Note that fixative will remove the sticky portion along with the sample. Wheals (steep-walled, circumscribed elevation in the skin due to edema ) due to hypersensitivity reaction, Fluid-filled elevation of epidermis, <1cm, Vesicles and bullae on ear pinna due to bullous pemphigoid, Steep-walled, circumscribed elevation in the skin due to edema, Wheals associated with intradermal allergy testing in a horse, Superficial pyoderma (Courtesy of Sonya Bettenay), Use the adhesive tape technique on dry skin or in the interdigital area (Courtesy of Sonya Bettenay), Impression smear: slide pressed on skin (Courtesy of Sonya Bettenay), Aspiration smear: insert needle into nodule (Courtesy of Sonya Bettenay), Eosinophils, neutrophils and bacteria (Courtesy of Sonya Bettenay), Superficial pyoderma: neutrophils with intracellular cocci (Courtesy of Sonya Bettenay), Pyogranulomatous inflammation (deep pyoderma): many neutrophils and macrophages, few bacteria (Courtesy of Stefanie Peters), Malassezia and bacteria (Courtesy of Stefanie Peters), Grade 1 mast cell tumor with eosinophils (Courtesy of Sonya Bettenay). Two genera of yeast are seen: Malassezia species are more common in the United States than Candida species, which tend to be more common in Europe. How do I do it? Nodules on nose of dog with cutaneous histiocytosis. A 2-tiered histologic grading scheme for canine cutaneous mast cell tumors (MCTs) is based on morphologic characteristics of neoplastic cells, including karyomegaly, multinucleation, nuclear pleomorphism, and mitotic figures. If intracellular cocci are found, a true infection is present. BluePearl Veterinary Partners, Franklin, Tennessee. Keratin bars (DQ) Collagen . This book discusses canine and feline skin cytology and the importance of this diagnostic tool in interpreting skin lesions. In this test your veterinari… Cytology is the examination and study of blood or tissue cells under a microscope that can be done in dogs and other animals. A defect in epidermis that penetrates the basement membrane. Pustules on the abdomen of a dog with superficial staphylococcal pyoderma. Cytology is an inexpensive tool with a short turnaround time as it can be performed in clinic. More specific testing includes a culture of the causative organism as well as taking a small skin tissue sample for a skin cytology test. This book discusses canine and feline skin cytology and the importance of this diagnostic tool in interpreting skin lesions. Excessive stratum corneum, confirmed via histopathology. Nodule that is epithelial-lined and contains fluid or solid material. Abnormal nail morphology due to nail bed infection, inflammation, or trauma; may include: Onychogryphosis, Onychomadesis, Onychorrhexis, Onychoschizia, Onychodystrophy in dog with chronic allergies, Abnormal claw curvature; secondary to nail bed inflammation or trauma, Onychogryphosis in a dog with symmetric lupoid onychodystrophy, Claw sloughing due to nail bed inflammation or trauma, Onychomadesis in a dog with symmetric lupoid onychodystrophy, Claw fragmentation due to nail bed inflammation or trauma, Onychorrhexis in a dog with symmetric lupoid onychodystrophy, Claw splitting due to nail bed inflammation or trauma, Onychoschizia in a dog with symmetric lupoid onychodystrophy, Papules on a dog with superficial bacterial folliculitis, Paronychia in a dog with symmetric lupoid onychodystrophy, Flat lesion associated with color change >1cm, Hypopigmented patch (left), erythematous patch (right), Small erythematous or violaceous lesions due to dermal bleeding, Petechiae in a dog with cutaneous vasculitis, Venous dilation; most commonly associated with hypercortisolism, Phlebectasia and cutaneous atrophy due to hypercortisolism in a dog, Flat-topped elevation >1cm formed of coalescing papules or dermal infiltration. In this disease, papular lesions are very often associated with pustules and epidermal collarettes, which help the clinician to suspect the disease (Fig. It also enables observation of findings that might be missed at 100×, such as acantholytic cells and Demodex mites (Figures 4 and 5). Cocci are round, basophilic bacteria found individually, in clusters, or in large groups (Figure 10). Rods are often found individually or in sets of 2 placed end to end, called diploid rods (Figure 12). Griffin et al found that heat fixing versus not heat fixing otic exudate on glass slides before staining did not increase or decrease the number of Malassezia yeast organisms found on cytologic evaluation.3 I prefer the slide to be heat fixed, then stained with a quick stain (eg, DiffQuik). CUTANEOUS CYTOLOGY PROCEDURE Watch a video to review this procedure. For example, if a dog has end-stage proliferative ear disease, the degree of stenosis may make insertion of the applicator into the ear canal impossible. Part II. Put the slides under a microscope, condenser up. 3. All species have these granules, which may be seen in keratinocytes that are chronically irritated (eg, in allergic dogs/cats). These organisms are defined as a broad-based budding yeast. Diff-Quick. They are about half the size of an average red blood cell. CUTANEOUS CYTOLOGY EQUIPMENT Learn what equipment is needed. 2013). Dogs have round granules and cats have rod-shaped granules (similar to eosinophils; Figure 14). Moisten a cotton bud with saline solution or carefully rub the edge of a slide on the skin and then rub the material on the slide, Press clear adhesive tape (sticky side down) onto the skin. RBCs vary slightly with species; in dogs, RBCs are ~7 microns in diameter. Skin cytology is a very high-yield procedure for patients with skin disease. Rub or impress a slide on moist, exuding or greasy surface of infected skin. Intracellular bacteria should be scanned for because the presence of these bacteria is the true definition of skin infection. Ecchymoses of a dog’s leg due to vasculitis, Circular scale or crust with erythema, associated with folliculitis or ruptured pustules or vesicles, Epidermal collarettes in a dog with Staphylococcus superficial bacterial folliculitis. FIGURE 1. Nestlé PURINAInterpretation of Canine and Feline Cytology5 Choosing an area from which to collect a sample for cytology and deciding the method of sample collection depend on what abnormality is detected clinically. Rogers KR, Barton CL, Habron JM: Cytology during surgery. History is very important for proper diagnosis of skin diseases. Some types of skin cancer. Consider tape preps, which tend to be more useful in areas that are very dry or difficult to access with a slide, such as interdigital spaces, facial or tail folds, and periocular areas. Specific techniques on myringotomy may be found in Mueller and Kirk’s Small Animal Dermatology, 7th edition. Cytology is one of the most important yet commonly underused tools in veterinary medicine. Fungal spores from dermatophytes (ringworm) can be seen within neutrophils, can be free, or can be present within nuclear streaming. These granules are present in immature skin cells in the granular layer and are involved in “cementing” the cells together when fully mature. Finding eosinophils on skin cytology suggests the presence of parasites, fungi, or food allergies. Christopher MM, Hotz CS, Shelly SM, Pion PD. epithelial and mesenchymal tumours) is used, other tumours are grouped based exclusively on their morphology (e.g. FIGURE 8. When looking for Demodex mites or fungal spores, lower the condenser so that the light intensity does not “burn” through these organisms. Then scan the sample at 4X to 10X magnification for a representative area, … Small, medium, and large lymphocytes may be seen. Chris Reeder, DVM, DACVD In case of dry skin or in the interdigital area: When bacterial or yeast infection is suspected (inflammatory. Lack of hair due to genetic factors or defects in embryogenesis. Diff-Quick ®) Put the slides under a microscope, condenser up. Thickening of the epidermis, often due to chronic inflammation resulting in exaggerated texture, Lichenification of skin in a dog with chronic atopic dermatitis and Malassezia dermatitis, Flat lesion associated with color change <1cm, Pigmented macule (left) Erythematous macule (right). A biopsy is one of the more common diagnostic procedures performed in dogs. These are large organisms and are best evaluated with 4× to 10× magnification. Medium and large lymphocytes, which have a slightly more open chromatin pattern and more cytoplasm, can also be seen in inflammatory processes. In these cases, a red rubber or tomcat catheter can be used to obtain the sample while the patient is under general anesthesia. This term is often used to describe the nasal planum and footpads. Starting at 4× allows identification of specific areas of the slide for examination at higher powers. Cocci are most often Staphylococcus or Streptococcus species. Two distinct shapes are most common: cocci and rods. Increased melanin in skin, may be secondary to inflammation. Aspirates from MCTs may provide the same information more quickly, inexpensively, and less invasively. Dry, Flaky Skin. For most dogs, much of the skin is covered with hair. Emperipolesis in squames (rapid stain) Degenerating squames (rapid stain) Emperipolesis in squames . Your veterinarian will ask questions regarding the age of onset, progression of disease, and response to previous treatments. Acantholytic cells are “fried egg”–shaped, with a deeply basophilic, centrally located nucleus (Figure 4). Always start at low power! A... Stain the air dried slides (e.g. The presence of numerous bacteria with no intracellular bacteria may be the result of immunosuppression (eg, Cushing’s disease, hypothyroidism, neoplasia) or bacterial overgrowth. They are golden to brown in color and mostly rod-shaped; they have a refractive/reflective quality when going in and out of fine focus (Figure 13). Comp Cont Edu 20:1109-1119, 1998. Usually they are seen only in ulcerated areas of dermal mast cell tumors. Melanin granules are commonly mistaken for bacteria and are normally seen on pigmented areas of the skin. Bacteria always go in and out of focus when the fine focus on the microscope is used, whereas melanin granules have a refractory/reflective quality. This book discusses canine and feline skin cytology and the importance of this diagnostic tool in interpreting skin lesions. Pinterest. This book discusses canine and feline skin cytology and the importance of this diagnostic tool in interpreting skin lesions. Histopathology may be needed to differentiate from an erosion. Or perhaps you’ve found a skin lump and you’re not sure whether it’s a cyst or not.. CUTANEOUS CYTOLOGY (.pdf) Download and save the entire Cutaneous Cytology Diagnostic Technique Section for your continued reference. Dhaliwal RS, Kitchell BE, Marretta SM: Oral tumors in dogs and cats. If a dog has a patent ear canal with a ruptured or absent tympanic membrane, sampling of the middle ear may be possible. With more than 600 clinical and cytological color pictures, it explains the cytological patterns observed in all cutaneous inflammatory and neoplastic lesions in cats and dogs, as well as cutaneous metastasis of non-primary skin neoplasms. Copyright © 2021 Today's Veterinary Practice. Using the edge of a glass slide to obtain the debris (usually a waxy substance) by scraping from distal to proximal in a scooping motion at a 30° to 45° angle. A skin cytology sample can be obtained in a variety of ways, depending on the type of lesion present. 5. Mast cells are also found later in a disease process (Figure 9). With more than 600 clinical and cytological color pictures, it explains the cytological patterns observed in all cutaneous inflammatory and neoplastic lesions in cats and dogs, as well as cutaneous metastasis of non-primary skin neoplasms. In patients with suspected pemphigoid diseases (erosions, Rods → culture and susceptibility advisable, Inflammatory cells with intracellular bacteria → clinically relevant infection that may require systemic antibiotic treatment, Eosinophils → can point to ectoparasites or allergies, Macrophages → seen in chronic, sterile and infectious processes, Slides, DiffQuick® or similar stain, mineral oil, adhesive tape, microscope, needle and syringe. Insert needle into nodule or abscesses and re-insert a number of times without leaving the skin. Neutrophils are acute inflammatory cells that destroy infectious organisms and are the main component of pus. When cells rupture during sampling, nuclear content (DNA) is often seen on cytology. Eosinophils are filled with red (eosinophilic) granules (Figure 7). With more than 600 clinical and cytological color pictures, it explains the cytological patterns observed in all cutaneous inflammatory and neoplastic lesions in cats and dogs, as well as cutaneous metastasis of non-primary skin neoplasms. Veterinary School Applications Are Up 19% — What Does that Mean for the Profession? For the aspiration technique: Connect the needle and syringe, direct the needle into the mass, and draw back and release the plunger several times. The stick portion should have a beveled edge. Eosinophils produce numerous cytokines and mediators to kill microorganisms and attract other cells, such as mast cells. Histopathology may be needed to differentiate from ulcer. With more than 600 clinical and cytological color pictures, it explains the cytological patterns observed in all cutaneous inflammatory and neoplastic lesions in cats and dogs, as well as cutaneous metastasis of non-primary skin neoplasms. Progressive leukotrichia in patient with vitiligo. Get the latest peer-reviewed clinical resources delivered to your inbox. Demodex, Otodectes, scabies, or other mites may be visible on cytologic preparations if the infection is severe enough. This reference guide was created as a source of step-by-step recommendations to assist the veterinary team in proper collection and preparation of appropriate cytological samples. Linkedin. He has served on several committees for the American College of Veterinary Dermatology, including the credentials committee and ad hoc exam committee. Use the beveled edge to gently scrape or extract material from around the proximal claw/claw skin folds and rub it onto a glass slide (, Obtain a sample by scraping the skin with the edge of a glass slide at a 30° to 45° angle (. Keratinocytes may display some interesting features that may be normal or abnormal, such as inclusion of keratohyaline granules or rounded acantholytic cells. The textbooks on skin cytology and dermatology in dogs and cats use a “hybrid” cytological classification of skin cancers; indeed, although for certain cancers a definition based on the origin of the cells and/or their architectural arrangement (e.g. According to Christopher et al in the Journal of the American Veterinary Medical Association, “Cutaneous/subcutaneous cytology are most accurate for diagnosis of lesions, whereas liver cytology is least accurate.”1 Moreover, Ruocco et al report that “Exfoliative cytology for diagnostic purposes is rarely used in dermatology despite the rapid and reliable results which this procedure can offer in many clinical conditions.”2 Knowing how to take cytologic samples and how to interpret those samples can be critical to an animal’s health, disease management, and overall wellbeing. This book discusses canine and feline skin cytology and the importance of this diagnostic tool in interpreting skin lesions. Most keratinocytes are octagonal to square and squamous in composition. These very small, round organisms have a clear halo and basophilic center (Figure 11). Skin surface and ear cytology is the most frequently used dermatologic diagnostic technique in practice. StumbleUpon. These cells are also phagocytic and are capable of ingesting bacteria and fungi. These cells direct activities of other cells (eg, neutrophils, eosinophils, keratinocytes) through the release of various messaging molecules, or cytokines. Ulcerations of the skin of a dog with vasculitis. Skin Cytology in Dogs and Cats Kinga Gortel DVM, MS, Diplomate ACVD Why do skin cytology? Occasionally, severe bacterial infections and dermatophytosis can cause these cells to develop. Stain the tape like a slide, let it air dry and press it onto a slide or put a drop of the blue stain o DiffQuick. Ruocco E, Brunetti G, Vecchio M Del, Ruocco V. The practical use of cytology for diagnosis in dermatology. Twitter. If the tympanic membrane is intact, a myringotomy using a spinal needle will be required. I like to write. In my experience, skin cytology is the diagnostic test most commonly missed in everyday referral cases. Bacterial cultures should be performed any time rods are seen on cytology. Skin biopsies provide valuable insight into the type of cells in an abnormal area of skin or a skin growth and whether the growth poses a more serious health threat to your pet. It can help to outline fungal spores, bacteria, and yeast, so look for these organisms in areas with larger amounts of nuclear streaming. In some breeds hair is shed regularly or, in non-shedding breeds, is constantly growing. Inflammatory cells are seen in almost all skin cytologic examinations and occasionally on ear canal and claw fold cytology. In dogs, papules are frequently observed during superficial staphylococcal pyoderma (Ihrke 1996; Miller et al. Nuclear streaming looks like fine threads of eosinophilic material (Figure 10). Withdraw the needle. Cytology involves examination of a tissue or fluid sample. Photo: Dr. James Askew, DVM Does your dog suffer from skin cysts? Dhaliwal RS, Kitchell BE, Marretta SM: Oral tumors in dogs and cats. 3.1). Its’ purpose is to help you identify bacterial or fungal organisms (yeast) and to assess the infiltrating cell types, neoplastic cells or acantholytic keratinocytes. I find direct impression smears to be most rewarding. Melanin granules are usually seen attached to keratinocytes, but they can be seen free on the slide. A discrete swelling containing purulent material, typically in the subcutis, Absence of hair from areas where it is normally present; may be due to folliculitis, abnormal follicle cycling, or self-trauma, Extensive alopecia secondary to cutaneous epitheliotropic lymphoma, well-circumscribed, circular, patchy to coalescing alopecia, often associated with folliculitis, “Moth-eaten” alopecia secondary to superficial bacterial folliculitis, Angioedema due to cutaneous drug eruption, Annular lesions in a dog with erythema multiforme, Fluid-filled elevation of epidermis, >1cm, Blood-filled elevation of epidermis, >1cm, Interdigital hemorrhagic bulla in a dog with deep pyoderma and furunculosis, dilated hair follicle filled with keratin, sebum, Comedones on the ventral abdomen of a dog with hypercortisolism, Dried exudate and keratinous debris on skin surface, Multifocal crusts due to pemphigus foliaceus. Lymphocytes are usually seen later in the course of skin disease and are not usually found in large numbers. Using a cotton-tipped applicator broken in half. With more than 600 clinical and cytological color pictures, it explains the cytological patterns observed in all cutaneous inflammatory and neoplastic lesions in cats and dogs, as well as cutaneous metastasis of non-primary skin neoplasms. These keratinocytes have lost their intercellular connections deeper in the epidermis and are usually found in animals with immune-mediated disease, such as pemphigus. You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. This is approximately the farthest it is possible to see into the ear without an otoscope. Description. Fissures of the footpads in a dog with superficial necrolytic dermatitis, Ulcer on skin surface that originates from and is contiguous with tracts extending into deeper, typically subcutaneous tissues, Accumulation of scale adherent to hair shaft, Follicular casts surrounding hairs from a dog with hypothyroidism, Idiopathic hyperkeratosis of the nasal planum (left) and footpads (right), Increased melanin in skin, often secondary to inflammation, Inflammatory lesions (left) resulting in post-inflammatory hyperpigmentation (right), Idiopathic hypopigmentation of planum nasale. Try to obtain a sample at the junction of the vertical and horizontal canals. They are not common but are of diagnostic value if seen. He or she will then perform a complete physical examination as well as a biochemistry profile, urinalysis, and complete blood count -- the results of which are typically normal unless the dog has a concurrent disease. 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