Dermatology

1.1 Explain the function and properties of the skin of companion animals 1.2 Outline skin and hair follicle morphogenesis 1.3 Describe gross skin anatomy and physiology including 1.3.1 Skin pH 1.3.2 Hair, hair cycle, hair colours 1.3.3 Voight, Blaschko and Tension lines 1.3.4 Footpad and claw 1.4 Discuss microscopic skin anatomy and physiology 1.4.1 Epidermis (stratum basale, stratum spinosum, stratum granulosum, stratum lucidum and stratum corneum) including basic knowledge of stratum corneum formation / desquamation and protective function as well as awareness of other resident cells such melanocytes, Langerhans cells and Merkel cells 1.4.2 Epidermopoiesis, keratogenesis and melanogenesis (superficial knowledge) 1.4.3 Basement membrane zone and their components (superficial knowledge) 1.4.4 The different types of adhesion structures (superficial knowledge) 1.4.5 Dermis 1.4.6 Adnexal structures including hair follicles and glands and thermoregulation 1.4.7 Vascular and neurological supplies to the skin including specialised sensory structures 1.5 Describe the pathological processes occurring in skin disease 1.5.1 Epidermal pathology (e.g. hyperplasia, acanthosis, hypergranulosis, hyperkeratosis, parakeratosis, lichenification, hyper- and hypopigmentation, depigmentation, epidermal separation and damage) 1.5.2 Inflammatory dermal diseases (e.g. nodules, granulomas, erythema, dermatitis) 1.5.3 Hair follicle pathology (e.g. folliculitis, furunculosis, atrophy, dysplasia) 1.6 Explain how pathological processes relate to clinical signs and the diagnosis of disease 1.7 Define hypersensitivity reaction types I, II, III, IV in the skin and give examples of specific skin diseases involving these processes 1.8 Explain the response of skin to physical, chemical and microbiological insults 1.9 Describe the pathogenesis of skin neoplasia (fundamentals of cancer biology including involvement of cell cycle, oncogens, tumour suppressor genes such as p53

2.1 Explain how to take an accurate clinical history and understand its interpretation in the diagnosis of skin disease. 2.2 Explain how to perform a general physical examination. 2.3 Carry out a detailed examination of the skin. 2.4 Accurately identify and describe skin lesions. 2.5 Describe key diagnostic tests (e.g. skin scraping, hair examination, skin cytology including Tzanck preparation, Wood’s lamp examination, collecting samples for bacterial and fungal culture, diascopy, Nikolsky sign, fine needle aspirate) and their use 2.6 Explain the pros and cons of intradermal testing and allergen serology in the management of atopic dermatitis.

3.1 Describe techniques to collect skin biopsies, sample processing, storage and recording. 3.2 Describe the basic cytology of samples collected from the skin including masses and discharging sinuses. 3.3 Interpret clinical laboratory medicine information in relation to skin disease, including: haematology, biochemistry and endocrine tests, fluid and electrolyte disorders and cytology 3.4 List the diagnostic tests for viral, fungal, protozoal and bacterial diseases (techniques and interpretation) 3.5 Explain the principles of the use of pattern analysis by histopathologists in dermatohistopathology as it relates to pathogenesis, disease and diagnosis. 3.6 Interpret histopathology reports.  

Alopecia 4.1 Describe the pathogenesis of alopecia 4.2 Identify the clinical features of alopecia 4.3 Recognise the differential diagnosis of alopecia and discuss specific conditions (e.g. follicular dysplasia, telogen and anagen effluvium, ectodermal dysplasia, pattern alopecia, colour dilution alopecia, traction and post-clipping alopecia, cyclic flank alopecia, paraneoplastic alopecia, degenerative mucinotic mural folliculitis) 4.4 Outline how to investigate alopecia using a problem-solving approach 4.5 Discuss treatment of alopecic conditions Keratinisation disorders 4.6 Describe the pathogenesis of keratinisation disorders/scaling 4.7 Identify the clinical features of keratinisation disorders 4.8 Recognise the differential diagnosis of keratinisation disorders and discuss specific conditions (e.g. ichthyosis, canine seborrhoea, sebaceous gland dysplasia, sebaceous adenitis, zinc -responsive dermatosis, Vitamin A responsive dermatosis, nasodigital hyperkeratosis, schnauzer comedone syndrome, ear margin seborrhoea, tail gland hyperplasia, feline acne, idiopathic facial dermatitis in Persian cats, metabolic, endocrine and neoplastic causes of scaling) 4.9 Outline how to investigate scaling diseases using a problem-solving approach 4.10 Discuss treatment options for keratinisation disorders Pigmentary changes 4.11 Describe the pathogenesis and clinical features of pigment changes, genetic or acquired, resulting in hypo- or hyperpigmentation 4.12 Recognise the differential diagnosis for pigmentary changes including specific conditions (e.g. lentigo, albinism, piebaldism, melanoderma and alopecia of the Yorkshire terrier) 4.13 Outline how to investigate pigment changes using a problem-solving approach 4.14 Discuss treatment options for pigmentary changes

6.1 Explain the biology of tumours. 6.2 Recognise common neoplastic presentations (localised, diffuse and systemic) 6.3 Demonstrate knowledge of the following types of neoplasia: neoplasia of skin structures (benign, malignant) (e.g. mast cell tumours, lymphoma, squamous cell carcinoma and their variants, mammary tumours, testicular tumours) 6.4 Recognise neoplasia of other structures with involvement of the skin (e.g. metastatic pulmonary adenocarcinoma in cats, nodular dermatofibrosis syndrome, superficial necrolytic dermatitis) 6.5 Recognise paraneoplastic syndromes (e.g. feline paraneoplastic alopecia, and thymoma associated exfoliative dermatitis in cats) 6.6 Formulate an approach to the diagnosis and staging of disease. 6.7 Recognise those conditions that could be confused with neoplasia e.g. autoimmune diseases 6.8 Identify the treatment options available (cytotoxic and noncytotoxic medication / chemotherapy / radiation) and the prognosis for different neoplasms.

7.1 Describe the anatomy of the pinna, external ear canal, bulla and inner ear including specialised glands and normal microbial flora and microbiome of the ear canal 7.1.1 Recognise the causes of otitis externa (predisposing, primary, secondary and perpetuating factors), otitis media and otitis interna as well as the clinical signs 7.1.2 Explain in detail the diagnostic procedures and treatment regimens of otitis externa, media and interna 7.2 Discuss the pathophysiology, clinical signs, how to achieve a diagnosis, and therapy for each condition affecting the pinnae in dogs and cats (including aural haematoma, auricular chondritis, ear margin seborrhoea, proliferative thrombovascular necrosis of the pinnae, feline proliferative and necrotising otitis externa and ceruminous cystadenomatosis) 7.3 Discuss the aetiology, clinical signs, diagnostic approach and therapy of infectious, parasitic, immune-mediated and neoplastic eyelid disease

8.1 Discuss the immune system and immune response by the skin 8.2 Describe urticaria and angioedema, allergic contact dermatitis, flea bite hypersensitivity, canine cutaneous adverse food reaction (CAFR), canine CAFR with concurrent atopic dermatitis, canine atopic dermatitis, feline atopic syndrome and feline atopic skin syndrome 8.3 Review the underlying pathogenesis, clinical signs, diagnostics and treatment options for allergic skin disease 8.4 Outline the different treatment modalities for canine and feline allergic skin diseases

9.1 Discuss in depth the structure and function of the skin immune system and the current theories of mechanisms that may lead to auto-immune disease 9.2 Explain the innate and adaptive immune response 9.3 Recognise the revised classification of auto-antibody-mediated autoimmune skin diseases in dogs and cats from 2018: 9.3.1 Antikeratinocyte autoimmune skin diseases (AISDs): • Pemphigus foliaceus • Pemphigus erythematous • Pemphigus vulgaris • Paraneoplastic pemphigus • Pemphigus vegetans (superficial knowledge) • IgA pemphigus (superficial knowledge) 9.3.2 Antibasement membrane AISDs: • Bullous pemphigoid • Mucous membrane pemphigoid • Linear IgA disease (superficial knowledge) • Pemphigoid of Gestation (superficial knowledge) • Epidermolysis bullosa acquisita • Type 1 bullous systemic lupus erythematosus • Junctional Epidermolysis bullosa acquisita • Mixed autoimmune subepidermal blistering disease 9.3.3 Demonstrate knowledge about aetiology including autoantigens targeted by autoantibodies, signalment, clinical signs, differential diagnoses, diagnostic approach and therapy of antikeratinocyte and antibasement membrane AISDs 9.4 Recognise the current (recommended/suggested) classification of lymphocyte-mediated autoimmune skin diseases in dogs and cats: 9.4.1 Antikeratinocyte AISDs: • Vesicular cutaneous lupus erythematous (VCLE) • Exfoliative cutaneous lupus erythematous (ECLE) • Discoid lupus erythematosus (facial, classic) (DCLE) • Discoid lupus erythematosus (generalized (GCLE) • Mucocutaneous lupus erythematosus (MCLE) 9.4.2 Antimelanocyte AISDs: • Uveodermatological (Vogt-Koyanagi-Harada) syndrome (VKH) • Vitiligo 9.4.3 Antifollicular AISDs: • Alopecia areata • Pseudopelade 9.3.4 Antisebaceous AISDs • Sebaceous adenitis 9.3.5 Demonstrate knowledge about aetiology, signalment, clinical signs, differential diagnoses, diagnostic approach and therapy for antikeratinocyte, antimelanocyte, antifollicular and antisebaceous AISDs 9.5 Explain the pathogenesis, clinical features, diagnostic approach and treatment options of immune-mediated diseases in which a dysregulated immune-response to exogenous antigens - but not self-antigen(s) - develops or fails to abate such as cutaneous adverse drug reaction, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, cryoglobulinemia and cryofibrinogenaemia. 9.6 Discuss immunosuppressive and immunomodulating drugs such as glucocorticoids, ciclosporin, tacrolimus, chlorambucil, azathioprine, mycophenolate mofetil, leflunomide, dapsone and human immunoglobulin and their application to the management of canine and feline immune-mediated disease; identify their properties, their synergistic immunosuppressive effects, their potential side effects and potential drug interactions.

10.1 Recognise the clinical pathology of the major bacterial, viral, protozoal, fungal and parasitic diseases (mites, insects and ticks) affecting the skin of companion animals in the UK and Europe including vector-borne diseases such as leishmaniosis. 10.2 Identify zoonotic diseases and their health and safety concerns and precautions to be taken. 10.3 Discuss preventative healthcare measures that can be implemented for infectious or parasitic skin conditions. 10.4 Discuss treatment measures for bacterial, viral, protozoal, fungal and parasitic skin conditions. 

11.1 Describe the normal skin anatomy of exotic species (rabbits and rodents, reptiles and cage birds) 11.2 Recognise the importance of husbandry (housing, environment andnutrition) on the dermatological health of these species 11.3 Define ecdysis/dysecdysis in reptiles 11.4 Identify the common conditions seen in rabbits and rodents, reptiles and cage birds and their pathogenesis, clinical features, differential diagnosis, investigation and treatment of them

12.1 Describe the nutritional supply to the skin and how deficiencies or excess in nutrients can lead to skin diseases 12.2 Demonstrate a basic knowledge of the role of nutrients (including essential amino acids, EFAs, vitamins and minerals) in metabolism and their importance to skin biology and pathology 12.3 Discuss the pathophysiology of nutritional skin disorders, breed predispositions, mode of inheritance if known, the clinical signs associated with these diseases, diagnostic tests to confirm diagnosis and treatment options 12.4 Explain the pathogenesis and clinical features of genetic (caused by mutant alleles), congenital (present at birth due to genetic defect) and hereditary skin conditions (can be congenital or tardive) 12.4.1 Recognise the differential diagnosis of genetic, congenital and hereditary conditions and the approach to investigations and treatment 12.5 Identify diseases due to physical agents, chemical agents, ultraviolet radiation, temperature change, and trauma, their clinical features and treatment options 12.6 Discuss the aetiology, clinical features, diagnosis and treatment of unusual and rare skin conditions such as cicatricial alopecia/scleroderma, feline hypereosinophilic syndrome, lichenoid keratosis, sterile nodular panniculitis, sterile granuloma/pyogranuloma syndrome, eosinophilic dermatitis and oedema (“Wells’ syndrome”), sterile neutrophilic dermatosis (“Sweet syndrome”), feline idiopathic ulcerative dermatitis, plasma cell pododermatitis

13.1 Identify different type of wounds and wound healing (dressings / topical treatment options) 13.2 Explain the medical and surgical management of wounds 13.3 Describe surgery of the anal sacs 13.4 Explain why some dermatological conditions become surgical (skin fold dermatitis, otitis externa/media, pododermatitis) or may benefit from laser therapy 13.5 Describe the principles of ear surgery (which techniques to use and when)

14.1 Explain the pathogenesis, clinical features, diagnostic approach and treatment options of diseases affecting the interdigital skin and/or footpads (e.g. familial foot pad hyperkeratosis, idiopathic nasodigital hyperkeratosis, vasculitis, viral papillomas, feline plasma cell pododermatitis, canine split paw pad disease, interdigital granulomas (“cysts”), granulomatous pododermatitis, pododemodicosis, corn formation in greyhounds) 14.2 Explain the pathophysiology, clinical signs, investigations and therapy of diseases affecting the claws and/or claw bed including neoplastic processes (e.g. squamous cell carcinoma, melanoma, mastcell tumour, keratoacanthoma); bacterial, parasitic and fungal diseases; symmetric lupoid onychitis, feline lung-digit syndrome 14.3 Describe anal sac diseases including inflammatory and neoplastic processes as well as anal furunculosis in dogs 14.3.1 Identify investigations needed to accomplish a diagnosis and be familiar with therapeutic options

5.1 Describe the physiology of the endocrine system (e.g. thyroid physiology, hormonal secretion of hypothalamus and hypophysis) 5.2 Explain the underlying pathogenesis, clinical signs, diagnostics and treatment options of the more common endocrine diseases (e.g. hypothyroidism, natural/spontaneous and iatrogenic hyperadrenocorticism, pituitary dwarfism, acromegaly, sex hormone dermatoses) 5.3 Describe metabolic diseases (e.g. xanthoma, calcinosis cutis and circumscripta superficial necrolytic dermatitis), their aetiology, andhow to diagnose and treat these diseases