Alopecia of the flankin a female Glen of Imaal Terrier.ppt

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1、Alopecia of the flank in a female Glen of Imaal Terrier,Author: Cathy Curtis,Editor: David Lloyd, European Society of Veterinary Dermatology,Click to reveal the text on this screen Click the forward arrow to jump to the next screen,History,3 year old neutered female Glen of Imal Terrier Presented wi

2、th flank alopecia of 3 months duration There were no signs of pruritus The dog was in good general health,History,General clinical examination was unremarkable,Clinical signs,Signs,The flanks showed Bilateral, well-demarcated areas of alopecia Intense hyperpigmentation of the underlying skin,How wou

3、ld you approach this case?,Signs,What are the next steps you would take? Make a list of your principle differential diagnoses List any samples you would collect List any tests you would perform to assist in making a definitive diagnosis,Case investigation - 1,Differentials,Principle differential dia

4、gnoses Inflammatory causes of alopecia Bacterial - Staphylococcal folliculitis Fungal Dermatophytosis Parasitic - Demodex canis Non- inflammatory causes of alopecia Hormonal Dystrophic or dysplastic Telogen or anagen effluvium Cicatricial,Case investigation - 2,Tests,Initial tests Skin scrapings, ha

5、ir plucks and fungal culture Haematology and biochemistry profiles Urinalysis,Results,Skin scrapings and fungal culture No ectoparasites or dermatophytes demonstrated Hair pluckings from the edges of the alopecic areas showed all hairs to be in telogen Haematology and biochemistry profiles Routine h

6、aematology and biochemistry profiles were unremarkable Urinalysis Unremarkable,Tests,What now?,Tests,Which differentials can you now eliminate? Are there any other tests you would carry out or samples you would collect? Should you institute therapy at this stage?,Additional procedures,Tests,Skin sca

7、pings and fungal culture results suggest that dermatophytosis and demodicosis are unlikely Endocrine tests and biopsy examination are now required No therapy is indicated at this stage,Additional diagnostic procedures - 1,Tests,Blood tests to investigate possible endocrinopathy Total T4 and endogeno

8、us TSH levels to assess thyroid function ACTH stimulation or low dose dexamethasone suppression test for adrenocortical function ACTH stimulation test for adrenocortical reproductive hormone function (basal reproductive hormone assays if the above is unavailable) Xylazine or clonidine stimulation te

9、st for growth hormone status (if available) Skin biopsy,Results of additional tests,Tests,Thyroid testing Endogenous TSH within normal range Total T4 within normal range,Results of ACTH stimulation test,Tests,Additional diagnostic procedures - 2,Tests,Histopathology report (Joan Rest) There is hyper

10、pigmentation of the non-thickened epidermis with markedly dilated follicular ostea filled with keratin Most follicles seen are in telogen Sebaceous glands are not atrophic A few melanophages are present adjacent to the bases of the follicles No current inflammation or micro-organisms were observed,A

11、dditional diagnostic procedures - 3,Tests,Morphological diagnosis Atrophic dermatosis,What is your diagnosis?,Do the investigations permit a definitive diagnosis? Are there any additional investigations which you think may need to be done?,Tests,Diagnosis,Canine idiopathic flank alopecia,Tests,How w

12、ould you deal with this case?,What is your prognosis? How will you advise the owner? What treatment would you consider?,Therapy,Prognosis,In many dogs with idiopathic flank alopecia, hair loss is temporary and regrowth may occur spontaneously In some cases, there is a cyclical pattern to the disease

13、 and it may be possible to predict the time of hair loss and hair regrowth Affected dogs remain healthy so the prognosis is good,Therapy,Action,Therapy,Client education and conservative treatment,Comment,The dog was followed for the next 18 months She regrew her hair 2 months after the referral appo

14、intment but again developed flank alopecia at the same time the following year Predictably, the hair regrew 5 months later No treatment has been administered and the dog remains in good general health,Therapy,Final diagnosis,Canine idiopathic cyclic flank alopecia,Therapy,Review,Notes,If you would like to review this case, please use the navigation buttons below,