Table Of ContentDiagnostics and Therapy in Veterinary Dermatology
Diagnostics and Therapy in Veterinary Dermatology
Edited by
Dawn Logas
Veterinary Dermatology Center
Silver Springs, FL, USA
This edition first published 2022
© 2022 John Wiley & Sons, Inc.
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Library of Congress Cataloging- in- Publication Data
Names: Logas, Dawn, editor.
Title: Diagnostics and therapy in veterinary dermatology / edited by Dawn
Logas.
Description: First edition. | Hoboken, NJ : Wiley-Blackwell, [2022] |
Includes bibliographical references and index.
Identifiers: LCCN 2021043862 (print) | LCCN 2021043863 (ebook) | ISBN
9781119680604 (hardback) | ISBN 9781119680628 (adobe pdf) | ISBN
9781119680635 (epub)
Subjects: MESH: Skin Diseases–veterinary | Skin Manifestations
Classification: LCC SF901 (print) | LCC SF901 (ebook) | NLM SF 901 | DDC
636.089/65–dc23
LC record available at https://lccn.loc.gov/2021043862
LC ebook record available at https://lccn.loc.gov/2021043863
Cover Design: Wiley
Cover Image: © Dawn Logas
Set in 9.5/12.5pt STIXTwoText by Straive, Pondicherry, India
10 9 8 7 6 5 4 3 2 1
v
Contents
Acknowledgments vii
Foreword ix
List of Contributors xi
1 The Skin as an Immune Organ 1
Domenico Santoro and Megan Boyd
2 How to Get the Most Out of Your Dermatologic History and Examination 9
Michelle Woodward O’Gorman
3 New Diagnostic Tools and Tests for Dermatology 16
Amelia White
4 When, Where, and How to Biopsy Skin 33
Dawn Logas
5 Antimicrobial-Resistant Staphylococcal Infection 39
Christine L. Cain
6 Fungal and Oomycete Infections 50
Darcie Kunder
7 Parasitic Infections 63
Catlin Contreary
8 Emerging Infectious Diseases in Veterinary Dermatology 75
Ana Milena Carmona-Gil
9 Canine Hypersensitivities 86
Rosanna Marsella
10 Feline Hypersensitivities 98
Cecilia Friberg
11 Common and Emerging Autoimmune Diseases 109
Rebekah Westermeyer
12 Endocrine and Metabolic Diseases with Dermatologic Manifestations 128
Katherine Doerr
vi Contents
13 Medical Management of Acute and Chronic Otitis 140
Dawn Logas
14 What Is the Difference Between Brand Name, Generic, and Compounded Drugs? 150
Mark G. Papich
15 Topical Therapies 156
Dawn Logas
16 Antimicrobial Resistance 163
Leah D. Blondeau and Joseph M. Blondeau
17 Omega-3 Fatty Acids: What’s New? 175
Dawn Logas
18 Immunopharmacology 180
Domenico Santoro and Megan Boyd
19 Allergen Immunotherapy 193
Natalie Gedon and Ralf Mueller
20 Biologic Therapies for Dermatologic Use 198
Valerie Fadokh
21 Use of Lasers in Dermatology 204
Jason B. Pieper
22 Unconventional and Plant-Based Therapies 212
Dawn Logas
23 Sedation, Anesthesia, and Pain Management in Small Animal Dermatology 218
Luisito S. Pablo
24 How Your Nursing Staff Can Improve Efficiency and Compliance in the Management
of Dermatologic Cases 227
Judy Lethbridge
25 Communication Between the Client, Primary Care Practitioner, and Dermatologist 238
JoAnn Stewart
26 The Future of Technology and Computers in Veterinary Medicine 245
Ceara Byrne and Jacob Logas
Index 251
vii
Acknowledgments
First, I want to thank Gail Kunkle and Richard Halliwell for all their love and support over the years. I love you guys
for their support and mentorship that got me started in der- more than you will ever know. Finally, I want to thank my
matology. Second, I want to thank my clients and patients best friend and business partner, Marcia Schwassmann, for
over the last 35 years who have taught me so much about making me a better person and veterinarian along with
dermatology that I did not know before. Next, I want to helping me edit this book.
thank my husband, Paul, and sons, Christopher and Jacob, Dawn Logas
ix
F oreword
Dear Colleague climate change and issues such as antibiotic resistance,
This book is not meant to be an all-i nclusive dermatology which are not found in other currently available dermatol-
text. It is meant to help you understand how dermatolo- ogy texts. As veterinarians we will become more important
gists think and what we feel is important when working up in the One Health movement as infectious diseases spread
our cases, so you can improve how you work up your own to new areas and antibiotic resistance continues to spread.
dermatology cases. It will also hopefully improve the use of I want to thank the authors who contributed to this book
our veterinary nurses and the communication between for their hard work and diligence in delivering practical
the primary care veterinarian and the dermatologist. chapters with information that primary care veterinarians
Furthermore, I have included information in this book can use every day.
about diseases whose incidences are increasing because of Dawn Logas
xi
List of Contributors
Joseph M. Blondeau, BSc, MSc, PhD Dawn Logas, DVM, DACVD
Royal University Hospital and University of Veterinary Dermatology Center, Maitland, FL, USA
Saskatchewan, Saskatoon, Saskatchewan, Canada
Jacob Logas, MS CS Georgia Tech, PhD
Leah D. Blondeau, PhD Georgia Institute of Technology School of Interactive
Royal University Hospital and University of Computing, Atlanta, GA, USA
Saskatchewan, Saskatoon, Saskatchewan, Canada
Rosanna Marsella, DVM, DACVD
Megan Boyd, DVM, DACVD University of Florida, Gainesville, FL, USA
Animal Dermatology Center, Studio City, CA, USA
Ralf Mueller, DVM, MANZCVSc (Canine Medicine), DACVD,
Ceara Byrne, MS CS Georgia Tech, PhD FANZCVSc (Dermatology), DECVD
Georgia Institute of Technology School of Interactive Centre for Clinical Veterinary Medicine, LMU Munich,
Computing, Atlanta, GA, USA Germany
Christine L. Cain, DVM, DACVD Luisito S. Pablo, DVM, MS, DACVAA
School of Veterinary Medicine, University of College of Veterinary Medicine, University of Florida,
Pennsylvania, Philadelphia, PA, USA Gainesville, FL, USA
Ana Milena Carmona- Gil, DVM, MSc Mark G. Papich, DVM
DermaVet Centro de Dermatología Veterinaria, Medellín, North Carolina State University, Raleigh, NC, USA
Antioquia, Colombia
Jason B. Pieper, DVM, MS, DACVD
Catlin Contreary, DVM, DACVD Iowa State University, Ames, IA, USA
Veterinary Dermatology Center, Maitland, FL, USA
Domenico Santoro, DVM, MS, DrSc, PhD, DACVD, DECVD,
Katherine Doerr, DVM, DACVD DACVM (Bacteriology, Mycology, Immunology)
Veterinary Dermatology Center, Maitland, FL, USA University of Florida, Gainesville, FL, USA
Valerie Fadok, DVM, DACVD, PhD JoAnn Stewart, RVT, CVPM, CCFP
Zoetis, Bellaire, TX, USA Executive Director, Collaborative Care Coalition,
Gurnee, IL, USA
Cecilia Friberg, DVM, DACVD
Sodra Djursjukhuset, Stockholm, Sweden Rebekah Westermeyer, BSEd, DVM, DACVD, MRCVS
Animal Allergy Specialists, Oahu, HI, USA
Natalie Gedon, DVM
Asia Veterinary Diagnostics, Kowloon, Hong Kong
University of North Carolina College of Veterinary
Medicine, Raleigh, NC, USA Amelia White, DVM, MS, DACVD
Auburn University College of Veterinary Medicine,
Darcie Kunder, VMD, DACVD
Auburn, AL, USA
Friendship Hospital for Animals, Washington, DC, USA
Michelle Woodward O’Gorman, DVM, DACVD
Judy Lethbridge, RVT (registered veterinary technician)
Baton Rouge Veterinary Specialists, Baton Rouge,
Veterinary Dermatology Center, Maitland, FL, USA LA, USA
1
1
The Skin as an Immune Organ
Domenico Santoro and Megan Boyd
KEY POINTS
● The skin is an extremely active immunologic organ.
● The skin has many resident immunologically active cells.
● The skin defense system includes a physical barrier (stratum corneum and hair), a chemical barrier (fatty acids and antimicrobial
peptides), an immunologic barrier (innate and adaptive immune system), and a microbiological barrier (beneficial microorganisms).
● Keratinocytes are the most immunologically active cells in the epidermis.
● The skin is commonly affected by immune system disorders.
The skin is the largest organ in the body. It has long When pathogenic microorganisms breach the physical
been known as the primary physical barrier between an and chemical defenses of the skin, they activate the skin-
organism and its environment, but since the early 1980s associated lymphoid tissue (SALT) (Table 1.1). SALT
the skin has been recognized as an active immune includes dendritic cells, mast cells, lymphocytes, and
organ with its own skin- associated immune system. keratinocytes, and forms part of the innate immune system
The skin’s defense system consists of physical, chemi- (Figure 1.1). Innate immunity, which is considered the
cal, immunologic, and microbiologic components that most ancient branch of the body’s immune defenses, is
protect the body against trauma, chemicals, toxins, and characterized by a rapid onset of action (minutes to hours),
microorganisms. a lack of specificity (it recognizes common microbial struc-
The physical barrier represents the first line of defense tures as opposed to specific organisms), and a lack of mem-
against invaders. It is composed of keratinocytes tightly ory, which means the response does not improve with each
bonded together by a lipid- rich mortar in the stratum cor- exposure. Cells of the innate immune system include mac-
neum (top layers) and keratinocytes joined together by rophages, dendritic cells, neutrophils, natural killer (NK)
tight cell- to- cell junctions in the lower layers. The chemical cells, mast cells, and keratinocytes. When innate immunity
barrier consists of compounds with active antimicrobial is overwhelmed, the adaptive branch of the immune sys-
activity, including fatty acids and antimicrobial or host tem (Figure 1.2), primarily made of T and B lymphocytes,
defense peptides secreted by sebaceous glands and is activated. The adaptive immune response is character-
keratinocytes. If the physical and chemical defenses of the ized by a slow onset of action (days to weeks), high speci-
skin are overcome by invaders, components of the innate ficity (recognizes unique antigens), and memory, which
and active immune system along with beneficial microor- means the speed and magnitude of the response improve
ganisms in the skin microbiome become important. with each exposure. The innate and adaptive branches of
Beneficial microorganisms compete for the same niche as the immune system are highly interconnected. When cells
pathogens and actively secrete antimicrobial peptides of the innate immune system are activated, they secrete
(AMPs) that inhibit the proliferation of pathogenic numerous inflammatory cytokines and chemokines that
competitors. prime and direct the adaptive immune system’s response.
Diagnostics and Therapy in Veterinary Dermatology, First Edition. Edited by Dawn Logas.
© 2022 John Wiley & Sons, Inc. Published 2022 by John Wiley & Sons, Inc.
Table 1.1 Cells of the innate and adaptive immune system discussed in this chapter.
Cell type Functions Location Cytokines produced Expressed molecules
Innate Keratinocyte Mechanical barrier, epidermal Epidermis IL- 1, IL- 6, TNF, IL- 8, IL- 10, IL- 12, IL- 15, TLR, MHC- I, MHC- II, AMP
production IL- 18, IL- 19, IL- 20, TGF, IL- 20, IL- 23,
Immune function GM- CSF, G- CSF
Langerhans cell Antigen- presenting cell Epidermis IL- 12, IL- 23, IL- 6, TNF Fc and mannose receptors, ICAM- 1, IL- 12,
MHC- II
Dermal dendritic cell Antigen- presenting cell Dermis IL- 12, IL- 23, IL- 6, TNF Fc and mannose receptors, ICAM- 1, IL- 12,
MHC- II
Mast cell Hypersensitivity reactions, Dermis TNF, IL- 1, IL- 4, IL- 5, IL- 6, IL- 13, CCL3, TLRs, NF- kB, NFAT, AP- 1
vasodilation, chemotaxis, CCL4, IL- 3, GM- CSF
inflammation
Eosinophil Hypersensitivity reactions, Dermis IL- 3, IL- 5, IL- 8, IL- 10, leukotrienes, Fc receptor
vasodilation, chemotaxis, GM- CSF, hydrolases
inflammation
Neutrophil Innate immunity, phagocytosis Dermis ROS, proteolytic enzymes TLRs, lectin receptor, mannose receptor
M1 macrophage Phagocytosis, antigen presentation, Dermis IL- 6, IL- 12, TNF, iNOS JAK1, JAK2, STAT1,
bactericidal activity STAT2
M2 macrophage Phagocytosis, antigen presentation, Dermis IL- 10, TGF, arginase- 1 JAK1, JAK2, JAK3, STAT6
regenerative effects
ILC (Innate lymphoid Innate immunity Dermis IL- 1, IL- 23, IL- 25, IL- 33, TSLP Id2, T- bet, GATA 3, ROR
cell)
Both innate γ/δ T cell Elimination of intracellular Dermis IL- 17, IFN MHC- I
and microorganisms and infected cells;
adaptive cell death
Natural killer cell Innate immunity against viruses and Dermis IFN, GM- CSF, IL- 3 MHC- I
intracellular bacteria
Natural killer T cell Elimination of lipid antigens Dermis IL- 4, IL- 17, IL- 22, IFN MHC- 1
Adaptive B lymphocyte Humoral response Dermis IL- 2, IL- 4, IL- 6, IL- 11, IL- 13, TNF, BAFF Antibodies
T- helper lymphocyte Coordinates immune function Dermis Various depending on the type of T- helper cell Various depending on the type of T- helper cell
T- cytotoxic lymphocyte Elimination of intracellular Dermis IFN Perforin, granzyme, granulysin
microorganisms and infected cells
T- regulatory Control of immune response Dermis IL- 10, TGF FoxP3, STAT5
lymphocytes
Key: AMP, antimicrobial peptides; AP, activator protein; BAFF, B- cell activating factor; CCL, chemokine ligand; FoxP3, forkhead box P3 protein; GATA, transcription factor; G- CSF, granulocyte
colony- stimulating factor; GM- CSF, granulocyte macrophage colony- stimulating factor; ICAM, intercellular adhesion molecule; Id2, DNA binding protein inhibitor 2; IFN, interferon; IL,
interleukin; iNOS, inducible nitric oxide synthase; JAK, Janus kinase; MHC, major histocompatibility complex; NFAT, nuclear factor of activated T cell; NF- kB, nuclear factor kappa B; ROR,
retinoic acid- related orphan receptors; ROS, reactive oxygen species; STAT, signal transducer and activator of transcription; T- bet, T box transcription factor; TGF, transforming growth factor; TLR,
Toll- like receptor; TNF, tumor necrosis factor; TSLP, thymic stromal lymphopoietin.
0005172709.INDD 2 09-27-2021 10:32:17
