Difference between revisions of "Malassezia Dermatitis"

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==Introduction==
 
==Introduction==
Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermitis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.
+
Malasseszia Dermatitis is a skin disease associated with the yeast [[Malassezia pachydermatis|''Malassezia pachydermatis'']]. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.
  
 
==Pathogenesis==
 
==Pathogenesis==
''Malassezia pachydermitis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermitis''.
+
''Malassezia pachydermatis'' proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as [[Atopic Dermatitis|atopic dermatitis]] and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to ''Malassezia pachydermatis''.
==Diagnosis==
+
 
===History===
+
==Signalment==
Affected dogs usually present with a greasy skin disease often with a characteristic odour and a variable degree of pruritus. Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed.
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Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed.
===Clinical signs===
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Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation and lichenification occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.
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==History==
The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs.  
+
Affected dogs usually present with a greasy skin disease often with a characteristic odour and a variable degree of pruritus.  
===Laboratory tests===
+
 
 +
==Clinical signs==
 +
Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are '''erythema and a greasy exudate''' which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation, lichenification and follicular plugging occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common.
 +
The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs.
 +
 
 +
==Laboratory tests==
 +
The most common method of diagnosis is by microscopic examination of a tape strip revealing an increased number of ''Malassezia pachydermitis''. Clear adhesive tape is applied to the affected area and removed, stained and examined under oil immersion. The yeast can also be cultured on Sabrouraud's dextrose agar at 32-37°C for 3-5 days.
 +
 
 
==Treatment==
 
==Treatment==
==Literature Search==
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Treatment is aimed at reducing the yeast population and treating any underlying skin conditions. The first choice of treatment is an antifungal medicated '''shampoo containing miconazole and chlorhexidine'''. Selenium sulphide in combination with enilconazole or ketoconazole can also be used topically but is less effective. The use of systemic antifungal drugs such as ketoconazole can also be considered. The response to treatment should be measured by clinical response and by a reduction in yeast populations in skin lesions upon microscopic examination.
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{{Learning
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|Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis00126.asp Malassezia dermatitis]<br>[https://www.vetstream.com/canis/Content/Bug/bug00277.asp Malassezia pachydermatis]
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|flashcards = [[Small Animal Dermatology Q&A 08]]
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|literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=malassezia&occuring1=title&rowId=2&options2=AND&q2=dermatitis&occuring2=title&rowId=3&options3=AND&q3=&occuring3=freetext&x=51&y=13&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Malassezia Dermatitis publications]
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|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2009/20093115170.pdf '''How I treat Malassezia dermatitis'''. Ghubash, R.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 17-21 January, 2009, 2009, pp 328-329]
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[http://www.cabi.org/cabdirect/FullTextPDF/2009/20093115083.pdf ''' How I treat Malassezia dermatitis'''. Rosenkrantz, W.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 17-21 January, 2009, 2009, pp 392-393, 5 ref.]
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[http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017851.pdf '''Malassezia dermatitis: diagnosis & management'''. Ihrke, P. J.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 169-171, 5 ref.]
 +
}}
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==References==
 
==References==
 
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* Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
**Regional lesions: muzzle, ears, interdigital, perianal
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* Foster, A, and Foll, C. (2003) '''BSAVA small animal dermatology (second edition)''' '' British Small Animal Veterinary Association''
**Or generalised disease
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* Bond, R, Hendricks, A. (2008) '''Veterinary Dermatology Integrated BVetMed course notes''' Department of Veterinary Clinical Sciences and Pathology and Infectious Disease. Royal Veterinary College, University of London.
**Erythematous, hyperpigmented, [[Skin Glossary - Pathology|lichenified]] and scaly lesions with alopecia
 
*Microscopically:
 
**[[Skin Glossary - Pathology|hyperkeratosis, parakeratosis]]
 
**Spongiotic pustular dermatitis
 
**[[Skin Glossary - Pathology|Acanthosis]]
 
**Organisms are usually present, minimum 3-5 yeasts per high-power field must be found to imply cause of disease
 
  
  
Grossly, regional lesions may be seen around the muzzle, [[Ear -  Anatomy & Physiology|ears]], interdigital, and perianal.  Other  common signs include erythema, hyperpigmentation, [[Skin Glossary -  Pathology|lichenified]] and scaly lesions with alopecia.
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{{review}}
  
Microscopically,  one may see;[[Skin Glossary - Pathology|hyperkeratosis,  parakeratosis]], spongiotic pustular dermatitis, [[Skin Glossary -  Pathology|Acanthosis]].
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{{OpenPages}}
  
[[Category: To Do - Dermatology]]
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[[Category:Expert Review]]
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[[Category:Dermatological Diseases - Dog]]
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[[Category:Cutaneous Mycoses]]

Latest revision as of 13:31, 23 August 2015


Introduction

Malasseszia Dermatitis is a skin disease associated with the yeast Malassezia pachydermatis. It is common in dogs but rare in cats. The yeast is found on skin and mucosal sites in healthy dogs and cats and under circumstances which remain poorly understood can proliferate and induce skin disease.

Pathogenesis

Malassezia pachydermatis proliferates and liberates enzymes and metabolites which induce cutaneous inflammation. Concurrent skin diseases such as atopic dermatitis and primary defects of keratinisation are recognised in approximately 66% of cases. Some dogs may show hypersensitivity to Malassezia pachydermatis.

Signalment

Basset hounds, Cocker Spaniels and West Highland Terriers are predisposed.

History

Affected dogs usually present with a greasy skin disease often with a characteristic odour and a variable degree of pruritus.

Clinical signs

Malassezia dermatitis can complicate or mimic allergic skin disease and scaling skin disorders. The main clinical signs are erythema and a greasy exudate which may result in matted hair with variable amounts of alopecia and scaling. Hyperpigmentation, lichenification and follicular plugging occur in chronic cases. Concurrent erythematous otitis externa with variable ceruminous discharge is common. The degree of pruritus is variable but can be extreme especially on the face in a small number of dogs.

Laboratory tests

The most common method of diagnosis is by microscopic examination of a tape strip revealing an increased number of Malassezia pachydermitis. Clear adhesive tape is applied to the affected area and removed, stained and examined under oil immersion. The yeast can also be cultured on Sabrouraud's dextrose agar at 32-37°C for 3-5 days.

Treatment

Treatment is aimed at reducing the yeast population and treating any underlying skin conditions. The first choice of treatment is an antifungal medicated shampoo containing miconazole and chlorhexidine. Selenium sulphide in combination with enilconazole or ketoconazole can also be used topically but is less effective. The use of systemic antifungal drugs such as ketoconazole can also be considered. The response to treatment should be measured by clinical response and by a reduction in yeast populations in skin lesions upon microscopic examination.


Malassezia Dermatitis Learning Resources
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Small Animal Dermatology Q&A 08
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Malassezia Dermatitis publications
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How I treat Malassezia dermatitis. Ghubash, R.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 17-21 January, 2009, 2009, pp 328-329

How I treat Malassezia dermatitis. Rosenkrantz, W.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 17-21 January, 2009, 2009, pp 392-393, 5 ref.

Malassezia dermatitis: diagnosis & management. Ihrke, P. J.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 169-171, 5 ref.


References

  • Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
  • Foster, A, and Foll, C. (2003) BSAVA small animal dermatology (second edition) British Small Animal Veterinary Association
  • Bond, R, Hendricks, A. (2008) Veterinary Dermatology Integrated BVetMed course notes Department of Veterinary Clinical Sciences and Pathology and Infectious Disease. Royal Veterinary College, University of London.




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