Los 5 Trucos de la Dermatologia

There are many tricks or practical clues that are learned over the years and many of them are not in the books.

I will mention those that I have learned from my experience:

In many patients with dermatopathies, better response is achieved with homemade balanced diets. It is not too difficult and only requires to be willing to spend time in the kitchen.

The use of frequent baths with natural water for the management of canine atopic dermatitis (AD) would have an anti-inflammatory effect as the temperature of water is lower than that of the inflamed skin. Also, it would have a sweeping effect on skin allergens.

In AD cases, it is recommended not to use water with the same temperature as the body temperature or higher because, as mentioned previously, inflamed skin is at high temperature.

In short- and stiff-hair dogs, it is always recommended to bath them downwards following the hair direction since intense massage against hair growth generates inflammation that predisposes to "post-bathing" folliculitis.

Rinse properly those dogs that have been bathed with antiseptic shampoo as the remainder can generate pruritus.

In dogs with pyoderma, it is recommended to bathe them with a frequency of 48 hours using the least irritating shampoos as these actions can substantially reduce the time of use of systemic antibiotics.

When considering Malassezia, therapeutic baths with chlorhexidine and propionic acid offer better results than any other anti-fungal bath.

In dogs with AD, it is suggested not to dry the hair with hot air since the skin is inflamed.

If the balanced food is placed in the freezer for at least 2 to 3 hours, this will kill storage mites.

In AD patient, when the only systemic treatment alternative is the administration of corticosteroid, we would train people for the rational use of prednisolone. This treatment should only be administered when the pruritus is greater than usual and develops scratch injuries.

The use of sodium hypochlorite in the environment and on the skin, at a proportion of 1 ml of sodium hypochlorite to 4 liters of water, will control bacteria and fungi.

50% acetic acid is useful to control Demodex and bacterial otitis.

When doing trichography, hairs should always be arranged to the same side on the slide.

If we suspect Demodex injai infestation, we should insist in doing pressure on the skin and deep skin scrapings as it is present in the depth of the sebaceous glands, so sometimes we do not find it.

In cases of sarcoptic mange, scrapings should be superficial and extensive. Prior to scraping, we should let the Vaseline act for a few minutes on the skin.

Do not use laundry soap frequently, as the skin pH is between 6.5 and 7 and laundry soap pH is 14.

When taking a sample using fine needle aspiration procedure, we should use needles as fine as possible. We should consider that, the larger de diameter of the needle and the syringe size, the greater is the possibility to damage cells.

If we have no answer to the treatment in a patient with pyoderma and still appears bacteria and inflammatory cells in phagocytosis in cytology samples, it is not necessary to interrupt antibiotic administration to take a sample for culture.

You can replace the scotch tape with liquid adhesive "boligoma" on the slide. You do the imprint on the skin, allowed to dry about 20 minutes, then stained.

When we request a culture and antibiotic sensitivity testing, we should always indicate to test bacteria sensitivity to those antibiotics that are available in daily clinical practice.

Circular lesions: How to differentiate fungi from bacteria and autoimmune causes. In Microsporum canis, dermatophytosis, lesions are circular and peeling, and sometimes there is folliculitis. Bacterial collarettes have a keratin flange, hairs inside the lesion, and there is no peeling. In autoimmune conditions, as in pemphigus foliaceus with nontraditional presentation, collarettes are similar to the bacterial folliculitis, but they are smaller and less inflammatory.