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The Principles of Dermatologic Diagnosis
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The collection of appropriate specimens forms a cornerstone of equine dermatology but failure to select the right specimens and to collect them and submit in the best form often leads to a disappointing outcome. The correct sample selection and collection and the use of experienced dermatopathologists makes dermatology a most satisfying speciality. There is probably more chance of resolution of skin disease in horses than in small animals and so there is a general expectation of success. However, success depends on a diagnosis and a diagnosis depends on a thorough clinical assessment and proper investigative procedures.
a) Skin Scraping:
This is primarily designed to identify burrowing skin mites, which are in any case uncommon in horses. The commonest mite in the UK is Chorioptes equi, which is a surface feeding mite and so groomings are usually better. Scrapings can also be useful in dermatophytosis (ringworm) diagnosis but pluckings are probably better and easier.
b) Skin Groomings:
This is used to harvest ectoparasites from a relatively large area of the body into a concentrated form so that even low numbers can easily be seen.
This is a simple and effective aid for location of most of the smaller ectoparasites including Chorioptes, Psoroptes, Harvest / Forage and Poultry mites and for lice (both Damalinia and Haematopinus sp.). They can readily be identified using a black tile or a simple magnifying glass. A dissecting / stereo microscope is very useful – movement of the skin dander is an obvious signal of living creatures! However, identification is important because some are incidental!
c) Hair Plucking:
This is the standard method for identification of dermatophyte infections but can also be used for some of the bacterial infections when a plucking is easily dislodged (e.g. dermatophilosis). Where dermatophytes or Dermatophilosis is suspected there is usually some scaling or crusting and hair loss.
d) Acetate tape preparations: (Sellotape)
Used primarily to identify Oxyuris equi eggs on the peri-anal region.
e) Skin Biopsy:
The value of biopsy should not be overstated - many different conditions can induce an almost identical histopathological effect (see notes later). This makes it difficult or impossible for the pathologist to state a definite diagnosis. It is unreasonable to expect him to be able to help in every case! It is very helpful to provide the pathologist with as much helpful information as possible (possibly sending in a copy of your history and clinical findings sheet). Pathologists are very willing to help but do not take kindly to being challenged unnecessarily and then derided because they cannot make a diagnosis for you - you are in the same team not competitors on opposite sides of the field! [...]
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