عرض تقديمي من powerpoint - ava · 4/24/2013 dr. khaled al-qudah 5 primary lesions…...
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4/24/2013 Dr. Khaled Al-Qudah 1
DERMATOLOGY
Dr. Khaled M. Al-Qudah
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Type of Skin Lesions
I. primary lesions:
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primary lesions…
Macule:
flat circumscribed
impalpable area of color
change level with the
skin surface (1cm), as
in Arabian fading
syndrome
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primary lesions…
Patch:
a macule more than
1cm, the
depigmentation of the
muzzle of this horse
shows white patches
and black macules
within patches
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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
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primary lesions…
Plaque:
a solid, elevated, flat-topped lesion, more than 1cm. They may be irregular in shape but are often circular. They are related to allergic reactions from drugs or feed
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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.
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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.
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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.
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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.
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primary lesions…
Wheal (urticaria, hive):
a circumscribed, semisolid, raised, round or flat-topped lesion of varying size from 2-3 mm up to 10-12 cm. they are usually associated with edema of the area.
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Wheals - Equine back from stable fly bites
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Type of Skin Lesions
II. Secondary lesions
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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
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Secondary lesions…
Hyperkeratosis:
localized, multifocal or
generalized
accumulation of
adherent keratinaceous
material.
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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.
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Secondary lesions…
Erosion: loss of
epidermis to varying
depths, but not
penetrating the
basement membrane.
Does not result in
scarring.
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Secondary lesions…
Ulcer: loss of tissue
that breaches
basement membrane
and the dermis, if
healing occurs, it
results in scar
formation.
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Secondary lesions…
Epidermal collarette:
circular rim of peeling
epidermis surrounding a
recent erosion or ulcer.
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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.
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Secondary lesions…
Lichenification
Chronic
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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.
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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
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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.
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Secondary lesions…
Hyperpigmentation:
develops due to
increased melanin in
the epidermis and/or the
dermis. This can be a
natural change.
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Secondary lesions…
Hypopigmentation:
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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.
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Secondary lesions…
Hypotrichosis Changes
in quality of hair coat.
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Secondary lesions…
Hypertrichosis
Increase of hair coat.
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Secondary lesions…
Hypertrichosis:
Hypertrichosis due to
hyperadrenallism in a
pony with a
hypophyseal tumor
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DISEASES OF EPIDERMIS AND
DERMIS
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Pityriasis (dandraft)-1
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.
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Clinical findings
Primary Pityriasis:
scales accumulate in
the area where the
coat is long
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Clinical findings
Secondary Pityriasis
associated with
lesions of primary
disease.
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Clinicl pathology: skin scraping. D. Diagnosis:
Hyperkeratosis.
Parakeratosis. Treatment:
Correction of primary cause.
Thorough washing followed by alcoholic lotion, salicylic acid with lanolin base.
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2-Parakeratosis
Keratinization of the epithelial cell is incomplete.
Etiology
-Deficiency of zinc
-Adema disease in cattle
-Chronic inflammation of cellular epidermis.
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Parakeratosis
Zinc defeciency
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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.
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Treatment
-Correction of the deficiency
-Remove of abnormal tissue by (salicylic
acid ointment) then application of astringent
preparation (white lotion paste).
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3-Hyperkeratosis
excessive keratinized
epithelial cells
accumulate on the
surface of skin.
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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.
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Clinical pathology:
biopsy section to histopathology
D.Diagnosis
Parakeratosis
Treatment
Salicylic acid ointment.
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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.
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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.
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5-Impetigo
Superficial eruption of
thin walled, usually
small, vesicles
surrounded by a zone of
erythema.
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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.
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6-Urticaria
allergic condition
characterized by the
appearance of wheals on
the skin surface common in
horses.
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Urticaria
Conventional wheals
lesions are 2-3 mm up
to3-5 cm in diameter
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Urticaria
Multiple giant wheals up
to 20-30 mm diameter
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Urticaria
Papular wheals,
multiple, small uniform
3-6 mm diameter
wheals
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Urticaria
Annular wheals.
Doughnut-like lesions
with regular or irregular
ring of edema
surrounding a
depressed, non or less
oedematous centre.
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Urticaria
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Urticaria Etiology…
Primary
Insect stings
Ingestion of unusual
food
Drugs as penicillin,
milk allergy.
Secondary
Respiratory tract
infection (strangles,
viral infection).
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Urticaria….
Clinical findings
Tense elevated with flat top lesions(0.5-5 cm)
Color changes in un-pigmented skin
No exudation or weeping.
Clinical pathology:
biopsies, tissue histamine
and eosinophils.
Treatment
– Antihistamine
– Change of diet
– Mild purgative
– White lotion.
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7-Dermatitis
Conditions characterized
by inflammation of
dermis & epidermis.
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Etiology
*Cattle:
1.Udder impetigo
(Staph. aurous).
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Etiology
Cattle: Cowpox
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Etiology
*Cattle Ulcerative mamilitis.
:
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Etiology
*Cattle:
Lumpy skin disease.
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Etiology
*Cattle:
F.M.D
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Etiology
*Cattle:
Rinderpest
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MCF
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Etiology Sheep, Goat
1.Strawberry Foot rot
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Etiology Sheep, Goat
3.Sheep pox.
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Etiology Sheep, Goat
Contagious ecthyma.
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Etiology Sheep, Goat
F.M.D
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Etiology Sheep, Goat
PPR
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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
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dermatitis
Viral papular dermatitis
lesions on the scrotum
of a stallion
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dermatitis
Horse pox: Typical
ulcerative, vesicular and
scabby lesions of horse
pox on the lips and
nasal margin
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Dermatitis
Dermatophytes:
Dermatophytosis - early
annular lesions - equine
gluteal region
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Dermatitis
Dermatophytosis -
bovine face - annular
alopecia (white rings)
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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.
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Photosensitization-8
Sensitization of the
superficial layers of
lightly pigmented skin,
mucosa & cornea to
light.
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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
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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.
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Photosensitization
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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.
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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
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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.