A day in the life of a dermatologist - Difficult cases (Parts 1 and 2) (Proceedings)


A day in the life of a dermatologist - Difficult cases (Parts 1 and 2) (Proceedings)

Apr 01, 2010

The following mystery cases will be analyzed from initial presentation to the final diagnosis, treatment, and follow up.

Case #1

Signalment : 10 month old, SF, DSH
History: Two month history of pruritus with a partial response to corticosteroids. Selamectin has been used monthly. There is another cat in the house that is nonpruritic.
Diagnostics: Impression smears, skin scrapings, trichogram, Woods lamp, fungal culture


Case #2

Signalment: 5 year old, CM Australian Shepherd cross
History: Has had ear infections for 9 months as well as scaly skin on the trunk. Many different otic medications and flushes have been used without improvement.
Diagnostics (initial): Ear cytology, Skin scraping, Bloodwork.


Case #3

Signalment: 3 year old, CM boxer
History: Nonpruritic nodules on the head for the last 3 months.
Differential Diagnoses: Mast cell tumors, Histiocytic tumors, Lymphoma, foreign body reaction, sterile pyogranuloma, infectious granuloma
Diagnostics: Cytology, histopathology, special stains


Case #4

Signalment: 4 year old, SF coyote cross
History: The first lesion started on the nose while in Arizona seven months prior to referral. At that time it had been diagnosed as solar dermatitis and had responded to prednisone and antibiotics. The lesions then spread over the face and body. Recently, there was no improvement with enrofloxacin and a methylprednisolone acetate injection.
Differential Diagnosis: Systemic lupus erythematosus, Pemphigus foliaceus, vasculitis
Diagnostics: Impression smears, skin scrapings, bloodwork, histopathology


Case #5

Signalment: 9 year old, CM DSH
History: One week prior to referral the cat had been seen by the RDVM for a bleeding claw that was thought to have been injured. This claw was removed surgically. Preoperative bloodwork was WNL. Four days after surgery, more digits were becoming affected. Referral was made at that time.
Diagnostics: Cytology, radiographs


Case #6

Signalment: 6 year old, CM, mixed breed dog
History: Had been adopted 1 year ago and has had ear problems since adoption. Ears are nonpruritic and have a green-colored discharge AU. Initial cytology showed many white blood cells and very few cocci. Tympanic membranes were not able to be visualized.
Diagnostics: Cytology, video otoscopy, CT


Case #7

Signalment: 11 year old, CM, Sheltie
History: Has had a pruritic lesion on one leg for more than 1 year. The lesion started below the elbow and spread to the foot. He is not bearing weight on the leg. Leg muscles have contracted and we are unable to extend the leg. There has been no response to amoxicillin/clavulanic acid or prednisone.
Diagnostics: Radiographs, Skin biopsy, tissue cultures (fungal, mycobacterial, aerobic/anaerobic bacteria).


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