generalised scaling in a male donkey
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Generalised scaling in a male donkey. Author: Mark Craig. Editor: David Lloyd. © European Society of Veterinary Dermatology. History. 10-year-old entire male donkey First signs Reduced appetite, weight loss, generalised scaling In progress over a 3-month period Treatment by referring vet

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generalised scaling in a male donkey
Generalised scaling ina male donkey

Author: Mark Craig

Editor: David Lloyd

© European Society of Veterinary Dermatology

history
History
  • 10-year-old entire male donkey
  • First signs
    • Reduced appetite, weight loss, generalised scaling
    • In progress over a 3-month period
  • Treatment by referring vet
    • Intramuscular penicillin/streptomycin daily for 10 days
    • No improvement

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History

clinical signs 1
Clinical signs - 1
  • Generalised exfoliative erythroderma
  • Thin, depressed
  • Rectal temperature, pulse rate, respiratory rate normal
  • No peripheral lymphadenopathy
  • No oral lesions were present

Signs

clinical signs 2
Clinical signs - 2
  • The donkey is thin and depressed
  • There is poor coat with generalised scaling

Signs

clinical signs 3
Clinical signs - 3

Exfoliation and erythema of the scrotum

Periocular scaling and greasy matted hair around the eye

Signs

clinical signs 4
Clinical signs - 4

Close up of scaling,

matting of coat and

underlying erythema

Signs

how would you approach this case
How would youapproach this case?
  • 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

Signs

differential diagnoses
Differential diagnoses
  • Bacterial infection including dermatophilosis
  • Dermatophytosis
  • Pemphigus foliaceus, SLE
  • Drug eruption
  • Cutaneous lymphoma

Differentials

tests 1
Tests - 1
  • Skin scrapings
  • Blood tests: routine haematological and biochemical screens
  • Fungal culture of scale and hairs
  • Multiple skin biopsy samples

Tests

tests 2
Tests - 2
  • Scrapings did not reveal ectoparasites or fungal structures
  • Scales/crusts were emulsified and smears examined for bacteria including Dermatophilus; no significant findings
  • Haematology: marked leukocytosis (35.1 x 103/mm3) with neutrophilia and lymphocytosis, slightly reduced RBC count.
  • Blood biochemistry: raised total protein, hyperglobulinaemia, raised ALP and CK

Tests

what now
What now?
  • What treatment should you now institute, if any, whilst waiting for the fungal cultures and biopsy results?
  • What are now your principle differential diagnoses?
  • Are there any other samples you would collect?

Tests

tests 3
Tests - 3
  • No immediate action taken
  • No parasites or evidence of dermatophytes demonstrated in scrapings
  • Smears failed to reveal significant bacteria
  • The leucocytosis (neutrophilia + lymphocytosis) were suggestive of possible bacterial infection but the blood biochemistry results were not diagnostic
  • Antibacterial therapy might have been instituted but was inhibited by cost and because no significant deterioration was expected before biopsy results were available

Tests

results
HistopathologyResults

An interface dermatitis

pattern predominated,

possible indicating lupus or

a drug eruption

Tests

what is your diagnosis
What is yourdiagnosis?
  • Do the investigations permit a definitive diagnosis?
  • Are there any additional investigations which you think may need to be done

Tests

further steps
Further steps
  • Consultation with the pathologist
  • The histological picture was not clear and the pathologist suggested a second opinion supported by immunohistochemical studies

Tests

results16
HistopathologyResults

Another view of the

histopathology showing

lichenoid infiltration and

microabscess formation with

predominantly mononuclear

cells

Tests

diagnosis
Diagnosis
  • Subsequent immunohistochemical studies showed a strong reaction to CD-3 of infiltrating cells.
  • A diagnosis of epidermotropic lymphoma was made

Tests

how would you deal with this case
How would you deal with this case?
  • What is your prognosis?
  • How will you advise the owner?
  • What treatment would you consider?

Therapy

prognosis
Prognosis
  • Prognosis is grave
    • Disease is fatal
    • Steroids and cytotoxic drugs are unlikely to be helpful
    • Euthanasia was carried out

Therapy

review
Review
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Notes

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