YOUR EPIDERMIS IS SHOWING: Skin Problems

When my brother and I were younger, it was a common way to get under each other’s skin by saying this simple phrase “Your epidermis is showing." As a basic biological phrase to describe the outer layer of the skin, never the less, it implied something more sinister. Things turned out okay with no long term psychological damage as my brother became a pediatrician and I became a veterinarian.

In people, the skin can be a window into something more serious going on beneath it . This photo is a picture of a nephew that was recently diagnosed with Rocky Mountain Spotted Fever. 

The “rash” is actually little holes of bleeders in the small capillaries caused by the bacterium Rickettsia rickettsii via a tick bite.

 I recently google searched and saw several companies exploiting such a silly saying on t-shirts and other paraphernalia. It seems skin still has relevance in today’s internet age, and it certainly a significant reason for pets going to the veterinary office.

WHAT IS THE MOST COMMON SKIN INFECTION THAT IS SEEN TODAY? WHAT IS THE CAUSE?

Staphylococcus pseudintermedius is a bacterium that is commonly found on the skin, nose, or intestinal tract of most normal, healthy dogs, and a lot of cats. Normally it causes no problems. However it is an opportunistic organism. This bacterium can infect almost any tissue, with skin (including ears) and soft tissue infections being the most commonly involved.  This is particularly prevalent when the skin has been damaged (due to scratching) by some other inciting cause:  allergies, insect bites, parasites, foreign bodies, chronic wetness, wounds, autoimmune disease, and surgery.

MY DOG WAS DIAGNOSED WITH PYODERMA. WHAT DOES THAT MEAN?

Pyoderma is an overgrowth of normal bacteria found on the skin. The signs consistent with pyoderma include redness, scales, papules (raised nodules of sudden onset), pustules (zits), collarettes (circular/red/scaly), and patchy alopecia (hair loss). They are rarely life threatening. However a pet’s constant scratching, discomfort, bleeding, and skin odor makes them very uncomfortable. In cats there are often multiple bumps around the neck or tail based that is called  ”miliary dermatitis”.

HOW ARE BACTERIAL SKIN INFECTIONS DIAGNOSED?

Besides the clinical signs, cytology (to rule out malassezia/yeasts vs bacteria), skin scrape for mange mites (demodex vs sarcoptic), and fungal cultures to check for ringworm. Occasionally skin cultures and biopsies will be obtained for complicated cases as well as blood testing for possible hormonal or medical issues.

HOW ARE BACTERIAL INFECTIONS OF THE SKIN TREATED?

With appropriate antibiotics for 14 to 21+ days is the standard protocol for generalized infections. For Topical treatment, antibacterial shampoos, anti-bacterial leave on rinses/sprays, and topical anti-bacterial creams. As a preventative, many dogs go on aggressive skin maintenance with topical antibacterial shampoos, anti-bacterial sprays/rinses on a weekly to twice weekly. This is to lower risk of vicious cycle of return to oral antibiotics on a regular basis. Appropriate antibacterial shampoos contain chlorhexidine, benzoyl peroxide, chlorhexidine- ketoconazole, ethyl lactate, and triclosan.  These remove crusts, scales, and bacteria. In addition they reduce itching, odor, and oiliness.

 In addition, antibacterial wipes such as Preva or Malaket wipes of the feet, rectum, belly, and armpits are helpful to lower pollen levels retained in the fur after being outside and control surface bacteria. Many pets owners body clip their allergy pets to reduce trapping of bacteria and debris in the fur, allow products closer contact to the skin, and decrease post bathing moisture that can lead to hotspots.

WHY IS IT IMPORTANT TO TREAT SKIN INFECTIONS FOR THE ENTIRE LENGTH OF PRESCRIBED TREATMENT OF ANTIBIOTICS? WHAT IS MRSP?

If the skin infection is not treated with prescribed antibiotics for approximately one week past normal, often the bacteria can mutate and become resistant to the next course of antibiotics. MRSP stands for methicillin-resistant S. pseudintermedius, which is a form of S. pseudintermedius that is highly resistant to many antibiotics, including most of the drugs that are commonly used to treat bacterial infections in dogs and cats. This includes antibiotics such as Clavamox and Cephalexin.

Betsy Sigmon DVM, Diplomate American Board of Veterinary Practitioners

Creature Comforts Animal Hospital

 Nikki Courie and Zeke