Facial alopecia, scaling and erosions in a Jack Russell terrier

Facial alopecia,scaling and erosionsin a Jack Russell terrier

Author: Ross Bond

Editor: David Lloyd

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History - 1

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History

•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 - 2

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History

•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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Clinical signs - 1

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Signs

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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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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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Tests - 1

Differentials

•Principle differential diagnoses

•Dermatophytosis

•Demodecosis

•Deep pyoderma

•Pemphigus foliaceus

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Tests - 2

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Tests

•Diagnostic tests

•Skin scrapings

•Wood’s light examination

•Fungal and bacterial cultures

•(Skin biopsy)

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Results - 1

Tests

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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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Results - 2

Tests

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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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What is yourdiagnosis?

Tests

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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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Diagnosis

Tests

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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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How would you dealwith this case?

•What is your prognosis?

•How will you advise the owner?

•What treatment would you consider?

Tests

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Prognosis

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Tests

•Prognosis is good

•However, lengthy antifungal therapy is oftenneeded with Trichophyton infections in dogs

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Therapy

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Therapy

•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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Comment -1

Notes

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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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Comment -2

Notes

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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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Review

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Notes

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