Severe crusting of nose

Re: Severe crusting of nose

Rob Loxley — Fri, 14 Sep 2012 21:59:21 GMT

or "Vitamin P deficiency"

Re: Severe crusting of nose

Busybee — Fri, 14 Sep 2012 19:46:23 GMT

[quote user="Martin Atkinson"]

As Jill Maddison said: 'Never let anything die without giving it the benefit of the 'roids'.

[/quote]

or, put in simple terms.... "Pred or dead"

Re: Severe crusting of nose

Richard Fox — Fri, 14 Sep 2012 14:39:38 GMT

Excellent - it was nice to see the lesions in the end were not limited to the planum although I would never say never - Sound like a typical case of PF in the end and great its cleared up on steroids :) Thanks again for the update :)

Re: Severe crusting of nose

Martin Atkinson — Fri, 14 Sep 2012 13:54:58 GMT

As Jill Maddison said: 'Never let anything die without giving it the benefit of the 'roids'.

Re: Severe crusting of nose

Glenn Hodgson — Fri, 14 Sep 2012 13:34:30 GMT

[quote user="Richard Fox"]

Thanks Glenn - updates are always very useful

[/quote]

This dog progressed to clear pemphigus. Euth was discussed in light of medical and financial concerns.

Dispensed a big pot of 'roids and 3 weeks later his nose/eyes/pinnae look great.

Thanks again for inputs

Re: Severe crusting of nose

Glenn Hodgson — Fri, 31 Aug 2012 14:10:53 GMT

Update:

Att. is an image to the dog today (this was the third attempt at a photo, he was wanting off for a walk!).

Overt progression of lesions up his face, inner pinnae just starting to go and mildest of lesions L. eyelid. Mild general dullness over the last 2 days. Not great news but clarifies diagnosis. Rather slower progression than I have seen in previous cases. It is now 3 months since primary lesion was 1st seen by owner.

Fingers crossed for the preds!

Re: Severe crusting of nose

James Laidlaw — Wed, 25 Jul 2012 13:16:17 GMT

We had a dog with severe nasal crusting that responded well to topical dermoscent bio-balm. Can't quite remember the exact details, but maybe more keratin-based lesion. Not expensive product and seemed well tolerated, may help settle and soften the area along with antibiotics.

Re: Severe crusting of nose

Richard Fox — Wed, 25 Jul 2012 13:04:38 GMT

Thanks Glenn - updates are always very useful

Re: Severe crusting of nose

Glenn Hodgson — Wed, 25 Jul 2012 11:12:37 GMT

[quote user="Richard Fox"]

I would suggest first to call the pathologists to discuss - we can be helpful over the phone too :) The additional lack of response to tx will be usefull for them to know!

The lesion is pretty non-specific (I can think of quite a few DDx based on that presentation) - The histo description sounds like pf but unusual if just limited to the nasal planum - acantholysis can also occur in bacterial infections too esp if there are loads of bacteria? Maybe ask them to do a PAS for fungi just in case if they have not already done it?

I would, as above put it on at least 3 weeks of BS ab's like cephalexins and perhaps culture before you do? if no response then try immunomod. therapy and or re-biopsy. Please speak to you pathologist first - they may have some helpful additional info they can give you before you go any further (esp with any additional history). Also have you tried a buster collar as you suggest self trauma has been notes - DLE with secondary trauma/infection is one DDx but no lichenoid pattern was described.

Some PF cases are refractory to Preds - also wierd adverse drug reaction always warrant consideration and also I have seen cases of pyoderma or other skin disease progress to pf following initiation of drugs like cephalexins (anecdotal) - there is self-induced PF for starters.

BTW Abbey does seem to acquire difficult skin cases and second opinions which we are all able to deal with and frequently consult with one another (even Trevor )

[/quote]

Thanks for the input.

I spoke with our pathologist yesterday and e.mailed him the images. These triggered this discussion/swayed us a bit away from routine PF. Def. right to discuss cases such as this with pathologist. Gleaned a lot from the phone call.

The consensus of opinion is def. tx with ab's for a period and reassess.

Thanks all for input. I'll try and get time to update thread in a few weeks.

Kind regards

Re: Severe crusting of nose

Richard Fox — Wed, 25 Jul 2012 09:24:07 GMT

I would suggest first to call the pathologists to discuss - we can be helpful over the phone too :) The additional lack of response to tx will be usefull for them to know!

Some PF cases are refractory to Preds - also weird adverse drug reaction always warrant consideration and also I have seen cases of pyoderma or other skin disease progress to pf following initiation of drugs like cephalexins (anecdotal) - there is drug-induced PF for starters.

BTW Abbey does seem to acquire difficult skin cases and second opinions which we are all able to deal with and frequently consult with one another (even Trevor )

Re: Severe crusting of nose

Louise6732 — Tue, 24 Jul 2012 21:01:58 GMT

Trevor Whitebread at Abbey labs is a excellent histopathologist for dermatology cases.

Louise

Re: Severe crusting of nose

sarah mason — Tue, 24 Jul 2012 20:51:29 GMT

It is probably worth asking for a second opinion from a second pathologist or at least call them to discuss the diagnosis. Probably also worth contacting a dermatology diplomat-likley to have experience with similar. Good luck

Re: Severe crusting of nose

Glenn Hodgson — Tue, 24 Jul 2012 20:33:31 GMT

uv was my comment. I agree with your thoughts re progression. Certainly not keen on immunosuppressive drugs in an otherwise well dog.

kind regards

Re: Severe crusting of nose

Rob Loxley — Tue, 24 Jul 2012 18:09:07 GMT

Put on 3 weeks minimum of cefalexin at a decent dose and re-biopsy (unless seems to be clearing with longer/more antibiotics)?

[quote user="Glenn Hodgson"]The pattern is very suspicious of UV involvement.[/quote]

Is this your comment or the histopathologist's?