BACTERIAL SKIN INFECTIONS (PYODERMAS)

Causes
– Staphylococci (`Staph bacteria´) are the most common organisms found in bacterial skin diseases (pyoderma’s) in dogs. Fortunately, these bacteria (S. intermedius) are not contagious to humans or other pets.

Signs
– Commonly itchy, yellow pustules are often observed early in the disease, and the dog´s skin can be reddened and ulcerated. Dry, crusted areas appear as the condition advances, along with loss of hair in the affected areas (lesions) and an odour.

All areas of a dog´s body may be involved, but most cases are confined to the trunk. The chin is one area commonly affected. Called chin acne, this condition is actually a deep bacterial infection. Obese dogs and dogs of the pug-nosed breeds are frequently affected by pyoderma in the skin folds on their face, lips and vulva. 

Other areas where pyoderma may occur include between the toes and on the calluses of the elbows that mostly affects the abdominal area in young puppies. 

Diagnosis
– This is usually made from the case history and appearance and location of the lesions. In some cases, it may be necessary to culture the skin (grow the bacteria) and conduct sensitivity tests to determine which antibiotic will be effective in treatment. Most bacterial skin infections in dogs are secondary to another disease such as parasitism, allergies, endocrine (hormonal) disorders or abnormalities in the immune system. Therefore, in recurrent cases, it is important to search for underlying causes. It may be necessary to do blood tests, allergy tests or skin biopsies to achieve a complete diagnosis. 

Treatment
– Initial treatments may entail removal of the hair in and around the lesions, washing of the whole dog with antibiotic shampoos such as benzoyl peroxide, careful drying and the application of an antibiotic ointment to local lesions, in most cases, antibiotics will also be administered orally for 3-4 weeks. Bandages or a protective collar which prevents the dog from mutilating the lesions may be applied. 
Some pyoderma involving skin folds can require corrective surgery. In recurrent cases where testing reveals no definable underlying cause, special staphylococcal vaccines as an alternative to long-term antibiotic treatment can be tried. 

It may be necessary to continue treatments such as antiseptic shampooing, antibiotic ointment applications and giving antibiotics orally at home. While most cases respond to treatment, recurrences of pyoderma are common, particularly if treatment recommendations and follow-up visits to your veterinarian are neglected. Glucocorticoid steroids cannot be administered.

Fungal Skin Infections (Ringworm) 

Cause
– The fungal skin infections of dogs are caused primarily be two species of fungi: Microsporum and Trichophyton. The skin diseases resulting from these fungi are commonly called `ringworm.´ 

Signs
– Ringworm is seen most commonly in young dogs. The fungi live in dead skin tissues, hairs and nails. Hair loss, usually in circular patches, may appear. If infected, the center of the patches may have a dry, crusty appearance. The head and legs are most commonly affected by ringworm, although the disease may spread over other parts of the dog´s body if not treated. Dogs may scratch the lesions.

Diagnosis
– The appearance of the lesions, the history of their development and the age of the dog are all helpful in diagnosing ringworm. A Wood´s Lamp Test (ultraviolet light) can be used to help diagnose the Microsporum species only. A definite diagnosis can be obtained through a fungal culture — grow the fungi found on the affected hairs. 

Treatment
– The hair around the lesions is clipped, and special fungicidal shampoos or rinses are used for bathing the dog. Topical lime sulfur and mandatory systemics should be administered. 

Public Health Aspects of Ringworm – Ringworm is contagious to humans, particularly to children and to other household pets. Infected dogs should be kept away from children and other dogs and cats until the infection is cures — which can be as long as 2-3 months or more after the treatment begins. Adults should be careful to wash their hands thoroughly after handling an infected dog. If treated early, ringworm is readily controlled in humans. Other household pets should also be examined for ringworm.

 

Allergic Skin Diseases

Allergies in dogs are common. Signs such as itchy skin, nasal and eye discharges and sneezing, and/or digestive upsets and/or skin lesions may indicate an allergy is present. Many skin diseases seen in dogs are caused by an allergy. 

Causes
– An allergy is a hypersensitivity reaction to allergy-causing substances known as `allergens´ or `antigens.´ Dogs (like people) can develop allergies at any age, and the signs can appear quite suddenly.
The most common allergy dogs develop is the flea saliva. The presence of a single flea on these allergic dogs causes intense itching. These allergies are seasonal in climate zones where fleas are eliminated by the cold in winter months — and a year-round problem in warmer climates. 

Atopy (atopic dermatitis, allergic inhalant dermatitis) is a pruritic (itchy) skin disease dogs develop in response to inhaled particles such as house dust, molds and pollens. This common form of allergy usually starts at a relatively young age. Rarely, dogs can be allergic to chemicals contained in soaps, waxes, carpets and flea collars. This type of hypersensitivity is known as a `contact allergy.´ Also, some dogs are allergic to insect bites and stings. Food allergies usually case diarrhea and/or skin lesions. 

Signs
– Itching is the primary sign of allergic skin diseases in dogs. The affected skin may appear normal, or red and moist in patches called `hot spots.´ Pus and dried crusts are apparent if a bacterial infection is also present. The dog tends to constantly scratch and lick affected areas. Initially, flea allergies are most evident over the dog´s back and near the tail. A dog´s face, feet, chest, and abdomen are more often affected by pollen and dust-type allergies. Contact allergies are seen mostly on the hairless areas of the abdomen and on the bottoms of the feet. 

Diagnosis
– The dog´s case history helps with the diagnosis. The intense itching and location of the lesions are also helpful in diagnosing the type of allergy present. Response to treatment (flea control) is often used as a method of diagnosis of flea allergy. Trials of special hypoallergenic diets are used to diagnose food allergy. Allergy testing is used to help choose immunotherapy. Blood tests are also available to diagnose allergies, but their use is more controversial. Ask your veterinarian for his or her current recommendations. 

Treatment
– Allergies can be controlled in most cases, with few `cured.´ Antihistamines and corticosteroids may be used by your veterinarian to give your dog relief from the intense itching. In mo
st cases this will stop the self-mutilation. The owner will be instructed to give corticosteroid tablets in decreasing dosages for a few months. Corticosteroids are potent drugs and should not be used carelessly or for long periods of time. The main objective in controlling flea allergies in dogs is to kill the fleas on the dog and in the dog´s environment. 
Another approach to allergy control is hyposensitization (immunotherapy). In this procedure, a correct diagnosis by intradermal or blood testing is necessary. The dog is then given injections of small but increasing doses of the allergy-causing substance at varying intervals for up to 12 months. Lifelong response may take up to 12 months.

Parasitic Skin Diseases

Cause
– Fleas are the most common parasitic skin disease found in dogs. Mange is another type of skin disease which is caused by mites. There are two severe types of mange: sarcoptic mange and demodectic mange.

– Ear mites, lice, and ticks are other parasites that affect dogs. Their presence irritates the dog, leading to self-mutilation. 

Signs
– Sarcoptic mange causes intense itching, loss of hair and crusting of the skin. A dog´s ears, front legs, chest and abdomen are most often affected by sarcoptic mange.

– Demodectic mange can cause itching. The skin is reddened and scaly, and hair loss occurs in round patches resembling `ringworm.´ The face and front legs are most commonly affected, although some cases may be generalized. Generalized demodectic mange is often a sign of underlying internal disease or a hereditary problem. 

– Ear mites cause severe irritation in the ears. Often, an affected dog will scratch the hair off the back of its ears. Ticks, lice and fleas may transmit other diseases, in addition to causing irritation. 

Diagnosis
– Mange is often suspected on the basis of the case history and the appearance and location of the lesions. A skin scraping test is always performed to aid in identifying parasites. Ear mites, which are barely visible to the naked eye, appear as small white objects. The black debris commonly seen in the ears of dogs with ear mites is a combination of dried blood, normal ear wax and discharges from inflammation. Lice, fleas and ticks can also be seen by close examination of the dog´s skin. 

Treatment
– Mange is treated by clipping the affected areas and washing them with an antiseptic. Anti-mite dips are often necessary and may be used weekly or biweekly for several months. Shampoos can be sued before each dip. The dog´s eyes should be protected with mineral oil or eye ointment and the ears plugged with cotton before dipping. Most cases of mange respond well to this treatment. Antibiotics can be administered in cases of mange where infection may be present.

Ear mites can be readily treated Initially, your veterinarian may recommend a thorough cleaning of the dog´s ears while the animal is sedated. This treatment can be followed up with home treatments using special solutions or ointments to kill the mites and prevent infections in addition, insecticidal dips, sprays, powders or shampoos are often used. 

Lice, ticks and fleas must be killed on the dog and in the dog´s environment with insecticides. Dips, shampoos, flea collars, sprays, powders, foams and foggers containing insecticides are available from your veterinarian to help control these parasites.

Hormonal Skin Diseases

Skin diseases caused by hormonal abnormalities in dogs are difficult to diagnose. The thyroid gland, adrenal glands, pituitary gland, testicles and ovaries all produce hormones. If excessive (`hyper´) or deficient (`hypo´), these hormones produce changes in the skin and hair coat. Most hormonal problems that affect the skin produce hair loss that is evenly distributed on each side of the dog´s body. The skin may be thicker or thinner than normal, and there may be changes in the color of the skin or hair coat. These diseases usually are not itchy. 

When any of the hormone-producing glands malfunction, they affect other body functions besides the skin. Hormonal skin diseases in dogs can be much more serious than a `skin problem.´ 

Some causes of hormonal skin disease, such as hypothyroidism and adrenal gland problems, can be diagnosed by special blood tests and effectively treated. Others may be more difficult to diagnose and treat. Skin changes related to the sex hormones can be successfully treated with surgical neutering, if this has not been performed previously. 
 

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Condition	Description	Symptoms	Diagnosis	Treatment
Atopy (Allergic Inhalant Dermatitis)	Allergic reaction by the animal to something it inhales such as pollen, house dust mites and mold	Licking of feet, inflamed ears, itching, redness, sometimes development of infection or hot spots	Intradermal or serologic (blood) testing for allergies	Reduce exposure to allergen (what the pet is allergic to), shampoos, fatty acid supplements, steroids, antihistamines, immunotherapy
Food Allergies	Allergic reaction to something in the diet	Licking of feet, inflamed ears, itching, redness, sometimes development of infection or hot spots	Food elimination trials	Change in diet
Allergic and Irritant Contact Dermatitis	Reaction of the pet’s skin to something it had contact with such as wool or plastics	Red skin and small bumps or blisters on the areas of skin that are sparsely haired and directly exposed to the offending substance, itching	Patch test, exclusion trials	Restrict exposure to the allergen or contact irritant in the pet’s environment, steroids, antihistamines
Flea Allergy Dermatitis (Flea Bite Hypersensitivity)	Severe reaction by the animal to the saliva of the flea	Intense itching, redness, hair loss; sometimes development of infection or hot spots	Presence of fleas; reaction to intradermal testing	Flea Control in the environment and on the pet; steroids and antihistamines for the itching
Sarcoptic Mange	Infection with the Sarcoptes mite	Intense itching and self-trauma	Skin scraping and microscopic examination – the mite is often very difficult to find	Amitraz (Mitaban) dips (off-label use*); ivermectin (off-label use*)
Demodectic Mange in Dogs (Red Mange)	Infection with the Demodex mite – occurs when the immune system is deficient	Hair loss, scaliness, redness, pustules, ulcers, sometimes itching	Skin scraping and microscopic examination	NO Steroids! Amitraz (Mitaban) dips
Cheyletiella (Rabbit Fur Mite) Mange	Infection with the Cheyletiella mite	Itching, scaliness	Skin scraping and microscopic examination – the mite is often very difficult to find	Permethrin (Dogs ONLY) or Pyrethrin
Ringworm	Infection with several types of fungus	Hair loss, scaliness, crusty areas, some itching	Culture	Miconazole, lime sulfur dips; oral griseofulvin or itraconazole
Yeast Infection	Infection with, most commonly, Malassezia; usually follows some other underlying disease	Itching, redness, sometimes oiliness	Skin scraping/smear and microscopic examination, culture	Treat underlying disease; oral ketoconazole; miconazole shampoos
Hot Spots: Acute Moist Dermatitis	Result from allergies, flea bites, mange, anal gland disease, poor grooming, ear infections, plant awns or burs, arthritis	Hair loss; red, moist, oozing skin; constant licking or scratching	Physical exam and history	Treat underlying condition; clean area; apply Domeboro solution; topical and/or oral antibiotics and steroids
Cutaneous Lymphoma	Rare type of skin cancer	Itching, ulcers, nodules, redness	Biopsy	Usually does not respond to treatment
Lice	Infection with several species of lice	Variable; itching, hair loss, crusts, rough hair coat	Finding lice or nits on skin or hair	Permethrin (Dogs ONLY) or Pyrethrin, ivermectin (off-label use*)
Skin Fold Dermatitis	Occurs where folds of skin touch each other such as lips, vulva, face (in breeds like bulldogs)	Redness, oozing, itching	Physical exam; microscopically examine smear for evidence of infection	Treat any infections; clean areas daily; surgical correction if severe
Hookworms	Infection with the larvae (immature forms) of hookworms	Red bumps, usually on feet, rough foot pads, abnormal nail growth, itching	Physical exam, history of poor sanitation	Treat for intestinal infection; move animal to different environment
Neurodermatitis: Acral Lick Dermatitis (Dogs) Psychogenic Dermatitis (Cats)	Self-licking in dogs and cats results in self-trauma; possible causes include anxiety, boredom, stress (e.g., new member in household)	Acral Lick: red, hairless, well-circumscribed lesion usually on forearm; cats: symmetrical hair loss, sometimes ulcers, on abdomen, groin, along the back	Exclude other causes; history important	Relieve underlying cause e.g., anxiety;
Bacterial Infection	Often occurs as a result of another condition	Redness, pustules, bumps, sometimes itching	Microscopic examination of smear; culture	Treat underlying condition; topical and/or oral antibiotics
Ear Mites	Infection with Otodectes	Intense itching of ears, redness, dark crumbly discharge in ears	Direct visual or microscopic examination of ear discharge	Clean ears and apply medication containing pyrethrin (Ear Miticide)
Pelodera Dermatitis	Accidental infection with larvae from a non-parasitic worm that lives in straw and other organic material	Intense itching, redness	Skin scraping and microscopic examination	Remove bedding; mild antibacterial shampoo; steroids if necessary to control itching
Chiggers (Harvest mites)	Seasonal disease caused by larvae of the chigger	Itching, bumps usually on feet, abdomen, folds at base of ears	Visualization of mite larvae or microscopic examination of skin scraping	Permethrin (Dogs ONLY) or Pyrethrin

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Skin medications for dogs include cephalexin, clindamycin, clotrimazole, enrofloxacin otic, gentamicin sulfate, nystatin neomycin sulfate, and thiabendazole.