Pet owner educational atlas. Dermatology

THE VETERINARY PUBLISHING COMPANY SMALL ANIMALS

Pet Owner Educational Atlas

DErmAtOlOgy Reviewer: Carmen Lorente

Pet Owner Educational Atlas

Dermatology TECHNICAL SPECIFICATIONS Author: Servet.

Reviewer: Carmen Lorente.

Format: 22 x 28 cm.

Number of pages: 60.

Binding: Hardcover, wire-o.

Year: 2013.

ISBN: 978-84-941014-7-2.

PVP: 60 e.

This illustrated work aims at helping veterinary surgeons to communicate with pet owners. In keeping with the previous volume about surgery, the illustrations of this atlas dedicated to dermatology will simplify the explanations given by vets to their clients about the anatomical, physiological and pathological characteristics of skin, as well as those about the diagnostic tests, treatments and surgical techniques that may need to be carried out in some cases.

Every illustration was designed to help in the different clinical aspects of the dermatology consultation, from the anatomical and physiological considerations about the skin and its annexes, to the graphic description of infectious, inflammatory, endocrine, allergic or tumoral disease processes which cause dermatological conditions.

The clarity and accuracy of the illustrations, designed to make the explanations given to owners easier to understand and less timeconsuming, turn this atlas into another useful clinical tool.

Aimed at veterinary surgeons, students, teachers and other professionals in the veterinary sector.

Centro Empresarial El Trovador, planta 8, oficina I - Plaza Antonio Beltrán Martínez, 1 • 50002 Zaragoza - España Tel.: 976 461 480 • Fax: 976 423 000 • pedidos@grupoasis.com • Grupo Asís Biomedia, S.L.

The veterinary publishing company

Pet Owner Educational Atlas . Dermatology TABLE OF CONTENTS 1. Anatomy of the skin and hair Healthy skin cross-section Structure of the hair follicle Skin barrier Characteristics of the nail. Trimming technique

2. Physiopathology of the skin and hair Stages of wound healing Good against poor wound healing Primary lesions: Macule Papule Plaque Pustule Vesicle Nodule Tumour Cyst Bite Wart

Lesions that can be primary and secondary: Scale Alopecia Crust Ulcer Erosion Follicular cast Blackhead Alteration of pigmentation

Secondary lesions: Blackhead Epidermal collarette Scar Fissure Excoriation

Lichenification Erosion Callus (hyperkeratosis)

Diseases of the hair follicle Types of alopecia: inflammatory and non-inflammatory Characteristics of pruritus

3. Medical and surgical treatments Types of wounds: Cuts Puncture wounds Contusions Lacerations/avulsions Abrasions Bites Gunshot wounds

Types of burns: First-degree burn Second-degree burn Third-degree burn

Dressings. Moist healing Procedures to avoid skin tension (I).

Relaxing incisions: Simple Multiple Punctate incisions Z, V and Y-plasties

Procedures to avoid skin tension (II).

Suture patterns: Walking suture Subdermal suture Relaxation suture

Local, distant and axial flaps

Centro Empresarial El Trovador, planta 8, oficina I - Plaza Antonio Beltrán Martínez, 1 • 50002 Zaragoza - España Tel.: 976 461 480 • Fax: 976 423 000 • pedidos@grupoasis.com • Grupo Asís Biomedia, S.L.

The veterinary publishing company

4. Diseases of the skin Parasites

Eyes and ears

FAD. Flea-Allergy Dermatitis

Entropion and resolution

How ticks bite and attach to the skin

Ectropion and resolution

Types of manges (I): Sarcoptes, Cheyletiella and Otodectes

Normal ear. Correct cleaning and washing procedure

Types of manges (II): Demodex

External otitis. Ear exudate smears

Mosquito bite and transmission of diseases

Otitis media and interna

Miasis larvaria

Ear haematoma. Types of resolution

Fungi and yeasts

Neoplasms

Dermatophytosis: Microsporum, Trichophyton and Epidermophyton

Nodules. Inflammatory or neoplastic process?

Cutaneous mycoses

Fibrosarcoma and surgical resolution with wide safety margins

Dermatitis caused by Malassezia

Mastocytoma and metastases

Bacterial infection

Squamous cell carcinoma

Pyotraumatic dermatitis, acute moist dermatitis or hot spot

Mammary tumour

Deep and superficial pyoderma

Frequent foot pad disorders

Mucocutaneous pyoderma and epitheliotropic lymphoma

Interdigital fistula caused by a foreign body (splinters)

Sebaceous adenitis

Anal sac diseases

Infectious and sterile panniculitis

Dental fistula

Skin folds (I). Lip fold dermatitis and its surgical resolution

Pemphigus foliaceus. Autoimmune mechanism

Skin folds (II). Tail fold dermatitis and its surgical resolution

Allergies and atopies

Miscellaneous

Anaphylactic reaction. Angioedema Endocrine diseases Kerato-seborrheic disorders

Centro Empresarial El Trovador, planta 8, oficina I - Plaza Antonio Beltrán Martínez, 1 • 50002 Zaragoza - España Tel.: 976 461 480 • Fax: 976 423 000 • pedidos@grupoasis.com • Grupo Asís Biomedia, S.L.

Pet Owner Educational Atlas

Dermatology Reviewer: Carmen Lorente

7

Anatomy of the skin and hair

1

Healthy skin cross-section

9

Physiopathology of the skin and hair

5 Secondary intention

healing phases

STRATA:

2 Proliferative phase

1 Inflammatory phase

Corneum Granulosum

Haemorrhage

Spinosum

Suppuration (pus) Fibrin clot

Neutrophil diapedesis

Basale

Arrival of fibroblasts that synthesize collagen

Platelets aggregate Initial vasoconstriction (5-10 minutes)

Phagocytosis cell migration

Posterior vasodilatation and increase of the vascular permeability

Interstitial oedema

Proliferation of endothelial cells

Granulation tissue formation

Nerve endings

Superficial

Epidermis

3 Remodelling phase

New epidermis

Migration of epithelial cells over the granulation tissue

Resorption of old collagen

Apocrine gland Hair follicle

Remodelling and contraction of the wound

Connective tissue formation

Deep

Nerve

Vascular neoformation

Arteriovenous plexus

Middle

Dermis

Epithelialization phase

Collagen synthesis and deposit

Sebaceous gland

Subcutaneous tissue

4

Cutaneous muscle Artery Vein

Bacteria

Erythrocytes

Macrophages

Platelets

Eosinophils

Neutrophils

Panniculus adipose tissue

Fibroblasts

Physiopathology of the skin and hair

7 Primary lesions

11

13

Medical and surgical treatments

15 Dressings. Wet healing Wet secondary intention healing of wounds with dressings

Macule Change in colour of the epidermis without altering elevation, consistency or thickness.

It may be erythematous and hyper or hypopigmented

Papule Small elevated lesion, erythematous and slightly hardened of up to 1 cm in length caused by cellular infiltration or proliferation

Nodule Solid lesion over 1 cm in diameter, dermal location and usually extended into the deep layers of the skin. It may be of inflammatory or neoplastic origin

1 Clean the lesion and disinfect the area

2 Shave the hair of surrounding areas

3 Wash the wound thoroughly with saline solution

4 Surgically debride of the wound

exhaustively

Tumour Large mass that can affect any skin structure. It may be of inflammatory or neoplastic origin

under pressure. Remove detritus or contaminating particles

Plaque Elevated lesion, flat, solid and wide of more than 1 cm in length associated to cellular infiltration or proliferation

Pustule Small circumscribed cutaneous elevation that contains purulent material. It may be intraepidermal, subepidermal and follicular

and its edges

Cyst Cavity delimited by an epithelium, which is clinically presented as a nodule or tumour. Desquamative materials or glandular secretions are stored in its interior

Skin wheal Oedematous cutaneous area, raised and irregular that often changes size and shape

5 Apply a bandage with dressings that promote the correct formation of granulation tissue. Monitor the healing

Layers of the dressing Tertiary or retaining layer

Vesicle Small circumscribed elevation with a collection of clear fluid within the epidermis or below it. It can be intraepidermal or subepidermal

Wart Solid elevation of the epidermis with a formation of exophytic projections and generally covered by a scab

Secondary or absorbent layer Wound

Primary or contact layer

15

Skin pathologies

Skin pathologies

20 Tick bites and

35 Entropion and resolution

attachment to the skin Female tick ingesting blood in order to lay the eggs

Lesions in the cornea of the eye

The edge of the eyelid is folded and is in contact with the cornea

Surgical resolution techniques Tick ​​head (retractable sucking mouthparts)

HOTZ-CELSUS TECHNIQUE The tick secretes a substance that attachs its mouthparts into the host’s skin

Palps Chelicerae

Inflammatory skin reaction

Hypostome

Solves the entropion of the lower eyelid

MODIFIED HOTZCELSUS TECHNIQUE: ARROWHEAD Solves the entropion of the lateral edge of the eyelid

The saliva of the tick has an anticoagulant effect and causes a small haemorrhage from which it feeds

The tick inoculates the pathogenic agents during feeding

FRANS STADES TECHNIQUE Solves the entropion of the upper eyelid

17

19

Skin pathologies

42 Fibrosarcoma

47 Interdigital fistula caused

and resolution

by a foreign body (spikelet)

Surgical removal with wide safety margins Nodule on the withers

21

Skin pathologies

Deep penetration of the spikelet

Fibrosarcoma is a malignant neoplasm that may appear as a nodule in the skin. Its surgical resolution can be accompanied by radiation therapy

Lateral safety margins Location of the spikelet

Course of the fistula

When removing a malignant neoplasm (highly invasive) security surgical margins should be established. As a result, the resulting wound is larger than the tumour but this procedure also reduces the likelihood of recurrence or metastasis

Infiltrative digitations of the neoplasm

Interdigital inflammation

Spikelet entry point

Safety margins in depth

The veterinary surgeon introduces alligator forceps by the fistulous trajectory to access the spikelet.

Sometimes surgery is needed to remove the foreign body and close the fistula