CHAPTER 32 MALASSEZIADERMATITIS 483
CBC/biochemistry to detect underlying diseases (e.g., hypothyroidism, hyperadreno-
corticism).
Ultrasonography and radiography to investigate possible internal malignancy.
Histopathology:
Less sensitive method of diagnosis than cytology due to loss of superficial yeast
during processing
Considered significant if yeast organisms are found within the infundibulum andinterspersed within the stratum corneum
Superficial perivascular to interstitial dermatitis, accumulation of mast cells atthe dermal-epidermal junction, lymphocytic exocytosis, and parakeratosis
Concurrent bacterial folliculitis.THERAPEUTICS
Identify and treat any predisposing factors or underlying diseases.
Topical Therapy
Necessary component of the treatment since yeast organisms are located in the stra-
tum corneum.
Recommended twice weekly during active treatment; weekly maintenance in chronic
cases.
Antiseptic shampoo treatment: removes scale, exudation, and malodor; kills yeast and
bacterial organisms.
Active ingredients in creams/ointments/wipes: miconazole, clotrimazole, climbazole,
ketoconazole, terbinafine.
Active ingredients in shampoo/rinse therapy: sodium hypochlorite, chlorhexidine,
ketoconazole, miconazole, selenium sulfide, enilconazole, lime sulfur, acetic and
boric acids.Systemic Therapy
Ketoconazole: 5–10 mg/kg PO q24h for 2–4 weeks; discontinue or taper to the lowest
possible or pulse dose; dogs only.
Fluconazole: 5 mg/kg PO BID for 2–4 weeks; discontinue or taper to the lowest pos-
sible or pulse dose (dogs and cats).
Itraconazole: 5 mg/kg PO q24h for 2 consecutive days and repeated weekly for 3–4
weeks (small dogs and cats).
Terbinafine: 30–40 mg/kg PO q24h for 3 weeks; discontinue or taper to the lowest
possible or pulse dose (dogs and cats).
Precautions/Interactions
Ketoconazole: may cause gastrointestinal upset; masks signs of hyperadrenocorticism
and interferes with adrenal function tests by blocking cortisol production; strong