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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

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Generalised scaling in a male donkey l.jpg

Generalised scaling ina male donkey

Author: Mark Craig

Editor: David Lloyd

© European Society of Veterinary Dermatology


History l.jpg

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 l.jpg

Clinical signs - 1

  • Generalised exfoliative erythroderma

  • Thin, depressed

  • Rectal temperature, pulse rate, respiratory rate normal

  • No peripheral lymphadenopathy

  • No oral lesions were present

Signs


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Clinical signs - 2

  • The donkey is thin and depressed

  • There is poor coat with generalised scaling

Signs


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Clinical signs - 3

Exfoliation and erythema of the scrotum

Periocular scaling and greasy matted hair around the eye

Signs


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Clinical signs - 4

Close up of scaling,

matting of coat and

underlying erythema

Signs


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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


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Differential diagnoses

  • Bacterial infection including dermatophilosis

  • Dermatophytosis

  • Pemphigus foliaceus, SLE

  • Drug eruption

  • Cutaneous lymphoma

Differentials


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Tests - 1

  • Skin scrapings

  • Blood tests: routine haematological and biochemical screens

  • Fungal culture of scale and hairs

  • Multiple skin biopsy samples

Tests


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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


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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


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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


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Histopathology

Results

An interface dermatitis

pattern predominated,

possible indicating lupus or

a drug eruption

Tests


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What is yourdiagnosis?

  • Do the investigations permit a definitive diagnosis?

  • Are there any additional investigations which you think may need to be done

Tests


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Further steps

  • Consultation with the pathologist

  • The histological picture was not clear and the pathologist suggested a second opinion supported by immunohistochemical studies

Tests


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Histopathology

Results

Another view of the

histopathology showing

lichenoid infiltration and

microabscess formation with

predominantly mononuclear

cells

Tests


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Diagnosis

  • Subsequent immunohistochemical studies showed a strong reaction to CD-3 of infiltrating cells.

  • A diagnosis of epidermotropic lymphoma was made

Tests


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How would you deal with this case?

  • What is your prognosis?

  • How will you advise the owner?

  • What treatment would you consider?

Therapy


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Prognosis

  • Prognosis is grave

    • Disease is fatal

    • Steroids and cytotoxic drugs are unlikely to be helpful

    • Euthanasia was carried out

Therapy


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Review

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Notes


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