Bacterial Dermatitis Research Articles

Retrospective review of the pathology of American pikas.

American pikas (Ochotona princeps) are small lagomorphs that live in mountainous talus areas of western North America. Studies on the histopathology of American pikas are limited. We summarize here the clinical histories, and gross and histologic findings of 12 American pikas, including 9 captive (wild-caught) and 3 wild animals. Death was often attributed to stress (transport, handling, anesthesia) with few-to-no premonitory clinical signs. Infection was the cause of death in 2 cases: 1 had bacterial pyogranulomatous dermatitis, cellulitis, and lymphadenitis with sepsis; the other case had oomycete-induced necrotizing colitis. Incidental parasitic infections included sarcocystosis, nematodosis (oxyurids), and ectoparasitism. Most animals with adequate nutritional status had periportal hepatic lipidosis; this finding was absent in all animals with adipose atrophy, and it is possible that periportal hepatic lipidosis is non-pathologic in American pikas. Three cases had myocardial necrosis that was considered the cause of death; the cause of necrosis was not determined, but it may have been caused by stress or vitamin E-selenium deficiency. Esophageal hyperkeratosis was noted in animals with a history of anorexia and negative energy balance; accumulation of esophageal keratin can result from lack of mucosal abrasion by ingesta. Several histologic findings that are likely normal in American pikas include splenic extramedullary hematopoiesis, thymic tissue in adults, and Clostridium sp. in the enteric lumen.

Clinical characterization of a hypersensitivity mixed bacterial and fungal dermatitis in a translational model of porcine NASH.

The development of animal models of chronic liver disease via diet modification is a promising avenue for translational research but can lead to unexpected side effects that impact model adoption. While these side effects are well characterized in rodent models of nonalcoholic steatohepatitis (NASH), limited knowledge of these effects exists for novel porcine models of NASH. To close this gap, the present study investigates the side effects of diet-based NASH induction in pigs, with a systematic analysis of the pathologic mechanisms underlying dermatitis development and evaluation of treatment approaches. Twelve pigs (10 large domestic pigs, 2 Goettingen minipigs) were fed a methionine- and choline-deficient, high-fat diet for 8 weeks to induce NASH. A retrospective review of each animal's clinical record was performed to identify the side effects of the diet. Following the identification of diet-associated dermatitis, severity was judged by using a novel gradation system that characterized the individual lesions and body regions resulting in a cumulative evaluation. In addition to this clinical assessment, the etiology of the dermatitis was investigated via histopathologic and microbiologic testing. Furthermore, the success of prophylactic and therapeutic treatment approaches was evaluated by considering dermatitis development and clinical course. All study animals demonstrated unexpected side effects of the methionine- and choline-deficient, high fat diet. In addition to marked dermatitis, study pigs showed impaired weight gain and developed steatorrhea and anemia. Based on the skin gradation system, five animals developed severe dermatitis, four animals moderate dermatitis, and three animals mild diet-associated dermatitis. Histological and microbiological evaluation of the affected skin showed signs of a hypersensitivity reaction with secondary infection by bacteria and fungi. The analysis showed that preemptive bathing extended the lesion-free duration by nearly 20 days. Furthermore, bathing in combination with a targeted antibiotic treatment represented a helpful treatment approach for diet-associated dermatitis. The provision of a methionine- and choline-deficient, high fat diet represents an effective approach for inducing NASH liver disease in pigs but predisposes study animals to multiple side effects. These side effects are universal to animals on study but can be adequately managed and do not represent a significant limitation of this model.

Equine multinodular pulmonary fibrosis and presumed corticosteroid‐induced side effects in a horse

SummaryEquine multinodular pulmonary fibrosis (EMPF) associated with herpesvirus‐5 infection (EHV‐5), is a severe, fibrosing interstitial lung disease of horses. Most common reported clinical signs are pyrexia, weight loss, depression, respiratory distress with tachypnoea and cough. Multiple tissue tropism of the EHV‐5 has been suggested. Treatment with valacyclovir and corticosteroids has been reported to be successful in a few cases, but the disease is usually associated with a poor prognosis because of progressive impairment of respiratory function. Corticosteroid administration can carry potential side effects, such as hypothalamic–pituitary–adrenal axis suppression, laminitis and increased susceptibility to infections. This report described a case of an 11‐year‐old gelding diagnosed with EMPF. The horse was treated with valacyclovir and corticosteroids and, after a transient initial improvement, showed a rapid deterioration of clinical signs and multiple complications, including severe bacterial dermatitis, liver damage and pleural effusion of unknown origin. A polymerase chain reaction (PCR) assay of liver biopsy sample was positive for EHV‐5, confirming the virus' multiple tissue tropism. A role of corticosteroids in exacerbating the disease progression and the increasing susceptibility to infections was strongly suspected.

Epidemiological study of bacterial dermatitis in dogs of Wayanad district

A survey was undertaken to determine the epidemiology of bacterial dermatitis in dogs presented at the Teaching Veterinary Clinical Complex (TVCC), College of Veterinary and Animal sciences Pookode, from April 2017 to June 2018. Dogs of all age groups, breeds and both sexes with clinical signs of dermatitis were included in the study. Sterile swabs were used to collect samples aseptically from the dogs that showed clinical lesions of canine bacterial dermatitis. Samples were taken for culture and isolation of bacteria was done. There was no statistically significant difference among different age groups, however the highest occurrence was observed among dogs between 1-3 years (39.44 %) and out of 71 animals, 39 (54.93 %t) male dogs were positive for bacterial dermatitis, but no statistically significance among different sexes was observed. Among the various breeds studied, the highest occurrence was noticed in Labrador retrievers (23.94 per cent) when compared to other breeds but no statistically significance difference among different breeds was observed. Identification of bacterial isolates was done based on colony character, Gram’s staining, oxidase test, catalase test, oxidative fermentative test and growth in specific media. A total of 71 bacterial isolates were obtained. Bacterial isolates obtained were Staphylococcus species (84.51 %), Streptococci (7.04%), Micrococci (5.63 %), and Pseudomonas species (2.82 %).

Prevalence and Clinico-Pathological Studies of Inflammatory Canine Skin Infections in Mumbai

Skin is largest organ of the body and forms a physical barrier between the animal and its environment. Thus, it is constantly exposed to variety of possible harmful agents. A soft lustrous coat and healthy skin not only is marker for overall well-being of any animal but also has an aesthetic value. The present study reviews prevalence and clinico-pathology of inflammatory skin infections of canines in Mumbai region. Out of 50 cases, 38 dogs were presented with inflammatory lesion. Out of these, highest occurrence observed was that of fungal dermatitis (15/38) followed by bacterial dermatitis (12/38), Malassezia (06/38) and demodicosis (05/38). Non-descript breed was most commonly affected. Highest occurrence was noticed in dogs under the age of 3 years. Male dogs were found to be overrepresented. Cytological examination revealed corneocytes, squamous cells, fungal hyphae, intracellular cocci bacteria, demodex mites, malassezia yeast and inflammatory cells. Histopathology revealed mainly acanthosis, parakeratosis, spongiosis and inflammatory cell infiltration.

REVIEW OF HISTOLOGIC LESIONS AND MORTALITY IN RIO CAUCA CAECILIANS (TYPHLONECTES NATANS) OVER A 22-YEAR PERIOD

Rio Cauca caecilians (Typhlonectes natans) are a unique, fully aquatic species of amphibian from the order Gymnophiona. They are housed in several zoological institutions and aquaria with limited information available regarding health and disease. This retrospective study evaluates common pathologic findings and causes of mortality of Rio Cauca caecilians from three different institutions over a 22-y period. Comparisons to previous medical health surveys were conducted with evaluation according to age class and sex to determine whether the primary causes of mortality and common histologic findings have remained similar over time and between institutions. Between 1997 and 2019, the 62 mortalities included males (15/62; 24.2%), females (26/62; 41.9%), and undetermined sex (21/62; 33.9%). The majority of examined individuals were adult (38/62; 61.3%), followed by juveniles (13/62; 21.0%), neonates (9/62; 14.5%), and undetermined age class (2/62; 3.2%). Thirteen (21.0%) individuals were euthanatized. Adult females (16/62; 25.48%) represented the largest group. In adults, the most common lesion and contributor to death was renal disease (28/38; 73.7%) followed by skin disease (16/38; 42.1%), including oomycete dermatitis (8/38; 21.1%) from Saprolegnia sp. Other common findings included bacterial dermatitis, gastrointestinal nematodiasis, and adrenal hyperplasia. This retrospective study will provide a useful reference to help guide veterinary care, management decisions, and collection management planning for this caecilian species in managed care.

Mechanism of Anti-Inflammatory and Antibacterial Effects of QingXiaoWuWei Decoction Based on Network Pharmacology, Molecular Docking and In Vitro Experiments.

Background and Aim: QingXiaoWuWei Decoction (QXWWD) is a traditional Chinese medicine that is commonly used in clinical settings to treat inflammatory and bacterial diseases. However, there is still a lot to learn about its molecular mechanism. A network pharmacology approach was applied to investigate the pharmacological mechanisms of QXWWD in inflammation treatment. Methods: The basic mechanisms involved in the anti-inflammatory and antibacterial potentials of QXWWD were identified using network pharmacology and molecular docking. The principal components of QXWWD were identified by the HPLC-Q-Exactive-MS method. The antibacterial bioactivity of QXWWD was further investigated using the Kirby-Bauer disc diffusion method and the determination of the minimum inhibitory concentration. The anti-inflammatory activity of QXWWD was evaluated using mice ear swelling test, RAW264.7 cell culture, and pro-inflammatory cytokines measurement. Skin irritation and HE staining were employed to evaluate the safety of QXWWD topical use and to depict the drug’s potential therapeutic function. The hub genes and signaling pathways associated with inflammatory and bacterial diseases were validated by western blot in addition to biochemical and pathological markers. Results: Our findings revealed that the ethanolic extract of QXWWD had a strong inhibitory effect against Staphylococcus aureus, Enterococcus faecalis, and Streptococcus pneumoniae. Meanwhile, QXWWD was potentially effective in suppressing ear swelling, elevated white blood cell counts, and the TNF-α, IL-1, and IL-6 levels. According to skin irritation, QXWWD was found to be safe when tested for topical application. The results of HE staining showed that the possible therapeutic role of QXWWD was related to the change in skin microstructure. Also, the network pharmacology, molecular docking as well as Q-Exactive-MS and HPLC analysis suggested that the synergistic effect of quercetin, luteolin and other ingredients could serve as main contributor of QXWWD for its anti-inflammatory and antibacterial activities. Moreover, the JUN, MAPK1, RELA, NFKBIA, MYC, and AKT1 were the potential identified key targets, and MAPK/PI3K/Akt was among the possibly involved signaling pathways in the anti-inflammatory and antibacterial activities of QXWWD. Conclusions: From a therapeutic standpoint, QXWWD may be a promising antibacterial and anti-inflammatory agent for the treatment of bacterial, acute, and chronic dermatitis.

Prevalence and clinical presentation of skin affections in donkey (Equus asinus) in Egypt

Objective: To document prevalence and clinical presentation of skin diseases in donkeys as well as to investigate predilections for the most common conditions. Design: Epidemiological study Animals: A total of 1134 donkeys at northern Egypt were investigated. Procedures: A questionnaire was constructed to verify the number of infected contact animals as well as the associated factors. Physical examination was carried out and the distribution of skin lesions was recorded. Skin scraping and biopsy were obtained to perform bacteriological, mycological and histopathological examinations. Results: Thirty-five (3.09%) Out of 1134 noticed donkeys had skin affections including mange (18/35; 51.42%), dermatophytosis (6/35; 17.14%), bacterial dermatitis (6/35; 17.14%) urticaria (2/35; 0.57%) and allergic dermatitis (3/35; 0.86%). Conclusion and clinical relevance: The mange and dermatophytosis are the prevalent skin diseases in donkeys. Contact with other animal species of contaminated environment may contribute to the occurrence of the diseases.

Psoroptic Mange in a Weaner Pig

Mange is a contagious skin disease affecting various groups of animals. Psoroptic mange is a severe skin condition of farm animals; it is highly contagious and is responsible for huge economic losses in many farm animals. Infestation with Psoroptes has been reported all over the world in various farm animals, but none has ever been reported in swine. A male weaner large white breed pig of age 3 months weighing 10kg was presented with skin lesions and areas of alopecia during a routine farm visit by the handlers. The alopecia was found around the thorax, abdomen and ear regions with severe pruritus, emaciation, wrinkling and thickening of the skin with heavy crust formation on abdomen and the ears, along with curling of the tongue with attending vocal loss noticed on close observations. A tentative diagnosis of mange was made with the following differential diagnosis: Allergic dermatitis, Bacterial dermatitis, Fly bite dermatitis, Hypovitaminosis. Further confirmatory diagnosis was done by collection of deep skin scrapping from which Psoroptes mites were demonstrated and a case of psoroptic mange diagnosed. To the best of our knowledge this is the first demonstration of Psoroptic mange in pigs. The affected animal was treated using Ivermectin (1%) and Long acting Oxytetracycline (20%). This case may be the first case in which psoroptic mange was reported in pigs with effective ivermectin control. More work should be done on the prevalence and possible molecular characterization of Psoroptic mites on pigs across the globe to ascertain if there are other strains that can affect pigs.
 Key words: Psoroptes mite, Mange, Ivermectin, and Pigs

Presumptive heterophil extracellular traps recognized cytologically in nine reptile patients with inflammatory conditions

Background Neutrophil extracellular traps (NETs) represent a novel cellular mechanism of antimicrobial defense activity. Intravascular neutrophils produce extracellular web-like structures composed of chromatin, histones, and cytoplasmic granule proteins to attack and kill microbes. They may impact both pathogen and host; NETs correlate strongly with disseminated intravascular coagulation and mortality in critically ill humans. The mechanism was first discovered in human neutrophils in 2004. Presumptive heterophil extracellular traps (HETs) in a non-avian reptile species were first described in blood films of a gopher tortoise with systemic inflammation. Objective While prior reports are limited to blood film review and in vitro studies, this descriptive case series highlights the cytological identification of presumptive HETs in nine reptile patients. Methods Subjects included six gopher tortoises, one blood python (Python curtus), one Burmese python (P. bivittatus), and one desert king snake (Lampropeltis getula splendida). All six gopher tortoises (Gopherus polyphemus) had upper respiratory disease with bacterial etiology (including Helicobacter sp. and/or Mycoplasma sp.), and snakes had upper respiratory tract infection confirmed with serpentovirus (n = 2) or bacterial dermatitis (n = 1). Results Cytology samples with identified HETs included tissue imprints (n = 4), nasal discharge (n = 3), an oral swab (n = 1), and a fine needle aspirate of a skin lesion (n = 1). The identification of specific bacterial (n = 6) and/or viral pathogens (n = 2) was notable. Clinical relevance To the authors’ knowledge, this is the first report of presumptive HETs recognized in reptile cytology specimens, suggesting an active cellular process in vivo in response to systemic inflammation in non-avian reptiles, and contributing to further understanding of extracellular traps in these species.

Healthcare-seeking behaviour in reporting of scabies and skin infections in Ghana: A review of reported cases.

Scabies is a neglected tropical disease. In resource-poor settings, scabies and other skin infections are often unreported to a health centre, or misdiagnosed. Dermatological expertise and training are often lacking. Little is known about patient healthcare-seeking behaviour. This study reviewed diagnosed skin infections reported to urban (Greater Accra) and rural (Oti region) study health centres in Ghana over six months in 2019. Study staff received classroom and clinical dermatology training. Skin infection diagnoses and anonymised patient information were recorded. Descriptive statistics and spatial analysis described patient demographics, and distance travelled to clinic, noting bypassing of their nearest centre. Overall, 385 cases of skin infections were reported across the Greater Accra and Oti study clinics, with 45 scabies cases (11.6%). For scabies, 29 (64.4%) cases were in males. Scabies was the third most common diagnosis, behind bacterial dermatitis (102, 26.5%) and tinea (75, 19.5%). In the rural Oti region, 48.4% of patients bypassed their nearest clinic, travelling a mean 6.2 km further than they theoretically needed to. Females travelled further in comparison to males.

Preliminary dose escalation results from a phase I/II, first-in-human study of MGC018 (anti-B7-H3 antibody-drug conjugate) in patients with advanced solid tumors.

3071 Background: Antibody-drug conjugates (ADCs) are cancer agents that have a cytotoxic payload linked to a monoclonal antibody (mAb) that target cancer cells. ADCs offer increased cytotoxic activity while reducing normal tissue exposure. B7-H3 is expressed on multiple solid tumors with limited normal tissue expression. MGC018 is an investigational ADC with a duocarmycin payload linked to an anti-B7-H3 mAb. It is hypothesized that MGC018 has activity against B7-H3 expressing tumors with an acceptable safety profile. Methods: This study evaluates safety, dose-limiting toxicities (DLT), and maximum tolerated dose (MTD) of MGC018 in a dose escalation 3+3+3 design. In addition, pharmacokinetics, immunogenicity, and tumor response using RECIST v1.1 are evaluated. Cohort expansion will enroll at the MTD to assess safety and tumor response. Results: The study is enrolling Cohort 3 (6 total cohorts planned) in dose escalation. 20 patients (pts) were enrolled as of Feb 03, 2020. At least 1 treatment related adverse event (TRAE) occurred in 16 pts (80.0%). The most common TRAEs were neutropenia/decreased neutrophil count (35%); fatigue, lymphopenia/decreased lymphocyte count (30.0%); palmar plantar erythrodysaesthesia (PPE), skin hyperpigmentation (25.0%); pruritis, nausea, chills, infusion related reaction (20.0%); and vomiting, pyrexia, maculopapular rash (15.0%). Eleven pts (55.0%) experienced TRAEs ≥ Grade 3; events were decreased lymphocyte count/lymphopenia (n = 6), decreased neutrophil count/neutropenia (n = 3), PPE (n = 2), and maculopapular rash (n = 2). Three related serious adverse events occurred in 3 unique pts: pneumonitis in a pt with concurrent bacterial pneumonia, non-infectious gastroenteritis, and stasis dermatitis in a pt with chronic venous insufficiency. One DLT has occurred (Grade 4 neutropenia). No febrile neutropenia was observed. Target lesion decrease was noted in 1 pt each with small cell lung cancer (-6.3%), non-small cell lung cancer (-23.8%), and metastatic castrate-resistant prostate cancer (mCRPC) (-29.4%) with PSA change from 82.8 ng/ml to 57.1 ng/ml. One mCRPC pt with bone only disease had substantial improvement on bone scan and PSA decrease from 60 ng/ml to 4.7 ng/ml. Conclusions: Results to date demonstrate a manageable safety profile with early evidence of clinical activity. Continued dose escalation and clinical investigation of MGC018 is ongoing. Clinical trial information: NCT03729596 .

<p>Inverse Psoriasis: From Diagnosis to Current Treatment Options</p>

Inverse psoriasis represents a clinical variant of psoriasis that is sometimes difficult to diagnose due to its clinical similarity with other skin disorders involving the folds, mainly including mechanical intertrigo, fungal and bacterial infections, contact dermatitis, seborrheic dermatitis, and lichen planus. Dermoscopy represents a useful tool for an enhanced non-invasive diagnosis. The treatment of inverse psoriasis may be challenging and include topical corticosteroids, topical calcineurin inhibitors, vitamin D analogs, traditional oral systemic therapies such as cyclosporine and methotrexate, and biologic therapies.

Onicodistrofia lupóide simétrica canina como manifestação da psora latente: relato de caso

Symmetrical Lupoid Onycodystrophy (SLO) is a unusual immuno-mediated pathology with idiopathic etiology that can affect canine species. Differential diagnosis includes fungal, bacterial and autoimmune dermatitis and neoplasia. Histopathology is the main diagnostic technique, although it demands on the distal phalanx amputation. There are no predispositions regarding to dog’s breeds and the age of ill dogs can be from 3 to 8 years old. Clinical management can take up to six months to show some effect and has a uncertain prognosis. Homeopathy aims to patient well-being and miasm dynamics must be comprehended in order to set a correct prognosis evaluation. This article reports a canine clinical case with physycal and behavioural disturbances which, treated by its Simillimum (high-diluted medicine chosen by the similia principle), expressed the SLO as a latent psora manifestation and reached a cure status later. Homeopathy figure out as a great option to treat this illness condition.

Skin lesions caused by Orthopoxvirus in children.

IntroductionThe global eradication of smallpox and abandonment of mandatory smallpox vaccination has led to an increased proportion of the population who are immunologically naïve to infections caused by Orthopoxviruses (OPV).AimTo present the different courses of OPV infection in children and to highlight the diagnostic difficulties in their differentiation from the other inflammatory processes.Material and methodsWe retrospectively evaluated the medical documentation of 5 children with OPV infection. Clinical diagnosis of OPV infection was based on evaluation of animal contact and skin symptoms, characterised by either a single ulcer or disseminated lesions. In all five cases, blood samples and skin swabs were collected from the lesion(s) to identify specific OPV DNA fragments (Vgf, b9R and D11L genes) using PCR.ResultsTwo children presented with high fever, a single ulcer on the skin and local lymphadenopathy. The three other patients were in good general health and their skin lesions presented as a disseminated vesicular rash. Using the Vgf gene as the target for PCR, OPV infection was confirmed in material collected from skin lesions of all children and in blood samples of 4 children. The B9R and d11L genes tested positive in the skin material of 2 children and blood samples of 2 children. All analysed patients presented a history of ineffective antibiotic therapy.ConclusionsIn the case of unclear necrotising skin lesions in children, the primary diagnosis always includes bacterial dermatitis. However, if the patient has come into contact with animals, diagnosis of OPV infection should also be considered.

Changes in the cytokine profile and its correction in dogs with bacterial dermatitis

One of the most frequent pathologies that a veterinarian encounters in practice is dermatitis of various etiologies. According to statistics, the number of visits of patients with dermatological diseases increases every year. One of the factors provoking the susceptibility of an animal to allergens is the current environmental conditions.Treatment of skin infections and allergies in domestic animals remains a problem that needs to be addressed. It is known that an important component of the pathogenesis of allergic dermatitis accompanied by further infectious, in particular bacterial dermatitis, is the cytokine factor. The aim of the work is to study the level of the main classes of cytokines in bacterial eczema and the effect of Apoquel on the change in these indicators.

Method of Prevention of Bacterial Dermatitis During Adhesive Strapping of Infantile Umbilical Hernia

Method of Prevention of Bacterial Dermatitis During Adhesive Strapping of Infantile Umbilical Hernia

Myxobolus axelrodi n. sp. (Myxosporea: Myxobolidae) a parasite infecting the brain and retinas of the cardinal tetra Paracheirodon axelrodi (Teleostei: Characidae)

An investigation of mortalities in a group of cardinal tetras Paracheirodon axelrodi Meyers, 1936, a popular ornamental fish, revealed myxozoan parasites in ventricles of the brains in 3/10 fish and the ocular retina of a fourth. Parasite impacts were unclear, as additional histopathological findings were present, including bacterial dermatitis and meningitis. Ethanol-preserved specimens pooled from multiple fish were used for morphological characterization of myxospores. Elongate, teardrop myxospores were 20.5 ± 0.7-μm (mean ± SD; range = 19.0-21.8μm) long, 6.6 ± 0.5-μm (5.7-7.9μm) wide, and 5.1 ± 0.4-μm (4.8-5.9μm) thick (valvular width). Two, unequally sized, apical, pyriform polar capsules were in the same plane as the sutural ridge. The larger measured 9.9 ± 0.8-μm (8.0-11.2μm) long and 3.8 ± 0.3-μm (3.2-4.8μm) wide. The smaller was 4.1 ± 0.3-μm (3.5-4.5μm) long and 2.0 ± 0.1-μm (1.8-2.3μm) wide. Identical 1912bp 18S rRNA sequences were obtained from two pooled spore samples from tetra brains, which did not match any sequences in the NCBI nr/nt database. Phylogenetically, these parasites grouped loosely within a clade containing Myxobolus spp. from other South American characins and Unicauda spp. from siluriform catfish. Myxospores shared some morphological similarities with Myxobolus inaequus from the unrelated glass knifefish (Order: Gymnotiformes), but were genetically divergent (<85% similarity) from other myxozoan parasites of South American characins and shared few morphological features or tissue predilection sites. Based on host and tissue tropism, spore morphology, and 18S rRNA sequencing, we report this isolate as a previously unknown species, Myxobolus axelrodi n. sp.

A RETROSPECTIVE STUDY OF CAUSES OF SKIN LESIONS IN WILD TURKEYS (MELEAGRIS GALLOPAVO) IN THE EASTERN USA, 1975-2013.

Skin lesions of Wild Turkeys ( Meleagris gallopavo ) are a common cause of concern to wildlife biologists and the general public and are a frequent reason for submission to diagnostic laboratories. The purpose of this retrospective study is to evaluate the causes, occurrence, and epidemiologic patterns of skin lesions in Wild Turkeys in the eastern US. Skin lesions were diagnosed in 30% (n=199) of the 660 Wild Turkey samples submitted to the Southeastern Cooperative Wildlife Disease Study diagnostic service from 1975 to 2013. Avian pox was the most frequent cause of skin lesions (66%, n=131), followed by bacterial dermatitis (22%, n=44), ectoparasitism-related dermatitis (3%, n=6), fungal dermatitis (2.5%, n=5), and neoplasia (2.0%, n=4). Although the gross appearance of skin lesions is often insufficient to determine the etiology, the anatomic distribution of lesions and temporal occurrence of certain diseases may offer insights into likely causes. Cases with lesions involving or restricted to the head and neck were much more likely to be caused by avian pox than other etiologies. Similarly, lesions restricted to the feet were more likely to be of bacterial origin. Skin lesions observed in the fall and winter were more likely to be caused by avian pox, whereas bacterial dermatitis was more frequently observed in the spring and summer. This retrospective study provides a summary of the causes of skin lesions in Wild Turkeys and serves as a useful reference to diagnosticians and biologists when evaluating Wild Turkeys with skin lesions.

P-234 YI A Case Study

Inflammatory bowel disease (IBD) is a disease that affects the intestinal tract via an inflammatory process. Patients may have extraintestinal manifestations that can be just as debilitating as the intestinal inflammation itself. The skin is one of the most commonly affected organ systems in patients who suffer from IBD. (Skin Manifestations of Inflammatory Bowel Disease; Brian L. Huang,1 Stephanie Chandra,2 and David Quan Shih2). This is a single case study of a 37-year-old female with Crohn's disease for 23 years that went on vacation to Puerto Rico for 9 days. The day after returning, she developed a red, itchy, papular rash that lasted for over 14 months. She was in clinical remission with Humira and 6MP at the time of the rash. This case study raises the question, is gut flora in IBD patients causing skin rashes? Is this a case of Bacterial Associated Dermatitis caused by bacterial overgrowth? During the 14 months, the patient was seen by multiple specialty providers, had an ER visit, urgent care visits and 1 hospitalization. Skin biopsies were inconclusive, suggesting allergic reaction to bug bite or dermatitis. Colonoscopy and EGD showed mildly active Crohn's ileitis. All testing for infectious diseases were negative. She was treated with Valtrex, Vancomycin, Doxycycline, Permethrin cream, clindamycin foam, and triamcinolone cream, Hydroxyzine, Benadryl. She also had multiple sinus infections during this time and was treated with Levaquin, Biaxin orally and Vancomycin with Mupirocin nasal rinses. She was also treated with Diflucan for yeast infections due to the multiple antibiotics. After conventional treatments did not have any improvement, the patient decided to do an elimination diet for 30 days and start a probiotic. The patient's rash cleared up after the 30 day elimination diet and has remained significantly better with diet control. She has added almost everything back into her diet in moderation. She will occasionally break out with the rash. A correlation to a specific food has not been made. The patient continues on Probiotic daily, along with Humira and 6MP for her Crohn's disease. There are still too many unknowns regarding IBD and rashes. Was this triggered by long term Anti-TNF therapy? Is this part of the disease process? Is it diet related? Is it Bacterial Associated Dermatitis? The case shows the need for further research regarding unknown rashes occurring more frequently in IBD patients. Moving forward, I suggest creating a database for patients with IBD and rashes to gain understanding of why rashes are occurring more and what treatments are being used.