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Skin Diseases Miliary Dermatitis Eosinophilic Plaque Eosinophilic Complex Notes

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5. Skin Diseases: Miliary dermatitis, eosinophilic complex Feline military dermatitis (FMD) and Eosiniphilic Granuloma Complex (EGC) are extremely common cutaneous reaction patterns in the car MD → Papules and crust of this disease resemble millet seeds EGC → lesions affect the skin and oral cavity.

• Includes eosinophilic ulcer, eosinophilic plaque and eosinophilic granuloma Etiology Neither MD or EGC are a final diagnosis, nor are they pathognomic for any one disease Allergies → Biting insects, food, environmental allergens and rarely contact substances

• Fleas and other biting insects emphasized in EGC etiology Parasites → Fleas, demodex, cheyletiella, Notoedres, Otodectes - assoc with MD

• Fleas implicated in EGC Infectious Diseases → Staph, Strep, Pasteurella, Bacteriodes

• Dermatophytes → Microsporum Canis

• MD → Consider Malassezia

• EGC → Viral conditions are an added consideration Miscellaneous

• MD → Genetic, Immune-mediated diseases, Drug reactions, Nutritional, Idiopathic

• EGC → Genetic, Immune-mediated, Idiopathic

• Immune mediated e.g. Pemphigus foliaceus

• Nutritional e.g. biotin or F.A. deficiencies Pathogenesis of EGC:

• Pathogenic events in these lesions are most likely caused by eosinophil recruitment and degranulation. Circulating eosinophils move into tissues in reaction to inflammation prompted by antigen-antibody complexes, parasites, or microorganisms.

• Since eosinophils are attracted to and phagocytize antigen-antibody complexes, the presence of eosinophils in the EGC indicates that it is an immune-mediated disease Clinical Signs Miliary Dermatitis

• Lesions → small erythematous papules that develop into crusts

• 20 lesions arise from self trauma and produce alopecic erosions and excoriations

• Distribution → localized or generalized. Dorsal lumbosacral, cervical and inguinal regions mostly. o If head and neck are affected, consider notoedric/otodectic mange, food allergy, atopic dermatitis, pyoderma

• Additional signs → Peripheral lymphadenopathy of the inguinal L.N., Depression, Pain and twitching over affected areas Eosinophilic Granuloma Complex Eosinophilic Ulcer

• (indolent, rodent and lip ulcer) Well circumscribed, red-brown to yellow, ulcerated

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