Miami Veterinary Dermatology

03/12/2024

This is the right rear paw of a 9-month-old MN Maltese. The growth on his paw pad had been progressively growing since he was a few months old. An original biopsy done at another veterinarian’s office diagnosed the growth to be an inverted papilloma. However, despite treatment for papillomavirus using azithromycin and imiquimod, the growth did not resolve. We biopsied the growth and sent it to a dermatopathologist that diagnosed this growth as an apocrine hamartoma.

What is a hamartoma? It is a non-cancerous benign mass due to disorganized growth of normal tissue. There are many different types of hamartomas depending on the tissue they derive from. This patient’s hamartoma is from apocrine gland or sweat glands. Some consider these growths to be a developmental defect especially when seen in young dogs. CO2 laser surgery or surgical removal are the treatment options.

I thought this was a neat case to share with you and a differential to keep in mind in a young dog with a growth. This case also highlights where a dermatopathologist can make a key difference in providing the correct diagnosis.

Let me know if you have seen anything like this and how you treated it.

13/10/2024

Another veterinary extern in the books. Dr. Mario Flores from Peru spent the last 6 weeks in our practice. Always honored to have veterinarians from other countries take time away from their jobs, family and friends to come learn dermatology with our team. If you are interested in an externship, please DM me and I can connect you with my manager who can give you more information.

23/08/2024

The past three weeks we had the pleasure of having Dr. Nicole Jeria Visintini from Chile at our practice. We first met in Boston at the World Congress of Veterinary Dermatology, and then right after she came to Miami for an externship practice. Thank you, Nicole, for choosing our clinic to learn more about dermatology. Good luck in Chile!

If you are interested in an externship, please DM me and I will put you in contact with my manager.

🇨🇱

17/06/2024

These black spots on this 11-year-old male neutered Frenchie are viral pigmented plaques. The growths are caused by canine papillomavirus. Pugs and Miniature Schnauzer dogs are predisposed to these plaques, but it can occur in any other breed and is often associated with immunosuppression.

We are all aware of papilloma virus “warts” that affect the mouth and skin of dogs, and here is another presentation of this virus. However, canine pigmented plaque is unlikely to spontaneously regress, like we sometimes see the oral and skin types do.

The pigmented growths may be confused with skin freckles or benign cutaneous melanocytoma. Biopsy is important for differentiation.

Pigmented viral plaques typically occur in the ventral aspect of the body, like the axillae or abdomen, and in the medial aspect of the legs. The plaques are usually multiple, a deep dark color, can be flat to raised and can be solitary or cluster.

Although these plaques are benign, neoplastic transformation has been reported.

My patient is an older dog, not the typical breed predisposed, therefore, looking for immunosuppressive causes is important.

Did you know about canine pigmented plaques? Have you seen this before?

12/06/2024

Brown discoloration of the nails can be a sign of a yeast infection. This dog was very itchy of his paws due to his environmental allergies. He had just received a Cytopoint injection at his primary vet’s office but was still itchy of his feet. Cytology of the nails and paws showed numerous Malassezia organisms. The yeast infection was likely contributing to the itchiness. When you examine an itchy paw, look at the nails and nail beds too, and sample that area for cytology. I like to do tape cytology and was able to catch the yeast on the tape sample.

07/05/2024

Not all bumps on a dog’s paw are due to allergies. The red bumps and thickened hard spots on this dog’s paw pad are due to an uncommon condition called calcinosis circumscripta. In this condition there is deposition of calcium in the soft tissue which causes the formation of nodular lesions.

Calcinosis circumscripta are often found in previous sites of trauma, pressure point sites and bony prominences (where the skin and bone are thinly separated). They can also be found on the footpads and mouth, like the tongue. Not pictured were similar lesions like the paw on the underside of this dog’s tongue.

This condition is common in young large breed dogs. German Shepherds are predisposed. The dog in this picture is a small breed, so not the typical breed for calcinosis circumscripta.

When calcinosis is seen on the skin it is classified by dystrophic causes (following a tissue damage), metastatic (associated to abnormal calcium and phosphate metabolism) and idiopathic (where the cause is unknown). For our patient, it is hard to say what is the cause of the paw lesions. Our patient is on long term steroid medication for another non-derm related condition and therefore we suspect that the steroids may be playing a role.

Treatment of calcinosis circumscripta consists of surgical removal of the calcified tissue. The bumps on this dog were removed during the biopsy, but without discovering the underlying cause they are likely to reappear.

26/04/2024

Maybe it is something about the dermatitis around this dog’s eyes that gives him a sad look, or maybe and more likely it is because he really does feel sad and depressed. If you could see the rest of this dog’s skin and his ears, it would be impossible not to believe that this dog is hurting. Skin and ear problems can make a pet feel miserable. Happy this doggie’s pet parents found us, and we are starting the journey to help heal him.

16/04/2024

This is a 10-year-old MN cat that had these crusty lesions and pruritus of his face for 2 years. Various medications like systemic antibiotics, topicals, antiviral medications were tried with no resolution. Dermatophyte was ruled out with a fungal PCR. Other veterinarians had made recommendations to take skin biopsies of the lesions, but the client was nervous about sedating her cat due to a heart murmur. We were able to take biopsies under local anesthesia and this is how we got our answer to what was making this cat so uncomfortable. Histopathology showed that these lesions were Bowenoid in situ carcinoma or multicentric squamous cell carcinoma in situ. This is an uncommon premalignant neoplasm that behaves differently from squamous cell carcinoma, as it is not induced by sun exposure and found in haired areas of the body. Lesions can be irregular, plaque-like, elevated, crusty, or scaly. In rare cases, the lesions can progress to squamous cell carcinoma if left untreated.

Treatment options in the literature are cryosurgery or use of imiquimod (an immunomodulatory drug). Surgical removal is difficult because for many of these patients there are multiple lesions to remove, or lesions are in difficult areas to perform surgery on. Since Bowenoid lesions are superficial and confined to the epidermis, CO2 laser ablation should be considered as a treatment option. We referred this case to Dr. Boaz Man for CO2 laser therapy.

One may jump to think that a cat with an itchy face just has allergies, but there are other diseases to consider. Bowenoid in situ carcinoma is a differential to keep in mind in an older cat with unusual crusty lesions not responding to conventional therapies.

12/04/2024

It’s happening tomorrow!!!

05/04/2024

These past two weeks we had the pleasure of having another extern, Dr. Daniela Markus Gotze from Brazil.

We enjoy having veterinarians do an externship with us because as much as they learn from us we get to learn from them too. There are many different ways to practice dermatology. Hope to see you again Dr. Daniela.

05/04/2024

04/04/2024

03/04/2024

Dry flaky skin in dogs is not always dandruff like in people. Breeds like German Shepherds and Dobermans tend to get dry skin, but in the patients pictured here that was not the case. When presented with a patient like these, make sure to do a cytology of the skin and/or a skin culture to rule out a bacterial infection. Both of these dogs had a bacterial infection, the German Shepherd actually had a methicillin resistant staphylococcal infection.

02/04/2024

El Congreso Mundial de Dermatología es en Julio en la ciudad de Boston. Anímense y registrense!!! Quiero conocerlos a todos ustedes.
www.vetdermboston.com

25/03/2024

https://www.dvm360.com/view/a-multimodal-approach-to-antimicrobial-stewardship

Veterinarians should factor in cost, adherence, and pets’ temperaments