3.

5 Scales 159

Fig. 3.128  Histology of Malassezia overgrowth: many yeasts in the stratum corneum (arrow).
Note as the typical bilobed shape is well evident (inset)

been shown that in some feline breeds such as the Devon rex or in canine breeds
such as the Basset hound, the number of yeasts on the skin is physiologically higher
than in other breeds (Ahman et al. 2007). Anecdotally, is believed that when diag-
nosing a Malassezia overgrowth more than two yeasts per immersion field (×100)
need to be found. Although the number of yeasts usually found is greater than that
considered relevant to diagnosing a Malassezia overgrowth, in some dogs with
chronic lichenification, it is possible to obtain negative samples. This occurrence is
because severe epidermal hyperplasia may not allow the sampling of yeasts hidden
between the epidermal folds. To avoid this misdiagnosis it is advisable to carry out
repeated sampling from the same area to try to collect more deeply located yeasts.
In a severe infection, the number of yeasts is so high that many Malassezia spp. can
be easily collected with a piece of transparent acetate tape (Figs. 3.128 and 3.129).

3.5.1.3  Cutaneous Candidiasis

Candida albicans is a commensal mycelial yeast that colonises the mucous mem-
branes of dogs and cats. In addition to C. albicans, other yeasts such as C. parapsi-
losis and C. guilliermondii have been reported to cause dermatitis in dogs (Carlotti
and Pinn 1999; Mueller et al. 2002; Gross et al. 2005). These yeasts can occasion-
ally cause dermatitis, but when it happens they are usually opportunistic infections
due to an underlying disease that impairs the immune system, such as metabolic
diseases (superficial necrolytic dermatitis/hepatocutaneous syndrome), hormonal
160 3  Cytology of Canine and Feline Non-neoplastic Skin Diseases

Fig. 3.129  Cytology of Malassezia dermatitis: numerous Malassezia pachidermatis collected

from the same lesion as in Fig. 3.128

disorders (hypercortisolism and diabetes mellitus), visceral neoplasia etc. Usually,

the more humid body areas such as mucocutaneous areas, interdigitals, and skin
fold areas are more frequently affected and sometimes a smelly whitish film is
observed on the skin surface (Figs. 3.130 and 3.131) (Carlotti and Pinn 1999;
Greene 2012; Scott et al. 2001; Miller et al. 2013).
Like Malassezia, Candida may also be easily sampled using the imprint tech-
nique with a slide or a piece of transparent acetate tape.
Cytological Findings
Candida albicans yeasts live in the superficial layers of the epidermidis and for this
reason they are usually observed together with a variable number of keratinocytes
(Fig. 3.132). Candida is a dimorphic fungus and a normal inhabitant of the mucous
membranes. Unlike Malassezia, it is a mycelial yeast and can be observed in the
form of both roundish and oval spores, measuring 3–6 μm, and sometimes arranged
in pseudo-mycelia or in chains or as branched hyphal filaments (bipolar or multipo-
lar narrow based budding). Spores stain blue with the Romanowsky stain and have
a thin, transparent, pericellular halo (Figs. 3.133 and 3.134).
3.5 Scales 161

Fig. 3.130  Erythema and whitish patina in the interdigital area of a dog with pododermatitis due
to Candida albicans

Fig. 3.131  Erythema and whitish patina on the anal mucocutaneous junction in a dog with cutane-
ous candidiasis
162 3  Cytology of Canine and Feline Non-neoplastic Skin Diseases

Fig. 3.132  Histology of cutaneous candidiasis: many round to oval yeasts in the stratum
corneum

Fig. 3.133  Cytology of cutaneous candidiasis: many oval-shaped yeasts with a clear peripheral
halo, which adhere to corneocytes
3.5 Scales 163

Fig. 3.134  Cytology of cutaneous candidiasis: many oval yeasts with a achromatic peripheral halo

3.5.1.4  Dermatophytosis
Dermatophytosis is a fungal disease caused by keratinophilic fungi, mostly repre-
sented by Microsporum canis, Microsporum gypseum or by fungi belonging to the
Trichophyton mentagrophytes complex (Miller et al. 2013). As dermatophytes infest
keratin, one of the most common clinical signs is exfoliative dermatitis with alope-
cia, scales, erythema and broken hairs (Figs. 3.135, 3.136, and 3.137). For this rea-
son, it is not so uncommon to detect arthroconidia and/or hyphae on corneocytes,
especially in cats (Gross et al. 2005). The best sampling method for collection is the
imprint technique using a piece of transparent acetate tape.
In the case of infections caused by Microsporum persicolor, as this fungus is
corneophylic, which means that it does not infect hairs, but only the keratin of kera-
tinocytes, the sampling of scales is the only way to try to find fungi through cytol-
ogy (Carlotti and Bensignor 1999).
Cytological Findings
The infectious outer layers of the stratum corneum permits the collection of fungal
elements using the acetate tape test. The quantity of fungi is strictly linked to the
severity of the infestation (Figs. 3.138 and 3.139). Spores (arthroconidia) are very
small, rounded or oval, and are cytologically characterised by a pericellular clear
halo, whereas hyphae are linear branched filaments, with multiple segmentations
that give to fungi a bamboo pole appearance (Figs. 3.140 and 3.141). Hyphae are of
several different lengths, whereas arthroconidia vary in size from 2 to 5 μm, smaller
for M. canis, larger for M. gypseum and T. mentagrophytes, and assume a blue colour
with rapid stains, magenta with PAS and black with Gomori staining (Fig. 3.142).
164 3  Cytology of Canine and Feline Non-neoplastic Skin Diseases

Fig. 3.135  Yellowish scales on the face of a Yorkshire terrier with generalised dermatophytosis

Fig. 3.136  Scales on the head and pinna of a dog with generalised dermatophytosis
3.5 Scales 165

Fig. 3.137 Yellowish scales on the nose of a domestic short-haired (DSH) cat with
dermatophytosis

Fig. 3.138  Histology of dermatophytosis (PAS staining): many arthroconidia surround hair shafts
and slender segmented hyphae in the stratum corneum
166 3  Cytology of Canine and Feline Non-neoplastic Skin Diseases

Fig. 3.139  Histology of dermatophytosis (PAS staining): numerous hyphae in the stratum
corneum

Fig. 3.140  Cytology of dermatophytosis: numerous elongated and septated hyphae on the surface
of corneocytes
3.5 Scales 167

Fig. 3.141  Cytology of dermatophytosis: septated hyphae on the surface of corneocytes

Fig. 3.142 Cytology of dermatophytosis: numerous arthroconidia on the surface of the

corneocytes
168 3  Cytology of Canine and Feline Non-neoplastic Skin Diseases

Fig. 3.143  Cytology: a non-dermatophytic fungal body that looks like pathogenic dermatophytic
macroconidia

It should be remembered that any structure found on the slides resembling mac-
roconidia, should not be confused with pathogenic fungi, as the macroconidia of
dermatophytes grow exclusively on cultures and not on the skin (Fig. 3.143).

3.5.1.5  Demodicosis and Other Superficial Ectoparasites

Demodex mites are normal commensals of the skin of dogs and cats. Genetic predis-
position and imbalances of the immune system predispose animals to develop an
uncontrolled proliferation of mites. Diagnosis of demodicosis can be made using
various methodologies; among them, the deep skin scraping technique is the more
accurate (Miller et al. 2013; Mueller 2004). In dogs and cats different Demodex spp.
are recognised, showing morphological differences. In both species mites with long
and short bodies are distinguished; in dogs, a recent paper has demonstrated that the
short body mite formerly named Demodex cornei is genotypically strictly related to
Demodex canis and seems to be only a morphological variant of the latter (Sastre
et al. 2012).
In many dogs affected by generalised demodicosis, especially with exfoliative
dermatitis, numerous normal and short-body D. canis mites can be collected via the