Chapter 1 – Intertrigo: Prevention, Work-Up, and When (Not) to Use Antibiotics (00:12) John welcomes Dr Laura Buckley (Senior Lecturer, Veterinary Dermatology, University of Liverpool) and asks what “brachycephalic” means and which breeds it covers. Laura explains shortened muzzles and broad, domed heads; the most extreme include French and British Bulldogs, Pugs and Boston Terriers, with Cavaliers, Chihuahuas and Dogue de Bordeaux also affected. (01:44) Sue notes their huge popularity in UK primary care. Laura adds that around 40% of her clinic can be French Bulldogs, with brachycephalics a very large overall share. (02:22) Sue asks which skin problems are most common. Laura explains that atopic dermatitis and otitis (externa/media) lead, with interdigital furunculosis also frequent. Cavaliers often show primary secretory otitis media. Skin-fold dermatitis (intertrigo) and muzzle furunculosis are common, and lesions can form over bony prominences where itchy dogs rub. (04:17) Sue asks what intertrigo is and why brachys get it. Laura explains shortened muzzles leave redundant skin that folds around eyes and muzzle, creating humid, low-airflow pockets that accumulate keratinous/sebaceous debris. Microbial overgrowth follows; bristly coats plus rubbing traumatises follicles and escalates inflammation. (06:04) Sue asks about prevention. Laura suggests daily fold hygiene from the start: clean away debris; consider antiseptic wipes (e.g., chlorhexidine) once or twice daily, and increase during flare-prone periods. (07:14) Sue highlights how early routines improve compliance and handling; Laura agrees it gives a “head start,” especially as atopy often appears within the first three years. (08:31) John asks how early disease presents and how to work it up. Laura explains earliest signs are diffuse erythema in the fold, then partial/complete alopecia, erosion/ulceration, crusting; severe untreated cases may progress to folliculitis and even deep pyoderma. (10:05) Sue asks about cytology. Laura explains it’s pivotal: expect keratinous debris with cocci (staphylococci) or Malassezia in overgrowth; neutrophils with intracellular bacteria indicate infection and guide therapy. (11:05) John asks if systemic antibiotics are ever needed. Laura explains they’re rarely indicated: most cases respond to topical antiseptics/antimicrobials plus strong anti-inflammatory control. Consider systemic antibiotics only for genuine deep, painful, draining pyoderma, immunosuppression, poor feasibility for topicals, or proven topical failure - always post culture & susceptibility. (14:11) John asks how she controls inflammation. Laura uses topical glucocorticoids (often in combination products). For severe inflammation, short anti-inflammatory courses of prednisolone (~0.5–1 mg/kg for a few days before tapering) can calm tissue so topicals can work. (15:07) Sue asks about long-term routines and when to consider surgery. Laura advises daily fold cleaning (once–twice daily) and twice-weekly topical anti-inflammatories (e.g., hydrocortisone aceponate or mometasone) with minimal systemic absorption; discuss surgery if medical care is impractical, or if maintenance fails with frequent relapses or recurrent infections. Chapter 2 – Viral Pigmented Plaques (VPP) (17:40) John moves to VPP and asks which brachy breeds are affected. Laura most often sees Pugs, plus Boston Terriers, Chihuahuas and French Bulldogs. (18:51) Sue asks what they look like. Laura describes numerous, heavily pigmented, slightly raised plaques that may begin flatter and become scaly, verruciform and hyperkeratotic over time. (19:28) Sue asks how to differentiate melanoma. Laura says biopsy/histopathology is the diagnostic choice; FNAs from plaques are often low-cellularity keratinocytes, whereas melanoma cytology differs. (21:23) John asks if plaques regress. Laura explains most persist or increase, likely due to a virus-specific, genetically influenced immunodeficiency in other