Archives for posts with tag: well demarcated ulcers

This was one of my early “Help Line” cases, before I even had a formal help line and shows how useful and effective prompt telephone advice can be. 

Flora was a 3 month old kitten, belonging to a colleague of mine, that had a sudden onset of acute facial and neck dermatitis and systemic signs of anaemia.  The condition was very pruritic and it had started a few days after vaccination.
The vet was able to e-mail me photos and test results and I was able to guide her through the case work up and advise on the best course of treatment.

Often laboratory tests by themselves do not give an exact diagnosis, because the pathologist (clinical or histopathologist) can only report on what they see.  Their findings then have to be tied up with the clinical signs to arrive at the most likely diagnosis, which is where I can help.  Treatment can then be based on this diagnosis for the best outcome. 

Flora was just such a case, where the test results needed careful interpretation and the final diagnosis was a vaccine induced immune-mediated sterile granulomatous dermatitis with an immune-mediated haemolytic anaemia and thrombocytopenia.  

She was successfully treated with immunosuppressive doses of prednisolone.

This case also highlights the need for early diagnosis and aggressive treatment for a successful outcome.

Using my help line service can be very useful for these cases where urgent advice is needed, or for those cases when going to a referral centre is not possible (http://www.dermatologyreferrals.co.uk/online-advice.htm

Anita

(Case and photos reproduced with the kind permission of Jean Dyas MRCVS)

Advertisements
Lesions on presentation

Lesions on presentation

Recently  (January 2012)I saw a six year old Staffy bitch with well demarcated ulcers underlying pustular crusts on the trunk and legs, which, on the basis of the history, examination and cytology, I tentatively diagnosed as sterile pyogranulomatous dermatitis.

Sterile pyogranulomatous dermatitis is an aberrant immune response to almost any antigen (drugs, diet, infectious agents, etc).   It is a treatable condition; and correct diagnosis is (as always) the key to treatment.

The dog has previous history of allergies, but he had not had any signs of them for about 3 years; however, the condition had started about 3 weeks after administration of a worming tablet. It was not particularly itchy. 

Lesions resolved after 4 weeks of treatment

She was started immediately on treatment, based on the tentative diagnosis (made on history, clinical signs and cytology); and I am happy to say that she has responded well and the lesions have now resolved.   In this case I think it is likely that the wormer was the trigger.

For more on this case and general information see my website 

http://www.dermatologyreferrals.co.uk/case-study-01.htm

.    Anita