C H A P T E R | 1 6 

Pretreatment and
Posttreatment Response
Images

A B

FIGURE 16-1  Nasal Pyoderma. A, Alopecic, crusting, papular dermatitis on the nose before
treatment is provided. B, Following 3 weeks of aggressive antibiotic therapy (high dose, long
duration, and optimal frequency), the bacterial folliculitis and furunculosis were resolving.

550
 Pretreatment and Posttreatment Response Images 551

A B

FIGURE 16-2  Pyoderma. A, An adult German shepherd with generalized bacterial folliculitis
and furunculosis. The fur has been clipped, revealing numerous crusting, papular lesions with
drainage. B, After aggressive antibiotic therapy (high dose, long duration, and optimal frequency),
the bacterial folliculitis and furunculosis have resolved.

A B

FIGURE 16-3  Pyoderma. A, Severe erythematous dermatitis with numerous epidermal col-
larettes. B, After aggressive antibiotic therapy, the pyoderma has improved, but numerous epi-
dermal collarettes remain apparent. This dog had a multidrug-resistant Staphylococcus schleiferi
infection.

A B

FIGURE 16-4  Pyoderma. A, Alopecia and lichenification on the ventral neck caused by bacte-
rial pyoderma. Note the similarity to Malassezia (yeast) dermatitis. B, After aggressive antibiotic
therapy (high dose, long duration, and optimal frequency), the bacterial folliculitis and furuncu-
losis have resolved.
552 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-5  Pyoderma. A, An erythematous papular rash on the abdomen of a dog with
bacterial folliculitis is characteristic of pyoderma in dogs. B, After aggressive antibiotic therapy
(high dose, long duration, and optimal frequency), the bacterial folliculitis and furunculosis have
resolved.

A B

FIGURE 16-6  Pyoderma. A, This erosive dermatitis was caused by an aggressive Staphylococ-
cus infection in an adult German shepherd. Staphylococcus exotoxins are likely responsible for
the erosive lesions (similar to Staphylococcus scalded skin syndrome). B, After aggressive antibi-
otic therapy (high dose, long duration, and optimal frequency), the bacterial folliculitis and
furunculosis have resolved.
 Pretreatment and Posttreatment Response Images 553

A B

FIGURE 16-7  Pyoderma. Same dog as in Figure 16-6. A, Erosive lesions caused by the aggres-
sive Staphylococcus infection developed on the abdomen. B, After aggressive antibiotic therapy
(high dose, long duration, and optimal frequency), the bacterial folliculitis and furunculosis have
resolved.

A B

FIGURE 16-8  Nocardiosis. A, An erythematous plaque on the inner thigh with exudate. This
plaquelike lesion is unusual for Nocardia, which typically causes a more deep cellulitis. B, After
aggressive therapy with trimethoprim-sulfa, the lesions were resolving.

A B

FIGURE 16-9  Nocardiosis. Same dog as in Figure 16-8. A, This unusual plaque is not typical
of the cellulitis lesions associated with nocardiosis. B, After aggressive therapy with trimethoprim-
sulfa, the lesions were resolving.
554 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-10  Malasseziasis. A, Generalized alopecia with hyperpigmentation and lichenifi-

cation in the characteristic “elephant hide” pattern associated with yeast dermatitis. B, After
several weeks of systemic ketoconazole and topical antifungal therapy, the yeast dermatitis has
resolved. The underlying/primary condition (allergies or endocrine disease) must be controlled
to prevent recurrence of the infection.

A B

FIGURE 16-11  Malasseziasis. A, Severe erythematous, alopecic, lichenified dermatitis on the

face of a dog caused by secondary yeast dermatitis associated with primary allergic dermatitis.
B, After several weeks of systemic ketoconazole and topical antifungal therapy, the yeast derma-
titis has resolved.

A B

FIGURE 16-12  Malasseziasis. A, Severe alopecia, hyperpigmentation, and lichenification of

the face and axilla in the classic “elephant hide” pattern typical of yeast dermatitis. B, After several
weeks of systemic and topical antifungal and antibacterial therapy, the yeast dermatitis was
resolving.
 Pretreatment and Posttreatment Response Images 555

A B

FIGURE 16-13  Malasseziasis. A, Alopecia and lichenification on the face and neck of a young
miniature pinscher caused by a secondary yeast infection associated with food allergy. B, After
several weeks of systemic ketoconazole and topical antifungal therapy, the yeast dermatitis has
resolved. The food allergy was treated with a dietary food trial.

A B

FIGURE 16-14  Malasseziasis. A, Alopecia, hyperpigmentation, and lichenification on the face

and periocular skin of an adult Cocker spaniel with allergic dermatitis. B, After several weeks of
systemic ketoconazole and topical antifungal therapy, the yeast dermatitis has resolved.

A B

FIGURE 16-15  Malasseziasis. Same dog as in Figure 16-14. A, Alopecia and lichenification of
the tail base caused by secondary yeast dermatitis. Note the similarity to flea allergy dermatitis.
B, After several weeks of systemic ketoconazole and topical antifungal therapy, the yeast derma-
titis has resolved.
556 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-16  Malasseziasis. A, Severe alopecia, hyperpigmentation, and lichenification on

the ventral tail and perianal region in a dog with severe secondary yeast dermatitis. Based on the
perianal distribution, food allergy dermatitis should be considered as a possible primary condi-
tion. B, After several weeks of systemic ketoconazole and topical antifungal therapy, the yeast
dermatitis has resolved.

A B

FIGURE 16-17  Malasseziasis. A, Alopecia, hyperpigmentation, and lichenification in the char-

acteristic “elephant skin” pattern associated with secondary yeast infection. B, After several weeks
of systemic ketoconazole and topical antifungal therapy, the yeast dermatitis has resolved.
 Pretreatment and Posttreatment Response Images 557

A B

FIGURE 16-18  Malasseziasis. A, Alopecia and lichenification of the axillary region are char-
acteristic of yeast dermatitis. B, After several weeks of systemic ketoconazole and topical antifun-
gal therapy, the yeast dermatitis has resolved.

A B

FIGURE 16-19  Malassezia Otitis. A, Erythema, lichenification, and stenosis of the external ear
canal with a moist exudate. Cytologic evaluation demonstrated a predominant secondary yeast
infection. B, After several weeks of systemic ketoconazole and topical Otomax therapy, the yeast
otitis has resolved. The moist material is Otomax. Note that with resolution of the infection and
treatment with topical steroids, the ear canal swelling has decreased considerably.

A B

FIGURE 16-20  Malasseziasis. A, Alopecia and lichenification on the foot of an allergic dog
with secondary yeast pododermatitis. The interdigital space is usually the predominant site of
secondary bacterial and yeast infections; however, in this patient, the dermatitis extended to the
dorsal surface of the foot. B, After several weeks of systemic ketoconazole and topical antifungal
therapy, the yeast dermatitis has resolved.
558 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-21  Malasseziasis. A, A dark exudate has caused clumping of the hairs and crust
formation of the periocular skin and muzzle in this cat with secondary yeast dermatitis. Note the
similarity to feline pemphigus and idiopathic facial dermatitis of Persians. B, After several weeks
of systemic itraconazole (ketoconazole produces many adverse effects in cats) and topical anti-
fungal therapy, the yeast dermatitis resolved.

A B

FIGURE 16-22  Malasseziasis. A, Generalized alopecia, erythema, and lichenification in an

adult dog with secondary yeast dermatitis associated with an underlying allergy. B, After several
weeks of systemic ketoconazole and topical antifungal therapy, the yeast dermatitis has resolved.
Note that the dog was still pruritic from the underlying allergic disease, which remains
uncontrolled.

A B

FIGURE 16-23  Malasseziasis. A, Alopecia, hyperpigmentation, and lichenification in the char-

acteristic “elephant hide” pattern associated with yeast dermatitis. B, After several weeks of sys-
temic ketoconazole and topical antifungal therapy, the yeast dermatitis has resolved.
 Pretreatment and Posttreatment Response Images 559

A B

FIGURE 16-24  Dermatophytosis. A, Focal alopecia and erythema on the muzzle of an adult
Dachshund. B, After several weeks of systemic ketoconazole and topical antifungal therapy, the
dermatophytosis has resolved.

A B

FIGURE 16-25  Dermatophytosis. Same dog as in Figure 16-24. A, The alopecia and erythema
caused by folliculitis affect only the haired portion of the nose, unlike autoimmune skin disease,
which would affect nonhaired nasal planum. B, After several weeks of systemic ketoconazole and
topical antifungal therapy, the dermatophytosis has resolved.

A B

FIGURE 16-26  Demodicosis. A, Generalized alopecia and crusting papular rash on the face
caused by demodicosis. B, After several months of systemic miticidal therapy, the Demodex infec-
tion resolved (based on two consecutive negative skin scrapes 3 weeks apart).
560 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-27  Demodicosis. A, Generalized alopecia, crusting, and papular dermatitis affect-
ing an adult dog. B, After several months of systemic miticidal therapy, the Demodex infection
resolved (based on two consecutive negative skin scrapes 3 weeks apart).

A B

FIGURE 16-28  Demodicosis. A, Generalized alopecia, crusting, and papular dermatitis on the
head of an English bulldog puppy. B, After several months of systemic miticidal therapy (iver-
mectin), the Demodex infection resolved (based on two consecutive negative skin scrapes 3
weeks apart).

A B

FIGURE 16-29  Demodicosis. A, Generalized alopecia and papular dermatitis covering the
entire body. B, After several months of systemic miticidal therapy (ivermectin), the Demodex
infection resolved (based on two consecutive negative skin scrapes 3 weeks apart).
 Pretreatment and Posttreatment Response Images 561

A B

FIGURE 16-30  Demodicosis. A, Periocular alopecia in a young mixed-breed dog. B, After

several months of systemic miticidal therapy (ivermectin), the Demodex infection resolved (based
on two consecutive negative skin scrapes 3 weeks apart).

A B

FIGURE 16-31  Demodicosis. A, Generalized alopecia and papular rash in a Boxer puppy.
B, After several months of systemic miticidal therapy (ivermectin), the Demodex infection resolved
(based on two consecutive negative skin scrapes 3 weeks apart).
562 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-32  Demodicosis. A, Generalized alopecia, hyperpigmentation, and crusting

papular dermatitis in a dog with iatrogenic Cushing’s (caused by numerous long-acting injectable
steroid treatments). B, After several months of systemic miticidal therapy (ivermectin), the
Demodex infection is improving. The alopecia and hyperpigmentation will take longer to resolve
because of iatrogenic Cushing’s.

A B

FIGURE 16-33  Demodicosis. A, Generalized crusting papular dermatitis with draining tracts
caused by severe folliculitis and furunculosis. B, After several months of systemic miticidal
therapy, the Demodex infection resolved (based on two consecutive negative skin scrapes 3
weeks apart).

A B

FIGURE 16-34  Demodicosis. A, Generalized alopecia with a crusting papular rash. B, After
several months of systemic miticidal therapy, the Demodex infection resolved (based on two
consecutive negative skin scrapes 3 weeks apart).
 Pretreatment and Posttreatment Response Images 563

A B

FIGURE 16-35  Demodicosis. A, Alopecia with a severe, crusting papular dermatitis on the
trunk of an adult dog. B, After several months of systemic miticidal therapy, the Demodex infec-
tion resolved (based on two consecutive negative skin scrapes 3 weeks apart).

A B

FIGURE 16-36  Demodicosis. A, Alopecia with hyperpigmentation and lichenification on the

head, neck, and shoulder of an adult Cocker spaniel. Note the similar lesion type to Malassezia
(yeast) dermatitis, which would typically occur on the ventrum. B, After several months of sys-
temic miticidal therapy, the Demodex infection resolved (based on two consecutive negative skin
scrapes 3 weeks apart).
564 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-37  Demodicosis. Same dog as in Figure 16-32. A, Generalized alopecia, hyperpig-
mentation, and crusting papular dermatitis cover most of the cutaneous surface area. B, After
several months of systemic miticidal therapy (ivermectin), the Demodex infection resolved (based
on two consecutive negative skin scrapes 3 weeks apart).

A B

FIGURE 16-38  Demodicosis. A, Alopecia, erythema, hyperpigmentation, and lichenification

on the foot of a dog with iatrogenic Cushing’s disease. B, After several months of systemic miti-
cidal therapy (ivermectin) and discontinuation of the steroids, the Demodex infection resolved
(based on two consecutive negative skin scrapes 3 weeks apart).
 Pretreatment and Posttreatment Response Images 565

A B

FIGURE 16-39  Feline Demodicosis. A, Alopecia of the abdominal region in a cat with feline
demodicosis (Demodex gatoi). Note the similarity in lesion pattern (allergic alopecia) to other
causes (e.g., ectoparasitism, flea allergy, food allergy, atopy). B, The alopecia responded to weekly
lime sulfur dips. It is interesting to note that Demodex gatoi seems to be less sensitive to systemic
miticides (e.g., ivermectin, milbemycin, selamectin) than other mites.

A B

FIGURE 16-40  Canine Scabies. A, Generalized alopecia of a papular crusting rash in a stray
puppy. B, After several weeks of systemic miticidal therapy (ivermectin), the infection resolved.

A B

FIGURE 16-41  Flea Allergy Dermatitis. A, Severe alopecia, lichenification, and crusting
papular dermatitis on the lumbar area. The lumbar distribution (lesions caudal to the rib cage) is
characteristic of flea allergy dermatitis in dogs. B, After several weeks of aggressive treatment
with topical spot-on flea control, the flea allergy dermatitis was resolving.
566 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-42  Myiasis. A, Numerous maggots filling a cutaneous lesion in an adult dog.
B, The patient has been bathed and the maggots removed, leaving open cutaneous lesions.

A B

FIGURE 16-43  Allergic Dermatitis. A, An adult Shar pei with atopy and food allergy, demon-
strating generalized alopecia and papular dermatitis. B, The cutaneous lesions were resolving
with cyclosporine therapy. This patient had failed to improve with numerous allergy tests and
hyposensitization attempts, food trials, and symptomatic therapy.

A B

FIGURE 16-44  Canine Atopy. A, Periocular alopecia and erythema typical of allergic derma-
titis (atopy or food allergy). Note the similarity to other causes of blepharitis (e.g., demodicosis,
contact dermatitis). B, The periocular alopecia and erythema improved when the underlying
allergic disease was controlled.
 Pretreatment and Posttreatment Response Images 567

A B

FIGURE 16-45  Canine Atopy. Same dog as in Figure 16-44. A, Periocular alopecia and ery-
thema caused by the underlying allergy are apparent. B, The periocular alopecia and erythema
improved when the underlying allergic disease was controlled.

A B

FIGURE 16-46  Feline Allergic Dermatitis. A, Alopecia with or without apparent inflammatory
dermatitis can have many causes in cats (e.g., ectoparasitism, flea allergy, food allergy, atopy). B,
When the primary cause was identified and controlled, the overgrooming (pruritus) was dimin-
ished and the hair regrew.

A B

FIGURE 16-47  Feline Allergic Dermatitis. Same cat as in Figure 16-46. A, Allergic alopecia
with or without apparent inflammatory dermatitis can have many causes in a cat (e.g., ectopara-
sitism, flea allergy, food allergy, atopy). B, When the primary cause is identified and controlled,
the overgrooming (pruritus) is diminished and the hair regrows.
568 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-48  Feline Allergic Dermatitis. A, Eosinophilic plaques are common lesions caused
by allergic dermatitis in cats, regardless of the underlying cause (e.g., ectoparasitism, flea allergy,
food allergy, atopy). This eosinophilic plaque was likely caused by acute exposure to fleas or other
ectoparasites. B, These eosinophilic plaques resolved with aggressive flea control and injectable
steroid therapy.

A B

FIGURE 16-49  Feline Allergic Dermatitis. Same cat as in Figure 16-48. A, These symmetrical
eosinophilic plaques developed acutely. B, These eosinophilic plaques resolved with aggressive
flea control and injectable steroid therapy.

A B

FIGURE 16-50  Pemphigus Foliaceus. A, Crusting papular dermatitis on the face and ear
pinnae of a cat with pemphigus foliaceus. B, The crusting papular dermatitis was resolving after
several weeks of traditional immunosuppressive therapy.
 Pretreatment and Posttreatment Response Images 569

A B

FIGURE 16-51  Pemphigus Foliaceus. Same cat as in Figure 16-50. A, Alopecic, crusting,
papular dermatitis covering the ear pinnae is characteristic of autoimmune skin disease. Note (in
cats) the similarity to other causes of head and neck crusting dermatitis (e.g., ectoparasitism, flea
allergy, food allergy, atopy). B, The crusting papular dermatitis was resolving after several weeks
of traditional immunosuppressive therapy.

A B

FIGURE 16-52  Pemphigus Foliaceus. Same cat as in Figure 16-50. A, Crusting papular der-
matitis on the ear pinna and preauricular skin is apparent. B, The crusting papular dermatitis was
resolving after several weeks of traditional immunosuppressive therapy.

A B

FIGURE 16-53  Pemphigus Foliaceus. A, Alopecic, erythematous, moist dermatitis around the
nipples is a unique and common characteristic feature of pemphigus foliaceus in cats. B, The
dermatitis was resolving after several weeks of traditional immunosuppressive therapy.
570 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-54  Systemic Lupus Erythematosus. A, Multiple alopecic, erythematous areas of

erosive dermatitis on the face of a Jack Russell terrier. Note the similarity to lesions typical of
vasculitis, which can be familial in Jack Russell terriers. B, Multiple alopecic scars persisted despite
resolution of the active autoimmune skin disease with traditional immunosuppressive therapy.

A B

FIGURE 16-55  Systemic Lupus Erythematosus. Same dog as in Figure 16-54. A, A focal area
of alopecia and erythema. Note that the presence of erythema suggests an inflammatory
response and active disease. B, With immunosuppressive therapy, the active inflammation and
associated erythema should resolve. Depending on the severity of the lesion, alopecic scars may
persist.

A B

FIGURE 16-56  Systemic Lupus Erythematosus. Same dog as in Figure 16-54. A, Onychodys-
trophy was caused by concurrent vasculitis associated with lupus. B, With immunosuppressive
therapy, the onychodystrophy improved and the claws became more normal.
 Pretreatment and Posttreatment Response Images 571

A B

FIGURE 16-57  Systemic Lupus Erythematosus. A, Alopecic, crusting ear margin dermatitis
with a circular area of necrosis caused by vascular thrombosis. B, With immunosuppressive
therapy, the vasculitis associated with lupus resolved, allowing the skin to heal.

A B

FIGURE 16-58  Discoid Lupus Erythematosus. A, Depigmentation of the nasal planum is

unique and characteristic of autoimmune skin diseases. The alopecic, erythematous dermatitis
on the haired portion of the nose could be caused by folliculitis (pyoderma, Demodex, and der-
matophyte) but was associated with the autoimmune skin disease in this patient. B, The nasal
depigmentation and alopecic dermatitis were resolving after several weeks of therapy with
topical tacrolimus.

A B

FIGURE 16-59  Sterile Nodular Panniculitis. A, Multiple draining nodules on the shoulders
of an adult Chihuahua. B, The nodular lesions have resolved and the hair has regrown after several
weeks of immunosuppressive therapy.
572

A B

FIGURE 16-60  Sterile Nodular Panniculitis. Same dog as in Figure 16-59. A, Numerous drain-
ing nodules with crust formation on the shoulders of an adult Chihuahua. B, The nodular lesions
have resolved and the hair has regrown after several weeks of immunosuppressive therapy.

A B

FIGURE 16-61  Cutaneous Vasculitis. A, This ulcerative lesion close to the center of the digital
footpad is characteristic of vasculitis. B, The ulcerative lesion in the center of the digital footpad
improved after several weeks of therapy with pentoxifylline.

A B

FIGURE 16-62  Erythema Multiforme. A, Generalized alopecia with erosive, hyperpigmenting

lesions in an adult Pomeranian. Note that the well-demarcated serpentine borders of the lesions
are characteristic of cutaneous drug reaction, vasculitis, and autoimmune skin disease. B, Com-
plete resolution of the lesions after several months of immunosuppressive therapy with cyclo-
sporine (Atopica).
 Pretreatment and Posttreatment Response Images 573

A B

FIGURE 16-63  Erythema Multiforme. Same dog as in Figure 16-62. A, The generalized alo-
pecic, hyperpigmenting lesions with well-demarcated borders are characteristic of this disease.
B, Complete resolution of the lesions after several months of immunosuppressive therapy with
cyclosporine (Atopica).

A B

FIGURE 16-64  Erythema Multiforme. A, Severe erosive dermatitis on the periocular skin and
face of an adult Boxer. The dog also had a methicillin-resistant Staphylococcus aureus infection,
likely contracted from the owner, who worked in the human health care industry. B, Moderate
improvement in erosive dermatitis after several weeks of aggressive antibiotic therapy (based on
culture, high dose, long duration, and optimal frequency) and immunosuppressive treatment.

A B

FIGURE 16-65  Erythema Multiforme. Same dog as in Figure 16-64. A, Severe erosive derma-
titis on the periocular skin with concurrent corneal edema and uveitis. The dog also had a
methicillin-resistant Staphylococcus aureus infection, likely contracted from the owner, who
worked in the human health care industry. B, Moderate improvement in erosive dermatitis after
several weeks of aggressive antibiotic therapy (based on culture, high dose, long duration, and
optimal frequency) and immunosuppressive treatment.
574 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-66  Cutaneous Drug Reaction. A, A crusting nodular dermatitis covering the
entire head and body, likely caused by an idiosyncratic drug reaction. B, Complete resolution of
crusting nodular dermatitis after discontinuation of the suspected drug and several weeks of
immunosuppressive therapy.

A B

FIGURE 16-67  Canine Hyperadrenocorticism. A, An adult Chow with pemphigus foliaceus

demonstrating the characteristic depigmentation and erosive dermatitis on the nasal planum
and ear pinnae. B, Generalized alopecia and hyperpigmentation after overly aggressive (too long
duration) immunosuppressive therapy with steroids. Iatrogenic Cushing’s disease caused a sec-
ondary bacterial pyoderma and adult-onset demodicosis.
 Pretreatment and Posttreatment Response Images 575

A B

FIGURE 16-68  Canine Hyperadrenocorticism. A, Symptoms of Cushing’s disease can often

be subtle. This dog demonstrates a relatively normal fur coat but has poor body confirmation. 
B, After treatment with mitotane, the subtle symptoms of Cushing’s disease resolved. The dog’s
muscle tone and body posture were greatly improved.

A B

FIGURE 16-69  Canine Hyperadrenocorticism. A, Secondary bacterial pyoderma with alope-

cia and a crusting papular dermatitis on the perianal skin. B, When Cushing’s disease was treated
and antibiotics administered, the secondary bacterial pyoderma resolved.
576 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-70  Calcinosis Cutis. A, Severe alopecic, hyperpigmented, erosive dermatitis

caused by calcium deposition and secondary bacterial infection associated with iatrogenic Cush-
ing’s disease due to injectable long-acting steroid treatments. B, After discontinuation of the
steroids and several weeks of aggressive antibiotic therapy, the infection resolved and the calcium
was reabsorbed, allowing the skin to heal.

A B

FIGURE 16-71  Calcinosis Cutis. A, Severe alopecic, erythematous, papular dermatitis with
calcium deposition on the dorsum of a dog with iatrogenic Cushing’s disease. B, After discontinu-
ation of the steroids and several weeks of aggressive antibiotic therapy, the active inflammatory
process was diminished and the skin was healing.
 Pretreatment and Posttreatment Response Images 577

A B

FIGURE 16-72  Calcinosis Cutis. A, Severe erythematous papular dermatitis caused by a sec-
ondary bacterial infection associated with iatrogenic Cushing’s disease (caused by numerous
injectable long-acting steroid treatments) and calcium deposition. B, After discontinuation of the
steroids and several weeks of aggressive antibiotic therapy, the active inflammatory process was
diminished and the skin has become hyperpigmented. The calcium deposits organized, forming
a solid plate that could be lifted as a single sheet.

A B

FIGURE 16-73  Sex Hormone Alopecia. A, Generalized alopecia and hyperpigmentation

without apparent inflammatory dermatitis are typical of endocrine disease. B, Following castra-
tion, the fur coat regrew normally.

A B

FIGURE 16-74  Alopecia X. A, Two related male Pomeranians with alopecia X. The Pomeranian
on the left was recently treated, causing temporary regrowth of hair. B, The Pomeranian in front
has the noninflammatory alopecia with cutaneous hyperpigmentation characteristic of this
disorder.
578 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-75  Alopecia X. A, An adult Poodle with persistent dorsal alopecia despite several
treatment attempts. Note the biopsy-induced areas of hair regrowth typical of this syndrome. B,
The Poodle after sweater therapy.

A B

FIGURE 16-76  Sebaceous Adenitis. A, Generalized alopecia with erythematous, crusting der-
matitis on the trunk of an adult dog. B, After several weeks of topical antiseborrheic therapy and
systemic vitamin A supplementation, the dermatitis resolved.

A B

FIGURE 16-77  Feline Acne. A, Numerous comedones and papular dermatitis typical of feline
acne complicated by a secondary bacterial infection. B, After frequent comedolytic cleansing and
topical mupirocin ointment, the acne improved.
 Pretreatment and Posttreatment Response Images 579

A B

FIGURE 16-78  Parasympathetic Nasal Hyperkeratosis. A, Severe focal hyperkeratosis affect-

ing predominantly one side of the nasal planum seems to be a common lesion pattern of this
syndrome. B, After several weeks of topical mupirocin ointment therapy, the focal hyperkeratosis
was markedly improved.

A B

FIGURE 16-79  Canine Interdigital Pyogranuloma. A, Severe erosive interdigital dermatitis

with a secondary bacterial pyoderma in an adult German shepherd. B, The interdigital lesions
completely resolved after several weeks of aggressive topical and systemic antibacterial therapy,
suggesting that the secondary infection was the main cause of the severe dermatitis.

A B

FIGURE 16-80  Eosinophilic Plaque. A, This eosinophilic plaque (erosive dermatitis with crust
formation) on the preauricular skin developed acutely and was likely caused by exposure to fleas
or other ectoparasites. B, After aggressive flea control and treatment with injectable steroids, the
eosinophilic plaque completely resolved.
580 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-81  Indolent Ulcer. A, Severe tissue destruction of the upper lip is characteristic of
this disease. B, After several weeks of treatment with trimethoprim-sulfa (used as an antibiotic
and immune-modulating agent), the indolent ulcer was improving.

A B

FIGURE 16-82  Indolent Ulcer. Same cat as in Figure 16-81. A, Swelling and severe tissue
destruction of the upper lip are apparent. This cat had failed to respond to numerous treatment
attempts with traditional therapies for indolent ulcers. B, After several weeks of treatment with
trimethoprim-sulfa (used as an antibiotic and immune-modulating agent), the indolent ulcer was
improving.

A B

FIGURE 16-83  Feline Solar Dermatosis. A, A focal area of carcinoma in situ on the pinna of
an adult cat. B, Several weeks after laser ablation, the skin was completely healed and hair was
regrowing. Early detection and therapeutic intervention produced excellent cosmetic
outcomes.
 Pretreatment and Posttreatment Response Images 581

A B

FIGURE 16-84  Feline Solar Dermatosis. Same cat as in Figure 16-83. A, A papular rash on the
preauricular skin was caused by multiple solar lesions and foci of carcinoma in situ. B, Several
weeks after laser ablation, the skin was completely healed and the hair was regrowing. Early
detection and therapeutic intervention produced excellent cosmetic outcomes.

A B

FIGURE 16-85  Feline Solar Dermatosis. A, A focal area of carcinoma in situ on the upper lip
of an adult cat. (Courtesy R. Seamen.) B, Several weeks after laser ablation, the skin was completely
healed and hair was regrowing. Early detection and therapeutic intervention produced excellent
cosmetic outcomes. (Courtesy R. Seamen.)

A B

FIGURE 16-86  Blepharitis. A, Severe proliferative, erosive dermatitis on the eyelids and peri-
ocular skin of an adult Labrador. (Courtesy K. Tobias.) B, After several weeks of immunosuppressive
therapy (doxycycline), the severe erosive dermatitis resolved, leaving alopecic, scarred skin. Note
that the absence of erythema indicates resolution of the active inflammatory process.
582 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-87  Blepharitis. A, Alopecic, erythematous, erosive dermatitis on the eyelids and
periocular skin caused by marginal blepharitis. This immune-mediated skin disease is an unusual
manifestation of an aberrant immune response. B, After several weeks of immunosuppressive
therapy, the severe erosive dermatitis resolved, leaving alopecic, scarred skin.

A B

FIGURE 16-88  Blepharitis. Same dog as in Figure 16-87. A, Alopecic, erythematous dermatitis
affecting the eyelid margins is apparent. B, After several weeks of immunosuppressive therapy,
the severe erosive dermatitis resolved, leaving alopecic, scarred skin.

A B

FIGURE 16-89  Perianal Fistulae. A, Deep fistulous track with tissue proliferation completely
destroying the normal anal architecture. B, After several weeks of immunosuppressive therapy,
the perianal fistula was greatly improved.
 Pretreatment and Posttreatment Response Images 583

A B

FIGURE 16-90  Perianal Fistulae. A, Tissue proliferation surrounding a persistent fistula in an

adult German shepherd. B, After several weeks of immunosuppressive therapy, the perianal
fistula was greatly improved.

A B

FIGURE 16-91  Perianal Fistulae. A, Severe destruction of the perianal tissue. B, After several
weeks of immunosuppressive therapy, the perianal fistulae were greatly improved.

A B

FIGURE 16-92  Perianal Fistulae. A, Cryosurgery (using a canned cryogen, Verruca-Freeze) is

being performed to re-stimulate wound healing and resolve persistent perianal fistulae (which
had persisted despite several months of topical and systemic immunosuppressive treatment). 
B, Several weeks after the cryosurgical procedure, the perianal fistulae have almost resolved.
584 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-93  Squamous Cell Carcinoma. A, Multiple crusting papular lesions caused by
solar dermatitis and squamous cell carcinoma. B, Several weeks after laser ablation, the skin was
completely healed and hair was regrowing. Early detection and therapeutic intervention pro-
duced excellent cosmetic outcomes.

A B

FIGURE 16-94  Squamous Cell Carcinoma. Same cat as in Figure 16-93. A, Papular lesions
caused by solar dermatitis and carcinoma are apparent on the preauricular skin. B, Several weeks
after laser ablation, the skin was completely healed and hair was regrowing. Early detection and
therapeutic intervention produced excellent cosmetic outcomes.

A B

FIGURE 16-95  Squamous Cell Carcinoma. A, Severe crusting, ulcerative dermatitis associ-
ated with invasive squamous cell carcinoma on the nasal planum and upper lip of an adult cat.
B, Radical surgical excision was necessary to remove the entire tumor. Surgical correction would
have been much easier if performed earlier. (Courtesy R. Seamen.)
 Pretreatment and Posttreatment Response Images 585

A B

FIGURE 16-96  Squamous Cell Carcinoma. A, Focal area of carcinoma in situ on the upper lip
of an adult cat. (Courtesy R. Seamen.) B, Several weeks after laser ablation, the skin was completely
healed and hair was regrowing. Early detection and therapeutic intervention produced excellent
cosmetic outcomes. (Courtesy R. Seamen.)

A B

FIGURE 16-97  Squamous Cell Carcinoma. A, Severe tissue destruction of the entire distal ear
pinna caused by progression of the squamous cell carcinoma. B, Amputation of this cat’s ear
pinna was performed to remove the tumor. Early detection and therapeutic intervention provide
better cosmetic outcomes.

A B

FIGURE 16-98  Mast Cell Tumor. A, Alopecic, erythematous tumor on the ear pinna of a Dal-
matian. B, After several weeks of steroid therapy, the mast cell tumor was reduced in size.
586 CHAPTER 16  n  Pretreatment and Posttreatment Response Images

A B

FIGURE 16-99  Mast Cell Tumor. A, Multiple alopecic, erythematous tumors on the head and
ear pinna of a Dalmatian. B, After several weeks of steroid therapy, the mast cell tumors were
reduced in size.

A B

FIGURE 16-100  Epitheliotropic Lymphoma. A, Focal, alopecic, ulcerated lesions on a cat’s

lip. Note that the entire lip is swollen—a condition that is caused by infiltrating neoplastic cells.
B, After several weeks of topical steroid therapy, the inflammation associated with the tumor was
improved.

FIGURE 16-101  Epitheliotropic Lymphoma. Same cat as in Figure 16-100. A, Despite tran-
sient improvement associated with topical steroids, the lymphoma continued to spread. This
image was taken several weeks after chemotherapy was used to slow the tumor. B, Despite the
transient improvement associated with topical steroids and chemotherapy, the lymphoma con-
tinued to spread. This image was taken several weeks after aggressive radiation therapy was
provided. The tumor had improved, but the skin was left alopecic and scarred from the radiation
damage.