CHAPTER 29 KERATINIZATION (CORNIFICATION) DISORDERS 439
COMMENTS
Corticosteroids: may be used judiciously to control inflammation; mask signs of bac-
terial folliculitis and prevent accurate diagnosis of primary disease.
Vitamins A and D analogs: side effects can be severe; patients should be referred to a
dermatologist for treatment.
Antibiotics and topical therapy: monitor response every 3 weeks; patients may
respond differently to various topical therapies.
Seasonal changes, development of additional diseases (e.g., cutaneous hypersensitiv-
ity), and recurrence of bacterial folliculitis: may cause previously controlled patients
to worsen; reevaluation critical for determining whether new factors are involved and
whether changes in therapy are necessary.
Endocrinopathy: routine treatment monitoring; see specific chapters.
Selective autoimmune disorders: reevaluate frequently during the initial phase of
induction; less often after remission; clinical evaluation and laboratory data required;
see specific chapters.
Immunosuppressive therapy: monitor hemograms, serum chemistries, and urinalysis
with culture.
Retinoid drugs: monitor serum chemistries, including triglycerides, and tear produc-
tion.
Ketoconazole: monitor serum chemistries.
Skin aging may worsen keratinization disorders or increase frequency of relapses.
Dermatophytosis and several ectoparasites have either zoonotic potential or the abil-
ity to produce lesions in human beings.
Systemic retinoids: extreme teratogen; do not use in intact females because of severe
and predictable teratogenicity and the extremely long withdrawal period; women of
child-bearing age should not handle this medication.
Synonyms
Keratinization disorders=cornification disorders, seborrhea, idiopathic seborrhea,
keratinization defect, dyskeratinization, and incorrect human terms (eczema, psori-
asis, dander, dandruff); sebopsoriasis: appropriate term to describe the similarities
between some human and canine keratinization defects.