribed impalpable area of color change level with the skin surface (1cm), as in Arabian fading syndrome 4/24/2013 Dr. Khaled Al-Qudah 3
4 primary lesions Patch: a macule more than 1cm, the depigmentation of the muzzle of this horse shows white patches and black macules within patches 4/24/2013 Dr. Khaled Al-Qudah 4
5 primary lesions Papule: a circumscribed, palpable solid usually round mass in the skin, less than 1cm. Slight erythmea may show in non-pigmented skin; heavily pigmented skin may not show any color change. It can be associated with pruritus caused by insect bites 4/24/2013 Dr. Khaled Al-Qudah 5
6 primary lesions Plaque: a solid, elevated, flattopped lesion, more than 1cm. They may be irregular in shape but are often circular. They are related to allergic reactions from drugs or feed 4/24/2013 Dr. Khaled Al-Qudah 6
7 primary lesions Nodule: a circumscribed, solid, usually round mass, usually raised and rounded more than 1cm. Nodules have the same origins as papules but increased size due to more severe reaction. 4/24/2013 Dr. Khaled Al-Qudah 7
8 primary lesions Vesicle: a circumscribed, elevated, fluctuant fluid filled lesion containing serum, (1cm). Due to the thin layer of skin covering both vesicles and bullae, they often rupture, leaving a reddish eroded surface. 4/24/2013 Dr. Khaled Al-Qudah 8
9 primary lesions Bulla: a vesicle more than 1cm. They can be epidermal or subepidermal. they often rupture, leaving a reddish eroded surface, therefore rarely seen intact. 4/24/2013 Dr. Khaled Al-Qudah 9
10 primary lesions Pustule: a vesicle filled with pus (inflammatory cells). These lesions are seen in staph. and strept. Skin infections and later stages of Equine Coital Exanthema. These are pustules due to ECE on a stallion s penis. 4/24/2013 Dr. Khaled Al-Qudah 10
11 primary lesions Wheal (urticaria, hive): a circumscribed, semisolid, raised, round or flat-topped lesion of varying size from 2-3 mm up to cm. they are usually associated with edema of the area. 4/24/2013 Dr. Khaled Al-Qudah 11
12 Wheals - Equine back from stable fly bites 4/24/2013 Dr. Khaled Al-Qudah 12
13 Type of Skin Lesions II. Secondary lesions 4/24/2013 Dr. Khaled Al-Qudah 13
14 Secondary lesions Scale: an accumulation of loose fragments of stratum corneum. May be white or discolored by secretion of sebum or blood breakdown products. Thicker and more adherent scale 4/24/2013 Dr. Khaled Al-Qudah 14
15 Secondary lesions Hyperkeratosis: localized, multifocal or generalized accumulation of adherent keratinaceous material. 4/24/2013 Dr. Khaled Al-Qudah 15
16 Secondary lesions Crust (scab): a dried, solid, adherent consolidation of varying combinations of serum, blood, pus, cutaneous debris, and microorganisms. It may or may not be infected. 4/24/2013 Dr. Khaled Al-Qudah 16
17 Secondary lesions Erosion: loss of epidermis to varying depths, but not penetrating the basement membrane. Does not result in scarring. 4/24/2013 Dr. Khaled Al-Qudah 17
18 Secondary lesions Ulcer: loss of tissue that breaches basement membrane and the dermis, if healing occurs, it results in scar formation. 4/24/2013 Dr. Khaled Al-Qudah 18
19 Secondary lesions Epidermal collarette: circular rim of peeling epidermis surrounding a recent erosion or ulcer. 4/24/2013 Dr. Khaled Al-Qudah 19
20 Secondary lesions Lichenification: thickened skin that is hard, with exaggeration of normal lines and markings. It occurs as a result of chronic inflammation and is due to repeated rubbing or biting at areas affected by pruritus. 4/24/2013 Dr. Khaled Al-Qudah 20
21 Secondary lesions Lichenification Chronic 4/24/2013 Dr. Khaled Al-Qudah 21
22 Secondary lesions Excoriation: Superficial traumatic abrasions and scratches which remove some of the skin substances, commonly caused in animals by rubbing or scratching pruritic skin. 4/24/2013 Dr. Khaled Al-Qudah 22
23 Secondary lesions Fissure: the skin may split due to drying out and loss of elasticity. The split area often bleeds if forceably moved as is seen here in a Dermatophilus infection of the nose 4/24/2013 Dr. Khaled Al-Qudah 23
24 Secondary lesions Alopecia (hypotricosis): complete absence or loss of hair where it normally occurs. This illustration shows a horse s neck with alopecia due to Dermatophilus infection causing loss of hair. 4/24/2013 Dr. Khaled Al-Qudah 24
25 Secondary lesions Hyperpigmentation: develops due to increased melanin in the epidermis and/or the dermis. This can be a natural change. 4/24/2013 Dr. Khaled Al-Qudah 25
26 Secondary lesions Hypopigmentation: 4/24/2013 Dr. Khaled Al-Qudah 26
27 Secondary lesions Comedo: plugged hair follicle by keratin and sebum, either black or white. Found in feline and canine (Schnauzer Comedo Syndrome) the causes are unknown, but believed to be an inherited disorder of Keratinization. 4/24/2013 Dr. Khaled Al-Qudah 27
28 Secondary lesions Hypotrichosis Changes in quality of hair coat. 4/24/2013 Dr. Khaled Al-Qudah 28
29 Secondary lesions Hypertrichosis Increase of hair coat. 4/24/2013 Dr. Khaled Al-Qudah 29
30 Secondary lesions Hypertrichosis: Hypertrichosis due to hyperadrenallism in a pony with a hypophyseal tumor 4/24/2013 Dr. Khaled Al-Qudah 30
31 DISEASES OF EPIDERMIS AND DERMIS 4/24/2013 Dr. Khaled Al-Qudah 31
32 1-Pityriasis (dandraft) Presence of bran like scales on the skin surface. Etiology Infectious agent ring worm. Parasitic flea, louse, mange. Dietary -Hypovitminosis-A -Poisoning by Iodine -Vitamin B deficiency -Deficiency of fatty acids especially linolenic. 4/24/2013 Dr. Khaled Al-Qudah 32
33 Clinical findings Primary Pityriasis: scales accumulate in the area where the coat is long 4/24/2013 Dr. Khaled Al-Qudah 33
34 Clinical findings Secondary Pityriasis associated with lesions of primary disease. 4/24/2013 Dr. Khaled Al-Qudah 34
35 Clinicl pathology: skin scraping. D. Diagnosis: Hyperkeratosis. Parakeratosis. Treatment: Correction of primary cause. Thorough washing followed by alcoholic lotion, salicylic acid with lanolin base. 4/24/2013 Dr. Khaled Al-Qudah 35
36 2-Parakeratosis Keratinization of the epithelial cell is incomplete. Etiology -Deficiency of zinc -Adema disease in cattle -Chronic inflammation of cellular epidermis. 4/24/2013 Dr. Khaled Al-Qudah 36
37 Parakeratosis Zinc defeciency 4/24/2013 Dr. Khaled Al-Qudah 37
38 Parakeratosis Clinical Finding -Lesions confined to flexor aspect of joint -Reddening Thickening of skin gray coloration -lesions (Crack & fissure). Clinical pathology: biopsy or skin section. D. Diagnosis Keratinization. 4/24/2013 Dr. Khaled Al-Qudah 38
39 Treatment -Correction of the deficiency -Remove of abnormal tissue by (salicylic acid ointment) then application of astringent preparation (white lotion paste). 4/24/2013 Dr. Khaled Al-Qudah 39
40 3-Hyperkeratosis excessive keratinized epithelial cells accumulate on the surface of skin. 4/24/2013 Dr. Khaled Al-Qudah 40
41 3-Hyperkeratosis Etiology -Chronic arsenic poisoning -Poisoning with highly chlorinated naphthalene compounds -Inherited (fish scale disease) of cattle. Clinical findings -Skin is thick & is corrugated & hairless -Fissures, scaly appearance -Secondary infection of the fissures if the area is wet. 4/24/2013 Dr. Khaled Al-Qudah 41
42 Clinical pathology: biopsy section to histopathology D.Diagnosis Parakeratosis Treatment Salicylic acid ointment. 4/24/2013 Dr. Khaled Al-Qudah 42
43 4-Pachyderma Thickening of the skin affecting all layers (subcutaneous tissue is involved). Etiology: Chronic or recurrent inflammation of the skin. Clinical findings: Thin or no hair coat, the skin is thicker & tight. 4/24/2013 Dr. Khaled Al-Qudah 43
44 D. Diagnosis No superficial skin lesions & no cell depries so the condition is differentiated from other conditions. Treatment -Cortisone preparations locally -Surgical removal of small areas. 4/24/2013 Dr. Khaled Al-Qudah 44
45 5-Impetigo Superficial eruption of thin walled, usually small, vesicles surrounded by a zone of erythema. 4/24/2013 Dr. Khaled Al-Qudah 45
46 Impetigo. Etiology the main organism is staphylococcus. Clinical findings: vesicles (3-6 mm), in early stages zone of erythema. vesicles may persist and become pastule. involvement of hair follicles acne. Clinical pathology: vesicular fluid culture. D. Diagnosis Cow pox and pseudo pox. Treatment prevent the occurrence of new lesions twice bathing with germicidal skin wash daily. 4/24/2013 Dr. Khaled Al-Qudah 46
47 6-Urticaria allergic condition characterized by the appearance of wheals on the skin surface common in horses. 4/24/2013 Dr. Khaled Al-Qudah 47
48 Conventional wheals lesions are 2-3 mm up to3-5 cm in diameter Urticaria 4/24/2013 Dr. Khaled Al-Qudah 48
49 Multiple giant wheals up to mm diameter Urticaria 4/24/2013 Dr. Khaled Al-Qudah 49
50 Papular wheals, multiple, small uniform 3-6 mm diameter wheals Urticaria 4/24/2013 Dr. Khaled Al-Qudah 50
51 Annular wheals. Doughnut-like lesions with regular or irregular ring of edema surrounding a depressed, non or less oedematous centre. Urticaria 4/24/2013 Dr. Khaled Al-Qudah 51
52 Urticaria 4/24/2013 Dr. Khaled Al-Qudah 52
53 Urticaria Etiology Primary Insect stings Ingestion of unusual food Drugs as penicillin, milk allergy. Secondary Respiratory tract infection (strangles, viral infection). 4/24/2013 Dr. Khaled Al-Qudah 53
54 Urticaria. Clinical findings Tense elevated with flat top lesions(0.5-5 cm) Color changes in unpigmented skin No exudation or weeping. Clinical pathology: biopsies, tissue histamine and eosinophils. Treatment Antihistamine Change of diet Mild purgative White lotion. 4/24/2013 Dr. Khaled Al-Qudah 54
55 7-Dermatitis Conditions characterized by inflammation of dermis & epidermis. 4/24/2013 Dr. Khaled Al-Qudah 55
56 Etiology *Cattle: 1.Udder impetigo (Staph. aurous). 4/24/2013 Dr. Khaled Al-Qudah 56
57 Etiology Cattle: Cowpox 4/24/2013 Dr. Khaled Al-Qudah 57
58 Etiology *Cattle Ulcerative mamilitis. : 4/24/2013 Dr. Khaled Al-Qudah 58
59 Lumpy skin disease. Etiology *Cattle: 4/24/2013 Dr. Khaled Al-Qudah 59
60 Etiology *Cattle: F.M.D 4/24/2013 Dr. Khaled Al-Qudah 60
61 Etiology *Cattle: Rinderpest 4/24/2013 Dr. Khaled Al-Qudah 61
62 MCF 4/24/2013 Dr. Khaled Al-Qudah 62
63 Etiology Sheep, Goat 1.Strawberry Foot rot 4/24/2013 Dr. Khaled Al-Qudah 63
64 Etiology Sheep, Goat 3.Sheep pox. 4/24/2013 Dr. Khaled Al-Qudah 64
65 Etiology Sheep, Goat Contagious ecthyma. 4/24/2013 Dr. Khaled Al-Qudah 65
66 Etiology Sheep, Goat F.M.D 4/24/2013 Dr. Khaled Al-Qudah 66
67 Etiology Sheep, Goat PPR 4/24/2013 Dr. Khaled Al-Qudah 67
68 Dermatitis Etiology Horse 1.Staphylococcal dermatitis (Saddle rash) due to Staph. aurous. The affected area of the saddle was extremely painful to touch. 2.staph. byicus 3.Actinomyces viscosum 4/24/2013 Dr. Khaled Al-Qudah 68
69 dermatitis Viral papular dermatitis lesions on the scrotum of a stallion 4/24/2013 Dr. Khaled Al-Qudah 69
70 dermatitis Horse pox: Typical ulcerative, vesicular and scabby lesions of horse pox on the lips and nasal margin 4/24/2013 Dr. Khaled Al-Qudah 70
71 Dermatitis Dermatophytes: Dermatophytosis - early annular lesions - equine gluteal region 4/24/2013 Dr. Khaled Al-Qudah 71
72 Dermatitis Dermatophytosis - bovine face - annular alopecia (white rings) 4/24/2013 Dr. Khaled Al-Qudah 72
73 Clinical Finding -Erythema & increased warmth. -Discrete vesicular lesion, diffuse weeping. -Edema, scab formation. -Diffuse cellulites or phlegmonous. Treatment -Removal of the stimulus. -Identification of etiological agent: Bacterial culture & Sensitivity. -Local + Systematic treatment together. -Anti histamine in allergic states. -Anesthetic when pain or itching. 4/24/2013 Dr. Khaled Al-Qudah 73
74 8-Photosensitization Sensitization of the superficial layers of lightly pigmented skin, mucosa & cornea to light. 4/24/2013 Dr. Khaled Al-Qudah 74
75 Photosensitization Photosensitization affecting the white facial stripe and the white digits in a mare with liver failure. The foot lesions affect the lateral aspects far more than the medial 4/24/2013 Dr. Khaled Al-Qudah 75
76 Photosensitization Severe photosensitization affecting the white areas of the skin. Notice the sharp cut-off of the severe dermatitis at the margins of the white areas. 4/24/2013 Dr. Khaled Al-Qudah 76
77 Photosensitization 4/24/2013 Dr. Khaled Al-Qudah 77
78 Etiology I. Primary photosensitization due to ingestion of exogenous photodynamic agent usually occurs when plant is in the lush green stage & is growing rapidly & the plant must be eaten in large amount. II. Photosensitization due to aberrant pigments synthesis: Congenital prophyria excessive production of body prophyrins. 4/24/2013 Dr. Khaled Al-Qudah 78
79 III. Hepatogenous Photosensitization normally: Chlorophyll by metabolism phylloerythrin (end product) which is excreted in bile. If bile excretion is obstructed, phylloerythrin accumulate in the body increase in the skin, that lead to skin is sensitive to light. IV. Photosensitization of uncertain etiology 4/24/2013 Dr. Khaled Al-Qudah 79
80 Clinical findings -Erythema edema weeping gangrene. -Distributed in non pigmented skin. -Irritation, rubs of affected part. Clinical pathology: no, field test for sensitivity Treatment -Removal from direct sun light. -Prevention of ingestion of further toxic materials. -Antihistamine. 4/24/2013 Dr. Khaled Al-Qudah 80
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