Pathology of the

Integumentary System
Lecture 3
Congenital / Environmental / Infectious

(web)

Paul Hanna

Fall 2013

CONGENITAL AND HEREDITARY SKIN DISEASE

Congenital Hypotrichosis
all domestic species
absence of hair follicles &/or abnormal follicular development

Cattle:
hereditary vs acquired (BVD, iodine, pituitary hypoplasia, teratogens)
r/o telogen or anagen defluxion

Dogs and Cats:

several hereditary forms

Congenital hypotrichosis in an Ayrshire calf

(note: thin hair coat due to failure of normal
development of many of the hair follicles)

Anagen or Telogen Defluxion (Effluvium)

eg anagen defluxion following severe neonatal

diarrhea / sepsis

CONGENITAL & HEREDITARY SKIN DISEASE

[For information only]

Hereditary collagen dysplasia (note:

distensible skin which tears easily)

Calf with icthyosis - a congenital

keratinization disorder

Mechanobullous disease / Epidermolysis Bullosa

[For information only]

www.beltina.org

Various forms of
epidermolysis bullosa
are recognized in
humans and domestic
animals that are
associated with
inherited defects of
structural / adhesion
molecules in the
hemidesosomes &/or
basement membrane.

Mechanobullous disease / Epidermolysis Bullosa

Epidermolysis bullosa is described in

Belgian foals and in the first few days of life
see skin / oral ulceration and also
separation / sloughing of the hooves.

[For information only]

Mechanobullous disease / Epidermolysis Bullosa

Extensive subepidermal clefting (vesicle / bulla

formation) of the skin)

[For information only]

CONGENITAL & HEREDITARY SKIN DISEASE

[For information only]

Pattern alopecia (Pattern baldness)

Idiopathic bald thigh syndrome, a form of pattern

baldness seen in greyhounds

Also:
Color dilution alopecia
Black hair follicular dysplasia
Other pattern baldness / follicular dysplasias

Canine Recurrent Flank Alopecia

aka = Seasonal (cyclic) flank alopecia

ENVIRONMENTAL INDUCED SKIN DISEASE

I. ACTINIC (SUN) INJURY

II. CHEMICAL INJURY

III. PHYSICAL INJURY

ACTINIC (SUN) INJURY

Epidemiology
amount of light reaching skin:
Environmental Factors (atmosphere / latitude / altitude / shelter)
Host Factors (quantity of hair / pigmentation / stratum corneum / genetics)

Path of sunlight
through atmosphere

ACTINIC (SUN) INJURY

Etiopathogenesis
visible light vs UV-A vs UV-B vs UV-C
UV-B free radicals damages nucleic acids, proteins & lipids cell death

www.skin-science.com

Note, arrows indicate apoptotic

keratinocytes (sunburn cells) due to
UV-B radiation. These can be induced
within 30 minutes of sun exposure.

ACTINIC (SUN) INJURY

Sunburn
due to: direct endothelial damage
damage to keratinocytes with release of inflammatory mediators

Solar dermatitis
chronically see thickened inflamed skin +/- dysplasia / neoplasia

Fig 14-5 (Hnilica Sm An

Derm) Feline Solar
Dermatosis. Alopecia,
erythema, erosions, and
crusting on the ear pinna.
As the disease
progresses, papules will
develop, with erosion and
ulceration that suggest
progression to squamous
cell carcinoma.
Sunburn on udder of a goat

ACTINIC (SUN) INJURY

also Mutagenesis:
pyrimidine dimer formation; esp in mutation hot spots on P53 gene

impaired P53 protein function

also promoter preferential replacement of damaged cells with mutated P53 cells

UV induced pyrimidine dimer formation

UV induced permanent mutation

ACTINIC (SUN) INJURY

Note: pyrimidine dimers are usually corrected by the

Nucleotide Excision Repair (NER) mechanisms. Even if it
was 99.9% effective, the more mutations there are, the
increased risk of one remaining unrepaired. Also certain
individuals can have defects in their NER repair mechanism.

ACTINIC (SUN) INJURY

ADDITIONAL
SUNBURNS

UV light can be tumor initiation and promotion note UV light can not only cause somatic
mutations of the cells (left image), it can also act as a cancer promoter, ie sunburns injures & kills
keratinocytes which results in hyperplasia. Hyperplasia is fertile ground for inducing additional
mutations / neoplastic transformation.

ACTINIC (SUN) INJURY

Photosensitization
photodynamic substances in skin are activated by UV-A or visible light

Type I exogenous origin of photodynamic agents

Type II aberrant heme pigment synthesis
Type III (hepatogenous type) failure to remove phylloerythrin
Type IV idiopathic

Photosensitization after treatment with a phenothiazine anthelmintic

Many plants contain chemicals which are

photoreactive, eg St Johns wort (above)

Photosensitization associated with liver disease; note

only poorly haired &/or white haired areas affected

Photosensitization in cattle; note only white areas affected.

There is enough pigment in the colored hair to absorb / block
the light and prevent activating the photodynamic agents.

CHEMICAL INJURY
Local application
agent must penetrate hair & st. corneum; enhanced by moisture &/or damage

Systemic absorption
ingestion of toxins with systemic effects on the skin and usually other organs

CHEMICAL INJURY
1. Primary Contact Irritant Dermatitis
skin contact by substances expected to cause irritation:
caustic chemicals (eg acids, alkalis)
concentrated drugs (eg insecticides)
soaps / detergents
body excretions (eg anal sac, urine)

Contact irritant dermatitis

(eg concentrated pour-on insecticide)

Contact irritant dermatitis

(eg concentrated lye solution)

CHEMICAL INJURY
2. Gangrenous Ergotism and Fescue Toxicosis
3. Many Others: thallium, selenium, mercury, arsenic, etc

gangrenous necrosis of distal limbs due to ergotism

PHYSICAL INJURY
Abrasion / Laceration / Ulceration / Foreign Bodies
Radiation
Extremes in Temperature
Callus / Hygroma
Feline Psycogenic Dermatitis

Burn victim note epidermal necrosis, ulcers / crusts

PHYSICAL INJURY
Acral Lick Dermatitis
esp large active breeds, esp < 5 yrs
psychogenic boredom &/or anxiety

Acral lick dermatitis, note focal area of alopecia,

erythema, erosion / ulceration

INFECTIOUS SKIN DISEASE

VIRAL SKIN DISEASES

BACTERIAL SKIN DISEASES
MYCOTIC SKIN DISEASES
PARASITIC SKIN DISEASES
PROTOZOAL SKIN DISEASES

VIRAL SKIN DISEASES

Local Infection
intact skin resistant to local infecting viruses (eg papilloma / poxviruses)
requires abrasion or arthropod bite

Contagious Pustular Dermatitis (= contagious ecthyma = "Orf)

common / worldwide parapoxvirus infection of sheep & goats.
typical pox phases (vesicles / pustules / crusts) but more hyperplastic / proliferative

Fig. 17-31 (Zachary) Schematic diagram of the development of a poxvirus lesion over time.

Contagious Pustular Dermatitis

mouth lips and oral cavity; eyelids, feet, mouth; rarely GI tract / viscera

Note, ballooning degeneration and

intracytoplasmic inclusion bodies.

Contagious pustular dermatitis is a

relatively common zoonosis in
individuals handling sheep & goats

Systemic Viral Infection

epitheliotropic
pantropic

other, eg 2o to pruritus

Canine distemper hard pad

Vesicular exanthema

Scrapie

VIRAL SKIN DISEASES

Diagnosis

history & clinical signs / lesions

skin biopsy
serology
virus isolation or identification

Raccoon scale / crust on

distal limbs due to canine
distemper virus infection

VIRAL SKIN DISEASES

CANINE
Papilloma virus
Canine distemper virus

CATTLE
Bovine mammillitis virus
Pseudocowpox
Papilloma virus

SWINE

Swinepox

HORSES
Papilloma virus

BACTERIAL SKIN DISEASES (PYODERMAS)

healthy skin is resistant to bacterial infection due to:
lack of moisture
physical barrier and continuous desquamation of stratum corneum
antibacterial effects of sebum/sweat and the normal microflora

factors assisting bacterial colonization / proliferation:

moisture and dirt

altered cornification
physical damage

result depends on agent pathogenicity / host defence mechanisms

BACTERIAL SKIN DISEASES (PYODERMAS)

pyodermas are common in dogs

PRIMARY

SECONDARY

Otherwise healthy

Not healthy

BACTERIA

One species

> 1 species

PATTERN

Characteristic

Not characteristic

Successful

Not successful

SKIN

ANTIBIOTICS

BACTERIAL SKIN DISEASES (PYODERMAS)

SUPERFICIAL

DEEP

epidermis

dermis / subcutis

no scarring

scarring

short

chronic

LYMPH NODE

no

yes

SYSTEMIC

no

+/-

pustules, crusts

pustule, nodule, abscess, sinus

pustules &/or perivascular

dermatitis with neutrophils

folliculitis / furunculosis
&/or nodular to diffuse
dermatitis / panniculitis,
suppurative to granulomatous,
bacterial agent

INVOLVE
REPAIR
DURATION

GROSS
HISTOLOGY

BACTERIAL SKIN DISEASES (PYODERMAS)

Diagnosis
history & lesions
culture
skin biopsy

Fig 3-14 (Hnilica Sm An Derm) Superficial

Pyoderma. Erythematous dermatitis with
epidermal collarettes formation is apparent.

CANINE
Pyotraumatic dermatitis ("hot spots or acute moist dermatitis)
intense pruritus self-trauma secondary bacterial infection.

note: focal alopecia, excoriation (erosion /

ulceration), exudation

CANINE
Impetigo
primary superficial pustular dermatitis, esp dogs (puppy pyoderma)
predisposed by moist / dirty environments, abrasions, parasitism, poor nutrition

Note, pustules and epidermal collarettes

CANINE

Skin fold pyoderma

FELINE
Subcutaneous Abscesses

Note, bite wounds overlying area of inflammation (panniculitis / cellulitis and

abscessation), which is not obvious on external visual examination, ie need to
dissect to find the underlying inflammation.

RUMINANTS
Papillomatous Digital Dermatitis (hairy heel warts)

Initially an erosive / ulcerative plaque-like lesion, which is intensely painful and

progresses to a proliferative / papillomatous (with long, thin papillae), less painful lesion

Papillomatous Digital Dermatitis

See epidermal hyperplasia & prominent

papillae extending from the surface.
Basophilic material at base of papillae is
composed of myriads of bacteria (H&E
stain).

Note, see myriads of spirochete bacteria

along the epidermal surface with silver
staining.

Papillomatous Digital Dermatitis

Transmission electron micrograph showing numerous spirochetes in an advanced

stage of a typical digital dermatitis lesion.
[Choi BK, et al. Spirochetes from digital dermatitis lesions in cattle are closely related to treponemes
associated with human periodontitis. Int J Syst Bacteriol. 1997 Jan;47(1):175-81]

RUMINANTS
Dermatophilosis (D. congolensis)
a superficial exudative dermatitis, seen most commonly in hot, humid areas.

Characteristic branching filaments of D. congolensis; filaments undergo

longitudinal & transverse septation to form parallel rows of coccoid bodies.

PORCINE
Exudative Epidermitis (Greasy Pig Disease)
acute, rapidly spreading, often fatal exudative pyoderma of suckling to weaner pigs.

infection with Staphylococcus hyicus, which have exfoliative exotoxins.

In the common peracute

form see greasy brownblack exudate / crust
which typically starts on
face &/or limbs and
quickly spread to the
entire body.

Note: cell crusts

composed of degenerate
inflammatory cells
admixed with keratin,
bacteria

PORCINE
Septicemia
Salmonella
"Diamond Skin Disease"

Salmonellosis - or other endotoxemias; note venous

infarction of extremities due to endotoxin induced venous
thrombosis.

Diamond Skin Disease in pig with Swine Erysipelas

Note rhomboid / diamond shaped erythematous
plaques typical of infection with Erysipelothrix rhusiopathiae.

MYCOTIC SKIN DISEASES

Cutaneous Mycoses
Dermatophytosis (Ringworm)
Malasseziasis
Candidiasis

Subcutaneous Mycoses
Systemic Mycoses
Diagnosis
history & lesions
fungal id / culture
skin biopsy

 Dermatophytosis (Ringworm)
common / worldwide distribution; mainly Microsporum & Trichophyton
young / immunocompromised
predisposing factors: overcrowding, high humidity, poor sanitation / nutrition
contagious direct or fomites
attacks keratinized layers inflammation due to proteases

 Dermatophytosis (Ringworm)
circular patches of scaling / alopecia to papules / pustules / furunculosis / crusting

Canine pinna, note focal alopecia,

erythema and scaling

Bovine head, note mulifocal alopecia with scaling /

crusting

Dermatophytosis (Ringworm)

note multiple to coalescing areas of alopecia with scale &

crust

Dermatophytosis (Ringworm)

Ringworm is the most commonly reported zoonosis in

people working with cattle. Although less common in
small animals, one study indicated ~50% of people
exposed to either symptomatically or asymptomatically
infected cats develop lesions.

Note: arthrospores surrounding and

hyphae within hair shaft.

 Malasseziasis (Malassezia pachydermatis)

yeast that are part of the normal microflora proliferate & cause dermatitis
secondary to underlying skin disease (eg allergies, seborrhea).

Malasseziasis in a couple of Westies (above)

and same dogs following treatment (right).
From: Nett CS, et al.
Epidermal dysplasia and Malassezia infection in
two West Highland White Terrier siblings.
Vet Dermatol. 2001 Oct;12(5):285-90.

Fig. 17-54B (Zachary) Stratum corneum contains numerous Malassezia pachydermatis yeast (arrows), which are bilobed
(peanut-shaped). The dermis is mildly edematousnote the mild separation of the collagen bundles by nonstaining to
lightly amphophilic extracellular fluid. Gomori's methenamine silver stainH&E counter stain. [note: cytologic methods are
much more sensitive than histology in detecting yeast]

Subcutaneous Mycoses
traumatic implantation of a wide variety of saprophytic fungi

Systemic Mycoses
primarily by inhalation; esp Blastomycosis & Cryptococcosis
host usually has compromised resistance to infection

Papular / nodular dermatitis,

due to Blastomycosis
note: crusted papules /
nodules on nostril and lip.