Today's Veterinary Practice

MAY-JUN 2014

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May/June 2014 Today's Veterinary Practice 45 TreaTing resisTanT skin infecTions in Dogs DermaTology DeTails | tvpjournal.com volved in skin infections, and its antimicrobial sensitivity, is important with regard to determining whether the dog is infected with a methicillin-resistant strain. WHAT ARE THE CLINICAL MANIFESTATIONS OF PYODERMA? Pyoderma can be classified many ways, but categorizing it by depth of skin affected is particularly useful because it can help determine type and duration of therapy. Surface pyodermas are bacterial infections confined to the surface of the skin. These bacteria produce toxins, resulting in inflammation. The best examples include fold pyodermas of the face, lips, tail, and axilla. Superficial pyodermas are bacterial infections that present beneath the stratum corneum layer of the epider- mis, and include impetigo, folliculitis, and bacterial over- growth syndrome. • Impetigo is a subcorneal pustular disease seen fre- quently on the abdomen of puppies; it may, or may not, be pruritic, but is often self-limiting. • Bacterial folliculitis —infection and inflammation of the hair follicles—is the most common pyoderma seen in dogs. It has many clinical forms, the features of which may be unique to the individual dog breed. The earli- est form is a follicular papule—the lesion progresses as bacteria spread into surrounding hair follicles. The clas- sic lesion is the epidermal collarette, characterized by a circular area of hair loss with variable redness, crusting, and hyperpigmentation. These lesions may, or may not, be pruritic; however, pruritus is usually quite profound in atopic dogs and pyoderma is a factor that escalates itch. • Bacterial overgrowth syndrome is a superficial cuta- neous disorder, associated with an overgrowth of S pseudintermedius and characterized by large numbers of bacteria, erythema, pruritus, and malodor. 17 Deep pyodermas are less common, and occur as either focal, or localized, furunculosis or generalized furunculo- sis and/or cellulitis. Furunculosis is caused by bacterial in- fection that affects the hair follicles and causes small ab- scesses under the skin. • Localized forms of furunculosis occur on chins of short-coated dogs (eg, English and French bulldogs, boxers, pugs, Boston terriers, Doberman pinschers, Great Danes, pitbulls and related breeds/crosses), on lateral stifles and other pressure points, and between the digits (interdigital pyoderma or interdigital cyst). Golden retrievers develop furunculosis that has many features of acute pyotraumatic dermatitis; however, it is an acute and deep bacterial skin infection. These dogs will often have fever, loss of appetite, and malaise prior to the eruption of the lesions. 6 Likely these infections represent an individual host–pathogen interaction. • Generalized furunculosis and cellulitis are not com- mon, but often accompany demodicosis. Inflammation is quite severe, and dogs are often systemically ill when infection is deep. German shepherd dogs develop a severe ulcerative pyoderma that is generalized and painful. Hemorrhagic bullae and ulcers often result in the mistaken TVP_2014-0506_DermDetails_Infections.indd 45 5/25/2014 8:39:51 PM

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