equine dermatology - performance equine .equine dermatology sabrina jacobs, dvm ... epidermal...

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  • Equine Dermatology

    Sabrina Jacobs, DVMPerformance Equine Vets

    Aiken, SC

  • Introduction:

    Bacterial Folliculitis Dermatophytosis (Ringworm) Dermatophilosis (Rain Rot) Urticaria (Hives) Culicoides Gnat Hypersensitivity (Sweet Itch) Pemphigus Foliaceous Grease Heel Syndrome (Scratches) Papillomans Sarcoids

  • Topics to be discussed:

    Etiology Pathogenesis Clinical signs Diagnosis Treatment

  • Bacterial Folliculitis

    Staphylococcus spp. Opportunistic Infection Crusts, papules, pustules typically in a

    circular pattern Pruritic (Itchy) Methicillin-resistant staph MRSA Diagnosis by Culture

  • Bacterial Folliculitis

  • Bacterial Folliculitis

  • Bacterial Folliculitis Treatment

    Remove Crusts Bathe with Chlorhexidine or Malaseb Shampoo

    (let sit for 15 minutes) Topical Triple Antibiotic or Silver Sulfadiazene

    Cream Systemic Antibiotics: SMZ (Baytril if resistant)

    may be necessary Keep dry

  • Dermatophytosis (Ringworm)

    Trichophyton equinum and T mentagrophytes are the most often fungal organisms identified

    Warm/Humid Climates Lesions on the limbs and pressure areas Scaling, Crusts, Alopecia (sharply demarcated) Zoonotic AND Contagious between horses Fomites- Tack, Bridles, Halters, Saddle Blankets Diagnosis: Special DTM Media (1-4 weeks)

  • Dermatophytosis

  • Dermatophytosis

  • Dermatophytosis Treatment

    Scabs and crusts should be removed, lesions cleaned well, clip hair (clean clippers to eliminate spread to other horses)

    Miconazole Shampoo (Malaseb) Ketaconazole Shampoo Ketaconazole Cream Silver Sulfa Diazene Cream Systemic Anti-fungals (Griseofulvin) in select cases

  • Dermatophilosis (Rain Rot)

    Actinomycete (Bacteria) Carrier animal, moist environment, abrasions Chronically affected animals are primary source

    of infection, moisture releases zoospores Mechanical transmission by flies or fomites Fall/Winter most common Dorsal surfaces affected Diagnosis: Cytology, Culture, Biopsy

  • Dematophilosis

  • Dermatophilosis

  • Dermatophilosis Treatment

    Remove crusts, can be very painful, sedation may be required

    Clip margins, most important Clean skin with chlorhexidine or betadine scrub Malaseb shampoo, Lime Sulfur Shampoo Systemic Antibiotics SMZ or Penicillin Immune Boosters (ie Eqstim) Use dilute Clorox for equiment or tack NOT THE

    HORSE! SSD can be used for deep lesions

  • Urticaria (Hives)

    Immune mediated reaction Food, inhaled, contact (insect, shavings, blanket),

    injection (insect, vaccines, drugs), Pitting edema, pruritis (small or large) Symptoms not a disease List of possible causes, can make the diagnosis

    seem ominous Serological testing vs Intradermal testing

  • Urticaria

  • Urticaria Treatment

    Depends on case: +/- glucocorticoids +/- bathing with oatmeal shampoo if

    contact +/- antihistamines +/- NSAIDS (Banamine) Can be life threatening

  • Culicoides Gnat Hypersensitivity

    Puritis! Puritis! Puritis! Breed predisposition: Welsh Ponies, Arabians,

    Connemaras, Icelandic Horses, QH, Shires, Andalusian, Friesian

    Seasonal (June- September) Mane, Tail, Ventrum, Face, Legs Alopecia, excoriations, open sores, bleeding Rule out other diseases (cytology, culture, ect) Allergy testing to Prove

  • Culicoides Gnat Hypersensitivity

  • Culicoides Gnat Treatment

    Fatty Acid Supplement (6-8 wks for effect) ****Boett Blanket: www.boettusa.com Antihistamines Allergy Shots Garlic? Glucocorticoids (Prednisolone) Topicals: Oatmeal Shampoo, Aloe, Steroids, Scratches

    Meds, Swat Fans, stall before dusk to mid-morning

  • Culicoides Gnat Hypersensitivity

  • Pemphigus Foliaceous Autoimmune skin disease Autoantibodies are directed against surface proteins of

    keratinocytes which results in acantholysis (loss of adhesion) Waxing and waning vesiculopustular disorder Vesicles, pustules, crusts, alopecia, epidermal collarettes, scaling Lesions can begin on head or legs and spread to rest of body Depression, poor appetite, weight loss, fever Diagnosis: Cytologies, biopsy, Cultures, Skin scrapings Treatment: Glucocorticoids Prognosis: Poor

  • Pemphigus folliaceous

  • Grease Heel Syndrome (Scratches)

    Numerous causes for grease heel exist. Infections, allergies, photosensitization,

    cannon keratosis, parasitic and idiopathic causes have all been associated with grease heel.

    Pathogenesis for the idiopathic form is thought to be due to an irritant, moisture or poor hygiene.

  • Scratches Syndrome Dermatitis of the lower legs Pruritus and pain may be

    present. Swelling and erythema that

    starts on the posterior aspect of the pastern and spreads dorsally and anteriorly.

    Lesions progress to include crusting, exudation, lichenification and ulceration.

  • Scratches Symptoms

    If lesions are allowed to progress then exuberant granulation and keloids develop (grapes).

    Lesions tend to be more sever in the hind limbs.

    Some horses only have 1 limb affected.

  • Scratches Treatment

    Affected areas should be clipped Cleaned twice daily Topical medications and steroid

    preparations may be beneficial Scratches Meds twice daily application Most important to keep DRY

  • Papillomas

    Papillomas are caused by papovaviruses (DNA). Two different viruses are thought to be involved.

    The presence of the virus in the skin stimulates epithelial proliferation.

    Verrucous warts usually occur in young animals; aural plaques are usually seen in older animals.

  • Papillomas

    Lesions consist of squamous verrucous papillomas.

    These lesions are located on the muzzle, genitalia and/or lower limbs.

    Verrucous warts usually spontaneously regress within 6 months.

  • Papillomas (Aural Plaques) Skin lesions consist of

    depigmented papules or plaques which occur in the inner surface of the pinna.

    The lesions progress to a larger coalescing plaques with adherent scale.

    No reliable treatment Aural plaques do not

    spontaneously resolve. Application of insecticides to

    the area help to prevent irritation of the plaques by feeding flies.

  • Sarcoids

    Most common causes of locally aggressive, non-metastatic fibroblastic nodular neoplastic lesions in horses, and they account for 3590% of dermatological neoplasms

    Bovine papillomavirus (BPV) Areas of trauma or injury or irritation Diagnosis: Visual or Biopsy Surgical excision alone results in 50% recurrence

  • Sarcoids

  • Sarcoids Treatment

    Chemotherapy injections Chemotherapy beads Cryotherapy Laser removal Xxterra (Herbal) Aldara (Immune Modifier) Acyclovir (Antiviral)

  • Questions?

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