additional diagnostic methods in dermatology notes: plenary lectures 2017... · praktische...
TRANSCRIPT
![Page 1: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/1.jpg)
Additional Diagnostic Methods in Additional Diagnostic Methods in DermatologyDermatology
University of Veterinary Medicine,
Department and Clinic of Internal Medicine
Noémi Tarpataki
![Page 2: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/2.jpg)
Place of laboratory proceduresPlace of laboratory procedures
Diagnosis
�� Additional Additional
examinationsexaminations
�� Clinical examinationClinical examination
�� HistoryHistory
![Page 3: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/3.jpg)
What can be examined?What can be examined?
� parasites, bacteria, fungi
� hair skin
� Other organs (immune-, hormonal system)
![Page 4: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/4.jpg)
Examination of the integumentumExamination of the integumentum� METHODS
- inspection / palpation / smelling / percussion
� ADDITIONAL EXAMINATIONS- flea comb / Wood-lamp / Otoscopy- skin scraping + pluged hairshuft sending to laboratory
--microscopic (parasitology, trichogram: structure of the pluged hairshuft)--microbiological: culture: bacteriology +mycology and resistency--microbiological: culture: bacteriology +mycology and resistency-- +/- taking and sending STERILE SWAB SAMPLE--(cytology (after staining))
-cytology--impression-smear (glass-slide; scotch tape)--aspiration (FNA)--swab smear (from extarnal ear canal)--”cytobrush” (PCR: papilloma/herpes etc.)(--from skin scraping or biopsy sample)
-biopsy sampling (by scalpel blade or biopsy punch, histopathology)-allergy tests: in vivo: IDST; in vitro: serum allergen-specific IgE-blood tests (blood count, biochemistry); hormons, function tests-immunological tests: ANA, immunocomplex, Coombs test, flow cytometry;
--(histopathology: immunfluorescency, immunhistochemistry)
![Page 5: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/5.jpg)
Instruments of Instruments of clinicalclinicalexaminationexamination
FleaFlea comb and comb and flotationflotation
![Page 6: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/6.jpg)
Instruments of clinical Instruments of clinical examinationexamination
![Page 7: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/7.jpg)
Instruments of clinical Instruments of clinical examinationexamination
![Page 8: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/8.jpg)
Sampling and sending Sampling and sending to laboratoryto laboratory
� Ask: what type of sample is needed for the given examination
� Ordering/ buying of the sampling � Ordering/ buying of the sampling instruments of the given laboratory (sterile swabs/ tubes with test medium/ solutions for biopsy sampling etc.)
� Accompanying documents and sample labeling
![Page 9: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/9.jpg)
Sampling for Sampling for own examinationsown examinations
� If we’ got microscope– Skin scraping
– trichogram
– Cytology– Cytology
� Instruments and materials– Scalpel blade, glass slide
– Paraffinoil
– Diff-Quick for staining
– Immersion oil
![Page 10: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/10.jpg)
SamplingSampling
� Appropiate method
� Correct evaluation of the results
![Page 11: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/11.jpg)
SamplingSampling
� Appropiate method
– For example: if only superficial skin scrape was takenscrape was taken
� Correct evaluation of the results
– the possibility of finding Demodex mites is less.
![Page 12: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/12.jpg)
SamplingSampling
� Appropiate method
� For example: if we are looking for Sarcoptes mites Sarcoptes mites
� Correct evaluation of the results
– we will have only 10-50% possibility of finding them even if we took the sample really from huge region
![Page 13: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/13.jpg)
Skin scraping for microscopic Skin scraping for microscopic examination and culturingexamination and culturing
� trichogram, citology
� bacterial and fungal culture
![Page 14: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/14.jpg)
Skin scraping for microscopic Skin scraping for microscopic examination and culturingexamination and culturing
� Method– Superficial / deep
pushing out of hair follicle / pulling out hair shufts– Huge surface / many region /
border of the lesion and healthy skinborder of the lesion and healthy skin– Crusts are not needed but sampling from the str.
corneum
� Evaluation of skin scrape– Sensitive method for ectoparasites,
except Sarcoptes mites– Bacterial culture: the antibiotic resistance is important– Fungal culture: the only sure method for proving
Dermatophytosis
![Page 15: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/15.jpg)
Skin scraping for
microscopic examination
and culture
![Page 16: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/16.jpg)
Instruments Instruments forfor skinskin scrapingscraping
![Page 17: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/17.jpg)
Multiple superficial scrapingMultiple superficial scraping
![Page 18: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/18.jpg)
Multiple superficial scrapingMultiple superficial scraping
� Sarcoptes scabiei (var. canis)
![Page 19: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/19.jpg)
Multiple superficial scrapingMultiple superficial scraping
� Sarcoptes scabiei (var. canis)
![Page 20: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/20.jpg)
Multiple superficial scrapingMultiple superficial scraping
� Notoedres cati, Otodectes cynotis
![Page 21: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/21.jpg)
Multiple superficial scrapingMultiple superficial scraping
� Linognathus setosus; Cheyletiella yasguri; Neotrombicula� sucking louse (pediculosis);cheyletiellosis; trombiculosis
![Page 22: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/22.jpg)
Multiple superficial scrapingMultiple superficial scraping
� Dermatophytosis
![Page 23: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/23.jpg)
Multiple deep scrapingsMultiple deep scrapings
![Page 24: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/24.jpg)
Multiple deep scrapingsMultiple deep scrapings
� Demodicosis
![Page 25: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/25.jpg)
Multiple deep scrapingsMultiple deep scrapings
� Demodicosis
![Page 26: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/26.jpg)
Multiple deep scrapingsMultiple deep scrapings
� Demodicosis
![Page 27: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/27.jpg)
Multiple deep scrapingsMultiple deep scrapings
� Demodicosis
![Page 28: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/28.jpg)
Swab samplingSwab sampling
� In case of pus
![Page 29: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/29.jpg)
SamplingSampling forfor trichogramtrichogram
![Page 30: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/30.jpg)
TrichogramTrichogram
� Demodicosis
� Dermatophytosis
� Cheyletiella
![Page 31: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/31.jpg)
TrichogramTrichogram
� Dd. of alopecia
![Page 32: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/32.jpg)
CytologyCytology
� Method:-impression-smear (glass-slide; scotch tape)-aspiration (FNA)-swab smear (from extarnal ear canal)-”cytobrush” (PCR: papilloma/herpes etc.)-”cytobrush” (PCR: papilloma/herpes etc.)(-from skin scraping or biopsy sample)
Evaluation– Sensitive method: bacterial and Malassezia owergrowth
– Differentiation of inflammatory (septic / non septic) and neoplastic skin lesions:
– Fast, but not always giving exact final diagnosis
![Page 33: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/33.jpg)
Cytologic examinationCytologic examination
� Direct smear
� Impression smear
� Swab smear� Swab smear
![Page 34: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/34.jpg)
CYTOLOGYCYTOLOGYFNA (fine needle aspiration)FNA (fine needle aspiration)
![Page 35: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/35.jpg)
![Page 36: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/36.jpg)
Cytologic examinationCytologic examination
� Fine-needle aspiration
![Page 37: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/37.jpg)
Cytologic examinationCytologic examination
� Fine-needle „biopsy”
![Page 38: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/38.jpg)
Staining Staining –– DiffDiff--QuickQuick
![Page 39: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/39.jpg)
Cytologic examinationCytologic examination
�Scotch tape stains
![Page 40: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/40.jpg)
Cytologic findingsCytologic findings
![Page 41: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/41.jpg)
CytologyCytology
intertrigointertrigo folliculitisfolliculitis
dr Vajdovich Péter
![Page 42: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/42.jpg)
CytologyCytology
Pseudomonas
deep pyodermadeep pyoderma sterile pyodermasterile pyoderma
aeruginosa
Photos of dr Péter Vajdovich
![Page 43: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/43.jpg)
CytologyCytology
� Malassezia pachydermatisyeast
![Page 44: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/44.jpg)
Cytology and/or PCRCytology and/or PCR
� „Cytobrush”
![Page 45: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/45.jpg)
Instruments of biopsyInstruments of biopsy
![Page 46: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/46.jpg)
Instruments of biopsyInstruments of biopsy
![Page 47: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/47.jpg)
Methods of biopsy samplingMethods of biopsy sampling
![Page 48: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/48.jpg)
Methods of biopsy samplingMethods of biopsy sampling
![Page 49: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/49.jpg)
Methods of biopsy samplingMethods of biopsy sampling
![Page 50: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/50.jpg)
Diagnostic value of histopathologyDiagnostic value of histopathology
![Page 51: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/51.jpg)
Diagnostic value of histopathologyDiagnostic value of histopathology
![Page 52: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/52.jpg)
IntraDermalIntraDermal ((allergicallergic) ) SkinSkin Test Test (IDST)(IDST)
![Page 53: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/53.jpg)
IntraDermalIntraDermal ((allergicallergic) ) SkinSkin Test Test (IDST)(IDST)
![Page 54: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/54.jpg)
IntraDermalIntraDermal ((allergicallergic) ) SkinSkin Test Test (IDST)(IDST)
![Page 55: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/55.jpg)
Blood samplingBlood sampling
� Allergy-serology
![Page 56: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/56.jpg)
Blood samplingBlood sampling
�Sarcoptes: IgG-serology
![Page 57: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/57.jpg)
Blood samplingBlood sampling
� Blood count, biochemistry, hormons
![Page 58: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/58.jpg)
Instruments of clinical Instruments of clinical examinationexamination
� Examination of external ear canal
![Page 59: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/59.jpg)
Aim of ear cleansingAim of ear cleansing
� diagnostic – therapy
� ↓↓↓↓ exsudate → ↓↓↓↓ infectious agents
� ▬ foreign body
� ↑ effectiviness of topically usable � ↑ effectiviness of topically usable drugs (ear drops)
� The external ear canal is more visible
![Page 60: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/60.jpg)
Ear clenaser depends on…Ear clenaser depends on…
exsudate:
– if it is ceruminous, fatty → oily ear cleanser
� exsudate:
– If it is purulent→ watery ear cleanser
![Page 61: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/61.jpg)
Effect of Effect of earear cleansercleanser ingridientsingridients
� Solving the fatty mass, degreasing effect of ceruminolytics:
� Organic oils and solvent: propilen-glycol, lanolin, glycerin, lanolin, glycerin, squalene (triterpen, shark oil), butilated hydroxitoluen, cocamidopropil-betain, mineral oils, sodium(Na)-docusate
� Indication: ceruminous otitis externa
� Contraindication: injury of ear drum! X
![Page 62: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/62.jpg)
Effect of Effect of earear cleansercleanser ingridientsingridients
� Surfactants: solving the mass into emulsion and keep it in
DSS (dioctil-sodium � DSS (dioctil-sodium sulfosuccinate), Ca-sulfosuccinate, urea, urea-peroxidase
� the best ceruminolytics!
![Page 63: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/63.jpg)
Effect of Effect of earear cleansercleanser ingridientsingridients
� Adstringents (drying the ear canal, preventing macerations by moisture):
� Izopropil-alcohol, boric acid, � Izopropil-alcohol, boric acid, acetic acid, benzoic acid, salicylic acid, sulfur, Al-acetate, silicone-dioxid
� Alone or together with the other ingridients
� For preventing OE (e.g. bath)
www.google.com
![Page 64: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/64.jpg)
Effect of Effect of earear cleansercleanser ingridientsingridients
� Antimicrobial effect:
� chlorhexidine, Tris-EDTA + 0.15% chlorhexidine, salicylic acid, 2% acetic acid + 2% boric acid, PCMX (parachlorometaxilenol), 2% boric acid, PCMX (parachlorometaxilenol), isopropil alcohol, 2-2.5% acetic acid, acidic NaCl, sacharids
� Use of combinated ear drops can be avoided with these ingridients
![Page 65: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/65.jpg)
Effect of Effect of earear cleansercleanser ingridientsingridients
� Topical anesthetic effect:– tetracain
� Help the skin barrier function– phytosphyngosine– phytosphyngosine
� Acidic (pH 6)– Lactic acid, acetic acid, NOT together with
aminoglycosid
� Basic (pH 8)– Tris EDTA: Otodine®, after rinsing: fluorokinolons
� Neutral– Epi-Otic®
![Page 66: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/66.jpg)
EarEar cleansingcleansing
� Bacterial OE e.g. twice for two weeks
� Filling the ear canals with ear cleanser (0,5-5 ml in syringes)Filling the ear canals with ear cleanser (0,5-5 ml in syringes)
� Massage for 1-2 minutes� Let the dog shake the head for
10-30 minutes� Drying/clearing the entrance
with a gause � Teach the owner
![Page 67: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/67.jpg)
LiteratureLiterature
� Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004.SCARAMPELLA, 2004.
� Clinical Handbook on Canine Dermatology, Didier Noel CARLOTTI, Virbac S.A.
� Skin Diseases in the Dog and Cat, D.I. GRANT, 1991.
� Picture of Int. Med.
� www.google.com
![Page 68: Additional Diagnostic Methods in Dermatology notes: Plenary lectures 2017... · Praktische Dermatologie bei Hund und Katze, Chiara NOLI, Fabia SCARAMPELLA, 2004. Clinical Handbook](https://reader033.vdocuments.net/reader033/viewer/2022041606/5e3492c3b701d01e75616946/html5/thumbnails/68.jpg)
Thank you for your attention!Thank you for your attention!