2023-2024 (03) Diagnosis Techniques

Veterinary Dermatology 28/11/2023
Lebanese University
Faculty of Agricultural & Veterinary Sciences
Veterinary Dermatology
3. Diagnostic
Techniques
Dr. Walid Darwiche
1. Diagnostic tests for

ectoparasitism
2. Diagnostic tests for
dermatophytosis
Plan 3. Trichography
4. Cytology
5. Bacterial culture and
sensitivity testing
6. Histopathology
Veterinary Dermatology - Dr Walid Darwiche 2
Dr. Walid Darwiche 1

• Unless the diagnosis is immediately obvious, many dermatology cases in

veterinary medicine present something of a challenge to the clinician.
• In these more complex cases, consideration of the signalment, history
and physical examination allows formulation of a differential
diagnosis, and then various tests and therapeutic trials are employed
to reach a definitive diagnosis.
• The tests available include those performed within the practice
laboratory and those offered by external commercial labs.
• The lack of reliability in a test can be attributed to a combination of

factors, including biological variation, test methodology, and the skill
of the clinician.
• It is important the clinician is aware of the limits of any diagnostic test,
and test results should be interpreted in the light of the case history
and clinical signs.
• This interpretation is of crucial clinical importance and is one of the most
common sources of diagnostic error.

1. DIAGNOSTIC
TESTS FOR
ECTOPARASITISM
• The tests available for the detection of external parasites are:

• Combings and coat brushings
• The use of acetate strips
• Skin scrapes
• Hair plucks
• Scabies igg ELISA
• Histopathological examination.

Ectoparasites encountered in small animal practice

Insects
Flea infestation Common
Lice Uncommon
Mites
Sarcoptes scabiei Common
Notoedres cati Rare in cats
Cheyletiella spp. Common
Otodectes cynotis Common
Neotrombicula autumnalis Common
Demodex spp. Common
Endoparasites
Pelodera, hookworms Uncommon to rare
General principles for microscopy

• Become familiar with the operation of your microscope.
• Apart from when using acetate strips, always apply a coverslip over
any material to be examined microscopically.
• Having excessive material on the slide will make thorough
examination difficult.
• Low power (×4 objective) is sufficient magnification for detection of
ectoparasites, although a ×10 objective may be required for more
detailed examination of specimens.

Combings
• A flea comb may be used to collect material
from the coat for gross examination.
• The test is useful for the detection of larger
external parasites such as fleas and lice.
• If fleas are present in large numbers, they
should be seen.
• However, fleas are only detected in around
60% of cases of canine flea allergy dermatitis
and the figure is considerably lower in cats,
who remove evidence of flea infestation by
grooming.
• Thus, flea combing is an insensitive test for
the diagnosis of flea infestation.
Coat brushing
examination
• This is a useful and moderately sensitive
test for the diagnosis of surface and
superficial parasites such as fleas, lice,
harvest mites and Cheyletiella spp. mites.
• Scale is dislodged from the dorsal trunk
onto a piece of A4 paper by combing or
vigorous brushing with the fingertips.
• The paper is folded and tapped so that
the material collected falls into the crease.
10

• Hair is removed and the material can be examined grossly for the
presence of flea feces, as well as larger parasites such as lice.
• The material should be collected onto clear adhesive tape, mounted
onto a glass slide and examined under the low-power light
microscope.
• The complete area under the adhesive tape should be carefully
examined.
11
Hair plucks
• Microscopic examination of hair plucks
may be useful to detect Demodex spp.
mites and Cheyletiella spp. or louse eggs.
• Hair plucks are very useful when taking
samples from areas that are difficult to
scrape, such as the feet in the case of
pododemodicosis, when skin scraping
would require sedation.
• Fifty to 100 hairs are plucked and mounted
in liquid paraffin on a glass slide under a
coverslip.
12

• The hair tips, shafts and bulbs

should all be carefully examined.
• One study showed deep skin
scraping to be more sensitive than
hair plucks in cases of localized and
squamous demodicosis, and
therefore demodicosis should not
be ruled out on the basis of not
finding mites on hair plucks.
Hair pluck from a case of pododemodicosis with

adult mites and egg (arrowed).
13
Skin scrapings
• Skin scrapings are used to detect the
presence of superficial and deep
parasitic mites such as Cheyletiella,
Sarcoptes and Demodex spp.
• Skin scrapings should be performed
when there is evidence of erythema,
scaling, crusting, alopecia, or a papular
or pustular eruption.
• In cases of canine scabies, the hocks,
elbows and pinnal margins are prime
sites for finding mites.
• Avoid scraping areas that are
excessively crusted or excoriated, as this
may lead to false-negative results.
14

• Three to five different sites should be sampled

(five in the case of suspected scabies or
demodicosis).
• Hair should be clipped with a No. 40 clipper
blade.
• When scraping for Demodex spp., it helps to
gently squeeze the skin between thumb and
forefinger, as this extrudes mites from the hair
follicles.
• A small amount of liquid paraffin to suspend
collected material (or water if using potassium
hydroxide) is applied to the area to be scraped.
• A blunted No. 10 scalpel blade is used to scrape
material from the skin surface.
15
• Deep skin scrapes resulting in

capillary oozing should be made
when looking for Sarcoptes or
Demodex spp. mites.
• Collected material is mounted onto a
glass slide in liquid paraffin or
potassium hydroxide.
• A coverslip should be applied.
• Examine samples for ectoparasites
under the low-power objective and
scan the entire area under the Deep skin scraping
coverslip.
16

Canine Sarcoptes IgG ELISA

• Commercial laboratories offer a Sarcoptes IgG ELISA test.
• This is a highly sensitive (∼90%) test, although false-negative
reactions may occur in early cases because seroconversion may
take up to 4 weeks following mite exposure.
• False-positive reactions may be seen in cases of canine atopic
dermatitis due to house dust mite hypersensitivity because of cross-
reaction between Dermatophagoides spp. house dust mites and
Sarcoptes scabiei.
17
18

Histopathological examination
• Histopathological examination is a very sensitive test for the
diagnosis of demodicosis and if skin scrapes have been
unrewarding, but demodicosis is still suspected, then
histopathology would be the definitive rule out.
• Histopathologically, canine demodicosis results in interface mural
folliculitis, perifolliculitis, folliculitis and furunculosis, and nodular
dermatitis.
• Mites should be evident on histopathological sections.
Histopathology is a highly insensitive test for other ectoparasitic
diseases.
19
Interpretation of test results

• With the exception of demodicosis, tests for ectoparasites are of
low sensitivity but 100% specificity.
• Sarcoptes spp. mites are only found on skin scrape examination in
around 50% of cases of canine scabies and Cheyletiella spp. mites
may also be difficult to detect in some cases.
• Indeed, in multi-animal households, it can be helpful to check in
contact (and frequently unaffected) animals for the presence of the
parasite.
20

• Fleas are notoriously difficult to find, particularly in cats with any of the
feline manifestations of pruritus.
• Thus, other diagnostic tests (scabies IgG ELISA) or trial therapy should
be performed where ectoparasitism is one of the differentials, but
external parasites cannot be detected.
21
• The situation is different in the case of demodicosis.

• Provided at least five carefully taken and thoroughly examined deep skin
scrapes are negative, then the clinician can be confident in ruling out
demodicosis as a cause of the skin disease, although there are rare
exceptions.
• Possibly due to the thickness of their skin, it can be difficult to detect
mites in the Shar Pei and occasionally mites can be difficult to find in
cases of pododemodicosis.
• With such cases, histopathological examination is indicated to rule the
disease in or out.
• Trial therapy is inappropriate for suspected demodicosis.
22

2. DIAGNOSTIC
TESTS FOR
DERMATOPHYTOSIS
23
• Dermatophytosis is invasion of keratinized tissue usually by

Trichophyton, Epidermophyton or Microsporum spp. of fungi.
• Techniques available for diagnosis include:

• Wood’s lamp examination
• Microscopic examination of hair shafts for the presence of spores
• Fungal culture
• Histopathology
24

Wood’s lamp
• Wood’s lamp is an ultraviolet light with a wavelength of 360 nm.
• Only lamps with two bulbs and a magnifier should be used.
• It is important to switch the lamp on and allow it to warm up for 5 minutes prior to
examination.
• Examination of the animal should be conducted in a darkened room.
• Hair shafts infected with certain strains of Microsporum canis fluoresce an apple green
color under Wood’s lamp examination due to tryptophan metabolites.
• Wood’s lamp examination is a test with high specificity (100% in the right hands) but
low sensitivity, as only 50% of strains of Microsporum canis fluoresce.
• Rare infections with M. audounii, M. distortum and Trichophyton schoenlenii may also
result in fluorescence.
25
Direct microscopy
• Most dermatophytosis cases in domestic animals involve ectothrix invasion of hair
shafts by fungal spores which can be visualized under ×40 magnification using the
light microscope.
• Fluorescing hairs or hairs from lesions may be plucked for direct microscopic
examination. Samples should be mounted on the slide in liquid paraffin or potassium
hydroxide.
• Hair shafts with distorted or damaged cuticles should be examined under higher
power for the presence of fungal spores.
• Although a test with high specificity in the right hands, this is not a sensitive
technique for the diagnosis of dermatophytosis in the hands of the inexperienced
clinician.
Ectothrix: occurring on the surface of the hair shaft
26

Fungal culture
• Fungal culture is arguably the most sensitive test for dermatophytosis and should be
performed whenever this disease is suspected.
• The simplest method of collection of material for culture is the MacKenzie brush
technique.
• This is most commonly used for routine screening of cats for dermatophytosis.
• A new toothbrush is used, and hair and scale are collected on the bristles by brushing
the hair coat for 30–60 seconds, paying particular attention to lesional skin.
• The shaft of the brush can be cut off and the entire head of the brush submitted to the
laboratory.
• In addition to using the brush method, it is advisable to culture scale scraped from
lesions and also hair plucks from lesion margins.
27
• Dermatophyte test medium (DTM) is used as an in-practice growth medium for the
diagnosis of dermatophytosis.
• DTM is Sabouraud’s dextrose agar with various antimicrobials that suppress bacterial
and some saprophytic fungal growth, along with phenol red as an indicator.
• Dermatophytes metabolize protein in the medium first, giving off alkaline
metabolites which turn the pH indicator red.
• This should happen within 10 days and should occur as the fungal colony grows.
28

Dermatophyte test medium showing red color change and white colony growth on the surface at
10 days. Note the darkly pigmented growth of saprophytic fungal organism on the edge of the
plate.
29
3.
TRICHOGRAPHY
30

• Trichography is the technique of microscopic examination of

hair shafts.
• Apart from ectoparasite diagnosis, the microscopic
examination of plucked hairs is also useful in the investigation
of causes of alopecia in cats and dogs and in certain scaling
disorders, particularly sebaceous adenitis.
31
Technique
• Fifty to 100 hairs are plucked using a pair of hemostat forceps, the
jaws of which are protected by drip tubing so as not to fracture the
shafts.
• The hairs are mounted on a microscope slide in liquid paraffin under a
coverslip.
• Hair tips, shafts and roots are examined under the low-power light
microscope.
32

Interpretation
• Normal hair tips taper to a
fine point.
• Fractured hair shafts indicate
self-trauma due to pruritus.
• This is a useful test in cases of
feline symmetrical alopecia
where it is not clear that the
cause of the alopecia is due to
self-trauma
Fractured hair shafts from a cat with alopecia due to self-
trauma.
33
Examination of hair bulbs

• A club-shaped, well-pigmented
bulb is characteristic of a hair in
the anagen (growing) phase
34

• A thin, straight, non-

pigmented, fully keratinized
tapered root is characteristic
of a telogen (resting) hair.
35
• In general, both telogen and anagen hairs will be seen on

trichography from healthy cats and dogs.
• Assessment of anagen-to-telogen ratios can be helpful in
ascertaining the cause of alopecia, although care must be
taken in interpreting these ratios.
• Breeds such as the Chow-chow, Samoyed, Pomeranian and
Husky retain large numbers of telogen hairs for a long period
of time and are said to have “telogen-dominated hair cycles”.
• Conversely, breeds including the poodle and Bichon Frise
have “anagen-dominated hair cycles”, where the hair
continues to grow. These are breeds that require hair cuts.
36

• Despite this breed variation, the absence of anagen hair

roots in a trichogram would be suggestive of a hair growth
cycle disorder such as an endocrinopathy.
• The presence of anagen bulbs indicates active hair growth
and would make a hair growth cycle disorder less likely to be
the cause of alopecia; self-trauma or a folliculitis would be
more likely in such cases.
Fractured hair shafts from a cat with alopecia due to self-

trauma.
37
Follicular casts
• The presence of follicular casts
(accumulations of keratosebaceous
material around the hair shaft)
indicates a follicular cornification
disorder of the hair follicle.
• This is most seen in the scaly form
of sebaceous adenitis as seen in
the Japanese akita and English
springer spaniel.
38

4. Cytology
39
• Cytology is a fundamentally important technique in veterinary

dermatology that can be employed quickly, easily and inexpensively in a
practice situation.
• Cytology frequently yields useful information on a case and enables a
more precise diagnosis to be made so that an accurate prognosis can
be given.
• It will greatly enhance the chances of therapeutic success.
40

Cytology is useful in the diagnosis of:
• Bacterial skin diseases

• Malassezia dermatitis
• Otitis externa
• Eosinophilic granuloma complex in cats
• Pemphigus foliaceus
• Ulcers and non-healing wounds
• Nodules and swellings.
41
Indications for cytology

• Pustules, macules, crusting and scaling lesions
• Vesicles and bullae
• Abscesses, cysts and draining sinus tracts
• Ulcers
• All suspected neoplasms, and other nodular, papular and plaque type
lesions
• Atypical or unusual lesions.
42

Cytological techniques
• In general, aim to take samples from fully developed lesions but
before secondary changes have occurred.
• The best samples are from intact pustules, below crust, the
leading edge of ulcers, and non-ulcerated tumors.
43
Glass slide impressions

• Impressions may be taken from any exudative
lesion.
• The lid of a pustule should be carefully opened
with a fine needle before taking four or five
impressions directly onto the glass slide.
• Move the slide slightly before each impression
to avoid too thick a build up of material.
• Be gentle when taking direct impressions,
otherwise cellular damage will render the
cytology uninterpretable.
• Where a direct impression is not possible,
material may be transferred from the lesion to
the slide using a cotton bud.
• Impressions of the underside of crust can be
diagnostically valuable, particularly in cases of
suspected pemphigus foliaceus.
44

Acetate strips
• Dry, greasy or waxy lesions are sampled using tape strips.
• A piece of tape about 50% longer than a microscope slide is used.
• The middle of the tape is pressed onto the area to be sampled several
times to collect surface cells and debris.
• Each end of the tape is attached to one end of a microscope slide,
forming a loop, and stained.
• Wrapping the tape around both ends of the slide holds it firmly in
position and facilitates microscopic examination under oil immersion.
45
Ear cytology
• Cytological examination of an aural discharge should be a standard
procedure when faced with otitis externa.
• The findings are invaluable when deciding on the treatment to use and
monitoring response to therapy.
• Samples of cerumen or pus can be collected from the vertical ear canals
using cotton buds.
• The swab should be gently rolled onto the slide.
• The same slide may be used for both ears.
46

Needle aspiration
• Nodules or swellings can be sampled by fine-needle aspiration.
• Most animals will tolerate needle aspiration without any form of chemical
restraint.
• The mass to be sampled should be sprayed with alcohol and held
firmly to avoid movement.
• The needle, usually 21-gauge, is introduced into the lesion and moved
backwards and forwards several times, redirecting the needle so that
different areas of the lesion are sampled.
• If necessary, the needle can be attached to a 5-ml syringe and negative
pressure applied while the needle is within the mass.
• The pressure should be released before withdrawing the needle.
47
• The needle is withdrawn and quickly attached to a syringe containing a

few milliliters of air.
• The contents of the needle are then expelled onto a clean slide, which is
quickly and gently smeared using a second slide.
• Speed is of the essence to avoid the sample dehydrating.
• The sample should be air dried and stained with a rapid stain.
48

Staining
• Diff Quik® are suitable stains for cutaneous cytology.
• Staining technique varies depending on the sample.
• For samples that air dry on the slide, such as pus, serum or blood, the
slide is first air dried and then all three components of the rapid stain
are used.
• Waxy or greasy samples such as ear cytology samples should be heat
fixed by passing through a Bunsen burner flame several times and
stained without using the first component of the stain, which is an
alcohol fixative.
• Similarly, tape-strip samples for Malassezia dermatitis are stained in just
the red and blue dyes.
• Use of the alcohol fixative dissolves the waxy and greasy material in
which the yeast organisms are found.
49
Cytological interpretation
50

Normal cytological
features
• It is important to be aware of the normal
features so that abnormalities may be
recognized.
• Most skin surface preparations contain
cells from the surface layer of the
epithelium, known as corneocytes.
• Corneocytes are large, polygonal,
translucent cells.
• Corneocytes frequently contain round or
slightly oval, black or brown melanin
granules, which should not be confused Stained tape-strip preparation showing corneocyte
with bacteria that always stain a blue (large arrowhead), cell from hair follicle (small
color under Diff Quik®. arrowhead) and melanin granules (arrow). ×1000
magnification. Diff Quik® stain.
51
• Numerous dark blue cigar-shaped structures that are now thought to be

root sheath remnants from hair follicles are seen on preparations from
haired skin.
• Hair shafts are usually seen in skin surface preparations. Occasional
microorganisms may also be detected on skin surface preparations.
• These include yeasts (Malassezia spp.),
bacteria (cocci and rods) and
sometimes, particularly from the feet,
saprophytic, non-pathogenic fungal
spores, which are usually segmented
and stain a green to blue color.
• Stain precipitate is frequently seen and
appears as a blue or purple crystalline
deposit.
52

Cytology from inflammatory lesions

Inflammatory cell types:
• Neutrophils, eosinophils, macrophages and lymphocytes may be
seen in preparations from inflamed skin.
• It is important to be able to recognize these cells and be aware of their
significance.
• Some inflammatory cells may take on different appearances depending
on the disease process and ageing changes.
53
Neutrophils:
• Neutrophils are the most common inflammatory cell type seen in
preparations from inflamed skin.
• They are seen in association with bacterial infections but may also be
present in sterile disease processes.
• The presence of phagocytosed bacteria confirms an active bacterial
infection.
54

• The distinction between a septic and non-septic etiology may be difficult in the
absence of bacteria, but the presence of ‘toxic’ or ‘degenerate’ neutrophils with
swollen pale nuclei is suggestive of infection.
• As neutrophils age the nuclei shrink, become hypersegmented and darker staining.
• These are known as pyknotic cells.
• Neutrophils may be damaged during slide preparation, resulting in purple-staining
streaks of nuclear material across the slide.
Neutrophils. Left to right: non-toxic cell, toxic neutrophil, pyknotic neutrophil and nuclear
stranding.
55
Eosinophils:
• Eosinophils are easily recognized by their distinct red to orange granules.
• There is considerable variation in granular morphology.
• Eosinophils are usually associated with allergic or parasitic diseases.
• They may be seen in large numbers from impression smears of feline eosinophilic
plaques or indolent ulcers and from canine eosinophilic furunculosis.
• Eosinophils are also frequently seen in cases of canine deep pyoderma.
56

Macrophages:
• Macrophages are large mononuclear cells about one and a half times the size of a
neutrophil.
• The cytoplasm of an activated macrophage takes on a foamy appearance due to the
accumulation of proteolytic enzymes.
• Macrophages are seen in some chronic inflammatory processes, often in association
with neutrophils in pyogranulomatous inflammation, but may also be seen within a
few hours of the initiation of inflammatory change.
• Therefore, their presence does not necessarily denote chronicity.
• The presence of pyogranulomatous inflammation even without evidence of bacteria is
often due to infection and is commonly seen in impressions from canine deep
pyoderma lesions.
Macrophages. Activated cell on the right.
57
Lymphocytes and plasma cells:

• Lymphocytes are mononuclear cells and are slightly smaller than neutrophils.
• Plasma cells are B lymphocytes, which have started to manufacture immunoglobulins.
• Lymphocytes and plasma cells are seen in some longer-standing and immune-
mediated lesions.
• Large numbers of atypical lymphocytes may be seen in impression smears of
lymphoma.
Left: lymphocyte. Right: plasma cell.
58

Microorganisms
Bacteria:
• Bacteria are commonly found in
cutaneous cytology preparations.
• An inflammatory infiltrate with the
presence of phagocytosed bacteria
denotes an active infection.
Neutrophil with phagocytosed cocci (arrow).

Eosinophils (arrowheads).
59
• Finding neutrophils with phagocytosed cocci from an

intact pustule confirms a bacterial pyoderma.
• On occasion, large numbers of bacteria, frequently
adherent to corneocytes, may be evident without a
significant inflammatory infiltrate.
• This may be seen in cases of long-standing, poorly
controlled atopic dermatitis and is known as bacterial
overgrowth syndrome.
Corneocytes with many adherent cocci

(arrows) from a case of bacterial
overgrowth syndrome.
60

Malassezia spp.:
• Malassezia spp., unipolar budding yeasts,
usually stain a purple color with Diff Quik®.
• In some situations, only the capsule of the yeast
stains and these are known as ghost forms.
• The significance of finding yeast organisms on a
cytological preparation depends on several
factors, including the anatomical site and the
presence or absence of visible inflammation.
Malassezia pachydermatis organisms from a

case of Malassezia dermatitis.
61
• Finding the occasional yeast organism

from the feet (or ear canal) is consistent
with normal skin.
• However, if the skin is inflamed or there
is evidence of pruritus, and yeasts are
seen in several fields, then antifungal
treatment would be indicated.
Malassezia ghosts
62

Acantholytic
keratinocytes
• Pemphigus foliaceus results in the
formation of pustules which
contain large numbers of non-toxic
neutrophils and acantholytic
keratinocytes.
• Less commonly, the pustule may
also contain eosinophils.
Cytology from pemphigus foliaceus showing
acantholytic keratinocytes and non-toxic neutrophils.
63
• Acantholytic keratinocytes are nucleated keratinocytes from the

stratum spinosum which have become detached from the epidermis and
have a distinctive rounded appearance.
• Note that acantholytic keratinocytes may also be seen in other pustular
and inflammatory dermatoses, including pyoderma and
dermatophytosis.
64

Ear cytology
• Cytological examination of any aural discharge should be a standard
procedure when faced with otitis externa.
• The findings are important when deciding on the treatment to use and
monitoring response to therapy.
• One of the most common primary inflammatory causes of recurrent otitis
externa is atopic dermatitis.
• Frequently, in the early stages of atopic dermatitis, the dog may be
presented with otitis externa and cytology reveals the presence of large
numbers of corneocytes but no evidence of infection.
65
• Occasional Malassezia organisms may be found in normal ear canals.

• Large numbers of yeasts will be seen in cases of Malassezia otitis
externa.
• Cocci and/or rods will be seen in bacterial otitis, and it is not un-
common to find a wide variety of microorganisms.
• If a rod infection is present, samples for bacterial culture and sensitivity
testing should be taken prior to starting therapy.
• The presence of neutrophils and phagocytosed rods is very suggestive
of infection with Pseudomonas aeruginosa.
66

5. BACTERIAL
CULTURE AND
SENSITIVITY
TESTING
67
• Canine and feline pyodermas are common presentations.

• In general, bacterial culture and sensitivity is not routinely
performed in these cases because the antibacterial
sensitivities of causal organisms are well known.
• Culture and sensitivity testing are indicated where:

• Unusual organisms are seen on cytology.
• There has been a poor response to an antibacterial which is
generally effective.
• In cases of canine deep pyoderma where long courses of therapy
are required.
68

Technique
• The best lesion to sample is an intact pustule, which is opened
with a fine hypodermic needle and discharge is collected onto the
tip of a bacterial swab.
• Prior to opening the pustule, the area should be gently swabbed
with surgical spirit to remove surface bacterial contaminants.
• If there are no intact lesions then a swab from the underside of a
crust or any other exudative lesion may be used, although the
results should be interpreted with caution and the organism
isolated should correlate with the results of cytological
examination.
69
• In deep pyoderma, swabs may be inserted into draining sinus tracts, or

the lesion gently squeezed to exude pus, which is collected onto the
swab.
• Deeper tissue samples may be collected for culture using a biopsy
punch or elliptical incision.
• Commonly, such material is submitted for both culture and
histopathological examination.
70

6.
HISTOPATHOLOGY
71
• Histopathological examination of skin biopsies is indicated in the

following situations:
• Unusual skin diseases
• Erosive or ulcerative disorders
• Nodules and tumors
• In severe or life-threatening conditions
• Where a presentation is suggestive of a condition readily diagnosed on
histopathology (zinc-responsive dermatosis, necrolytic migratory erythema,
sebaceous adenitis, some immune-mediated diseases)
• Where there has been a poor response to treatment.
• Histopathological examination is of little value in the investigation of

most cases of pruritus.
72

Technique
• Six- or 8-mm biopsy punches are suitable for most circumstances,
although scalpel excision is necessary for larger or fragile lesions or
when looking for evidence of panniculitis when there is a requirement to
include the subcutis.
• Unless an area such as the pinna, footpad, lip or nasal planum is to be
sampled, sedation and local anesthesia are usually adequate.
• Local anesthetic should not contain adrenaline, as this will cause
vasoconstriction within the sample.
73
• The biopsy punch should be considered a ‘circular scalpel blade’.

• The punch should be placed perpendicular to the skin surface and a
downward and rotational movement should be exerted to make the
incision.
• The punch should not be rotated in both directions because this can
induce artefactual changes in the sample.
74

• It is important to biopsy lesions that are going to contain representative

pathology.
• Suitable lesions include papules, pustules, vesicles, nodules, erosions or
ulcers.
• Crusts are also of diagnostic value, but there is usually little to be gained
from taking biopsies of chronic lichenified or excoriated areas.
• As a general rule, try and sample lesions at different stages of
development.
• Take skin samples from the center of the area of alopecia, as well as any
advancing margin when sampling areas of alopecia.
75
Sample submission
• Dermato-histopathology is a specialized area, and it is advisable to
submit samples to laboratories with expertise in this field.
• To obtain the most useful information from the histopathologist,
submission forms should be fully completed, giving signalment and a
full history, including a description of disease progression, presence of
any systemic signs, details of any previous diagnostic tests and results,
and response to previous treatment.
• Only with this information will the pathologist be able to perform clinico-
pathological correlation.
76

Interpretation of the histopathology report

• Histopathology reports are usually divided into several sections.
• The first section details how many tissue sections were examined and
gives the histopathological description of the lesions found.
• The next section gives the morphological diagnosis.
• This is a description of the histopathological reaction pattern.
• If the histopathological changes are pathognomonic then a specific
diagnosis may be given, but it is more likely that the pathologist will
discuss the changes and attempt to correlate them with the history given
by the clinician.
77
Dr Walid Darwiche
Thank you walid.darwiche@gmail.com
78

2023-2024 (03) Diagnosis Techniques

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

2023-2024 (03) Diagnosis Techniques

Uploaded by

Copyright:

Available Formats

Veterinary Dermatology 28/11/2023

1. Diagnostic tests for

Veterinary Dermatology - Dr Walid Darwiche 2

Dr. Walid Darwiche 1

• Unless the diagnosis is immediately obvious, many dermatology cases in

Veterinary Dermatology - Dr Walid Darwiche 3

• The lack of reliability in a test can be attributed to a combination of

Veterinary Dermatology - Dr Walid Darwiche 4

Dr. Walid Darwiche 2

• The tests available for the detection of external parasites are:

Veterinary Dermatology - Dr Walid Darwiche 6

Dr. Walid Darwiche 3

Ectoparasites encountered in small animal practice

Veterinary Dermatology - Dr Walid Darwiche 7

General principles for microscopy

Veterinary Dermatology - Dr Walid Darwiche 8

Dr. Walid Darwiche 4

Veterinary Dermatology - Dr Walid Darwiche 9

Veterinary Dermatology - Dr Walid Darwiche 10

Dr. Walid Darwiche 5

Veterinary Dermatology - Dr Walid Darwiche 11

Veterinary Dermatology - Dr Walid Darwiche 12

Dr. Walid Darwiche 6

• The hair tips, shafts and bulbs

Hair pluck from a case of pododemodicosis with

Dr. Walid Darwiche 7

• Three to five different sites should be sampled

Veterinary Dermatology - Dr Walid Darwiche 15

• Deep skin scrapes resulting in

Veterinary Dermatology - Dr Walid Darwiche 16

Dr. Walid Darwiche 8

Canine Sarcoptes IgG ELISA

Veterinary Dermatology - Dr Walid Darwiche 17

Veterinary Dermatology - Dr Walid Darwiche 18

Dr. Walid Darwiche 9

Veterinary Dermatology - Dr Walid Darwiche 19

Interpretation of test results

Veterinary Dermatology - Dr Walid Darwiche 20

Dr. Walid Darwiche 10

Veterinary Dermatology - Dr Walid Darwiche 21

• The situation is different in the case of demodicosis.

Veterinary Dermatology - Dr Walid Darwiche 22

Dr. Walid Darwiche 11

• Dermatophytosis is invasion of keratinized tissue usually by

• Techniques available for diagnosis include:

Veterinary Dermatology - Dr Walid Darwiche 24

Dr. Walid Darwiche 12

Veterinary Dermatology - Dr Walid Darwiche 25

Ectothrix: occurring on the surface of the hair shaft

Veterinary Dermatology - Dr Walid Darwiche 26

Dr. Walid Darwiche 13

Veterinary Dermatology - Dr Walid Darwiche 27

Veterinary Dermatology - Dr Walid Darwiche 28

Dr. Walid Darwiche 14

Veterinary Dermatology - Dr Walid Darwiche 29

Dr. Walid Darwiche 15

• Trichography is the technique of microscopic examination of

Veterinary Dermatology - Dr Walid Darwiche 31

Veterinary Dermatology - Dr Walid Darwiche 32

Dr. Walid Darwiche 16

Examination of hair bulbs

Veterinary Dermatology - Dr Walid Darwiche 34

Dr. Walid Darwiche 17

• A thin, straight, non-