Facial alopecia,scaling and erosionsin a Jack Russell terrier 
Author: Ross Bond
Editor: David Lloyd
  © European Society of Veterinary Dermatology
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
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History - 1
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10 year-old entire male Jack Russell terrier
Good general health
Progressive facial skin disease of 4 monthsduration
No response to ampicillin and prednisolone
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
History - 2
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Dog lives in rural environment
Lesion began as focal area of erythema andscaling caudal to nasal planum
Progressed caudally over face despite therapy
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Clinical signs - 1
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 Severe skin disease;   lesion well-demarcated
 Smooth-silvery skin at   healing areas rostrally
 Alopecia, scaling, erosions
 Nasal planum unaffected
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
How would youapproach this case?
Signs
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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 adefinitive diagnosis
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Tests - 1
Principle differential diagnoses
Dermatophytosis
Demodecosis
Deep pyoderma
Pemphigus foliaceus
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Tests - 2
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Diagnostic tests
Skin scrapings
Wood’s light examination
Fungal and bacterial cultures
(Skin biopsy)
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Results - 1
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No evidence of parasites & fungal elements onmicroscopy
No fluorescence on Wood’s light examination
Fungal growth evident on mycobiotic agar within 7days of incubation
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Results - 2
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   White colonies with granular     texture
   Dark tan / brown reverse     pigment
   On microscopy, numerous     microconidia and thin-walled     cigar-shaped macroconidia
   Trichophyton mentagrophytes     (granular form)
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Fungal culture: Sabouraud’s  dextrose agar, 5 days
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
What is yourdiagnosis?
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Do the investigations permit a definitive diagnosis?
Are there any additional investigations which youthink may need to be done?
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Diagnosis
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Dermatophytosis caused by T. mentagrophytes
Historical and clinical features strongly suggestive,supported by culture results
Skin biopsies confirmed hair shaft and follicleinvasion by fungal elements
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
How would you dealwith this case?
What is your prognosis?
How will you advise the owner?
What treatment would you consider?
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Prognosis
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Prognosis is good
However, lengthy antifungal therapy is oftenneeded with Trichophyton infections in dogs
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Therapy
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Griseofulvin orally at 50 mg/kg (divided twice daily)
Enilconazole (Imaverol) emulsion applied every4th day
Good clinical response after 8 weeks of therapy,but repeat cultures still positive
Cultures negative and complete clinical responseafter 12 weeks of treatment, which was withdrawnat this time
No relapse over a 6 month follow-up period
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Comment -1
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Owner’s lesions were present in this case,illustrating the zoonotic potential of caninedermatophytosis
Jack Russell terriers are predisposed to sylvaticdermatophytosis in the U.K.
The peripherally expanding, well-demarcatedlesions on the face were suggestive ofdermatophytosis
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Comment -2
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Lesions of dermatophytosis vary in appearanceand severity
Severely inflamed Trichophyton lesions on theface are misdiagnosed as pemphigus foliaceus
Absence of focal crusted lesions (“footprints” ofvesicopustules) and nasal planum involvementmade PF much less likely in this case
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History  |  Signs  |  Differentials  |  Tests  |  Therapy  |  Notes
Review
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