| A careful dermatologic history is critical to interpreting the physical examination findings and to choosing appropriate diagnostic tests. A complete general history should be obtained, including information about prior illnesses; vaccinations, husbandry (housing, feeding practices, etc), changes in attitude and food consumption; elimination practices; exposure to other animals; and travel within the past 6-12 mo. This should be followed by a detailed dermatologic history. Use of a
preprinted history form can be very useful for chronic or complicated cases. A good history is important because many skin diseases that look similar are differentiated based on interpreting clinical signs and historical patterns. |
| The following information should be obtained: 1) the primary complaint; 2) the length of time the problem has been present; 3) the age at which the skin disease started (distinct age predilections are seen in many diseases, eg, demodicosis and dermatophytosis in pediatric animals and signs of atopy in animals 1-3 yr old); 4) the breed (breed predilections include a predisposition of Cocker Spaniels to primary disorders of keratinization, and of terriers to atopy); 5) the presence
and severity of pruritus (including licking, rubbing, scratching, or chewing behaviors—owners often do not realize licking may be a sign of pruritus); 6) how the disease started and its progression (diseases that begin with pruritus may lead to self-trauma and subsequent development of secondary skin lesions [alopecia, seborrhea] or infections [bacterial or yeast pyoderma]); 7) the type of lesions the owner saw develop; 8) evidence of seasonality (suggesting fleas, allergic
skin disease, or weather-related diseases); 9) area on the body the problem was first noticed (ie, regional patterns seen in atopy [typically the face and feet], cheyletiellosis [primarily dorsal], scabies [primarily ventral], and endocrine hair loss [usually involves the trunk and spares the head and legs]); 10) any previous treatments and the responses to such (ie, antibiotic-responsive skin diseases suggest a bacterial etiology; pruritus that responds to small doses of
glucocorticoids, antihistamines, or essential fatty acids suggests allergic dermatitis); and 11) frequency of bathing and when the last bath was given (recent bathing may obscure or change important clinical lesions, excessive bathing and wetting of the skin can predispose to skin disease); 12) presence of fleas, ticks, or mites; 13) other contact animals (ie, evidence of contagion, which suggests fleas, scabies, cheyletiella, or dermatophytosis); and 14) the environment of the
animal (housing changes can influence the development of certain skin diseases, eg, contact dermatitis, contagious diseases). |
