Mystery dermatology: cases that make you go "Huh?" (Proceedings)

Case 1: Bob

• Signalment: 3 years old, castrated male, DSH

• History: Two month history of facial pruritus. This cat is current on his vaccinations and he lives with one other cat. The other cat is grooming more than usual.

• Clinical Signs: Alopecia and excoriations are present on the face. The rest of the body has no obvious skin lesions.

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Case 2: Bailey

• Signalment: 3 month old, female, Chihuahua

• History: Two month history of pruritus and crusting on both ears. Vulvar and vaginal areas are erythematous and swollen. Past treatments include: Albon, Amoxicillin, Clindamycin, prednisolone, diphenhydramine. According to the owner, the skin condition got worse when the dog was started on the amoxicillin (owner believes an allergic reaction occurred). The prednisone appears to help with the pruritus (when dog weaned off this drug the pruritus got worse). This dog is 10 out of 10 pruritic.

• Clinical Signs: T= 101.8 degrees F, P= 158 bpm, R= 44 bpm, wt= 2.2 pounds. Severe erythema and crusts on both ears. An area of alopecia was present on the left shoulder. Anal and vaginal areas were erythematous and swollen. Partial alopecia was present on the tail.

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Case 3: Lu Lu

• Signalment: 8 year old, female spayed, Maltese

• History: Six year history of a pruritic, crusting and erythematous dermatitis on the head, neck, legs and feet. This dog was serum allergy tested 6 years ago and she has been on immunotherapy since that time. The owner describes the crust on the head and neck as sludge type lesions that have not responded to treatment. Fungal cultures were performed in the past and they were negative.

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Within the last month LuLu has become PU/PD. A dental was performed on LuLu about 1 month ago. Blood work was taken at the time of the dental and it showed an elevated SAP (618 U/L, N= 23-212 U/L). This dog is 7 out of 10 pruritic with 10 being the most severe.

• Clinical Signs: T= 101.2 degrees F, P= 120 bpm, R= 40 bpm, wt= 13 pounds.

• The head and neck area had some thick, black scales and crusts which were adhered to the hair shafts. Salivary staining was present on all 4 feet. This dog had a swollen and erythematous vulva.

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Case 4: Sammy

• Signalment: 1 ½ year old, female spayed, Boxer

• History: For the past 8 months, Sammy has been extremely pruritic with erythema and alopecia. This dog has been treated with repeated courses of ketoconazole and Malaseb pledgets for secondary yeast skin infections. Sammy has received oral and injectable steroids with excellent response to both treatments. A fatty acid supplement and hydroxyzine were tried and this dog became extremely pruritic after administered these medications. About 1 ½ months ago, Sammy was allergy blood tested while on steroids. The allergy blood test showed that Sammy was allergic to two allergens (ie Mucor and dust mite). The RDVM questioned these test results and the laboratory recommended that Sammy be off of oral steroids for at least 1 month prior to submitting another blood sample for serum allergy testing. The RDVM recommended that Sammy be off of the steroids for one month and then referred for intradermal allergy testing.

• Clinical Signs: T= 102.6 degrees F, P= 144 bpm, R= panting, wt= 71.4 pounds.

• Sammy was erythematous with partial to complete alopecia on the muzzle, ventrum, feet and stifles. An erythematous papular rash was present on the sternum. This dog was excessively pruritic in the examination room.

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