Superficial necrolytic dermatitis in a dog

Background: Superficial necrolytic dermatitis (SND), hepatocutaneous syndrome (HCS), metabolic epidermal necrosis (MEN), and necrolytic migratory erythema (NME) are useful terms to describe a disease that likely has a multifactorial etiopathogenesis. SND is a rare and fatal disease characterized by skin lesions and liver disease. Common skin lesions include hyperkeratosis, fissures, erosion, ulceration, crusting, exudation from the paws, face, perianal regions, and pressure points. This case report aimed to report the case of a bitch that developed the rare Superficial Necrolytic Dermatitis disease, emphasizing the clinical signs of the disease, and the importance of complementary exams such as abdominal ultrasound and skin biopsy for the definitive diagnosis. Case: A 9-year-old, mixed-breed, neutered female was referred for clinical examination with 5 months history of hyperkeratosis and ulceration of the paw pads, presenting pain, lameness and weight loss. Abdominal ultrasound revealed a liver with heterogeneous echotexture, mixed echogenicity, irregular and poorly delimited margins with hypoechoic nodules throughout like honeycombs. The gallbladder was visualized with a moderately thick layer. Histological analysis confirmed the diagnosis of SND. Skin biopsies showed an increase in thickness of the epidermis due to irregular hyperplasia and proliferation of keratinocytes in the basal layer of the epidermis, pallor of the spinous layer of the epidermis and important parakeratosis. Due to the progression of the disease, significant worsening of the patient's clinical condition and pain, associated with the impossibility of cure, the animal was submitted to euthanasia. A necropsy was performed to allow assessment of the liver and pancreas. The biopsies showed a severe proliferative chronic hepatitis, steatosis and cholestasis associated with pancreatitis and necrotic multifocal proliferative fibrinopurulent areas in the pancreas. Discussion: Clinical signs such as lethargy, inappetence, weight loss, as well as the dermatological signs presented by this bitch are nonspecific clinical signs and require a deeper clinical, pathological and histopathological diagnostic investigation to reach the diagnosis of this disease. The definitive diagnosis is made on the basis of a characteristic honeycomb pattern in the liver or associated with a neoplastic finding in the pancreas on ultrasound examination and confirmed by histopathological evaluation of skin biopsies. Palliative treatment with corticosteroid anti-inflammatories, improvement in feed quality, with higher nutritional and protein intake and intravenous amino acid supplementation are suggested by some authors as treatment alternatives. However, not all owners can afford a costly lifetime treatment. With the progressive worsening of the condition, many owners opt for euthanasia as a way to shorten the suffering of the animal. This decision is not an easy one to make. Despite the poor prognosis of the disease, treatment options should be tried by veterinarians and owners prior to the option of euthanasia. However, new affordable nutritional and pharmacological strategies to treat or control the disease are needed in order to improve quality of life of SND patients.

Necrolytic migratory erythema in a cat with glucagonoma syndrome

Background: Glucagonomas are very rare neuroendocrine tumors of pancreatic endocrine islets alpha cells and they produced excessive amount of glucagon hormone. Necrolytic migratory erythema (NME) is a rare dermatosis that characterized by erosive, ulcerative and crusted lesions in different sites of the skin and the common cause of this situation related to glucagon secreted tumors. NME can occur commonly in man but some rare and recent reports available the occurrence of this situation in pet animals especially dogs. Both gross and histological findings in both human and animals are similar. This paper reports a NME case with glucagonoma and diabetes mellitus (DM) by clinical, histopathological and immunohistochemical examinations. Case: A 12-year-old, cat presented with complaints of skin lesions in neck region, hyperglycemia, weight loss and history of anorexia during the 2 months. Biochemical analysis results revealed high glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and creatinine levels but decreased blood urea nitrogen (BUN), total protein and potassium levels. After 2 weeks of anti-diabetic drug treatment, the blood glucose level became normal and skin lesions ameliorated but anorexia and weight loss continued. The cat exhibited general weakness and pain in abdominal area. Although the clinical sings ameliorated and skin lesions and serum biochemical findings returned the relatively normal levels compared the admission, the cat died after 2 weeks of treatment and necropsy performed. At necropsy, marked cachexia, loss of skin elasticity and decreased skin thickness were observed. During the examination of abdominal cavity of the cat, there was a mass 0.5x0.5 cm in diameter, hard and grayish color was diagnosed at the pancreas...

Necrolytic migratory erythema in a cat with glucagonoma syndrome

Background: Glucagonomas are very rare neuroendocrine tumors of pancreatic endocrine islets alpha cells and they produced excessive amount of glucagon hormone. Necrolytic migratory erythema (NME) is a rare dermatosis that characterized by erosive, ulcerative and crusted lesions in different sites of the skin and the common cause of this situation related to glucagon secreted tumors. NME can occur commonly in man but some rare and recent reports available the occurrence of this situation in pet animals especially dogs. Both gross and histological findings in both human and animals are similar. This paper reports a NME case with glucagonoma and diabetes mellitus (DM) by clinical, histopathological and immunohistochemical examinations. Case: A 12-year-old, cat presented with complaints of skin lesions in neck region, hyperglycemia, weight loss and history of anorexia during the 2 months. Biochemical analysis results revealed high glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and creatinine levels but decreased blood urea nitrogen (BUN), total protein and potassium levels. After 2 weeks of anti-diabetic drug treatment, the blood glucose level became normal and skin lesions ameliorated but anorexia and weight loss continued. The cat exhibited general weakness and pain in abdominal area. Although the clinical sings ameliorated and skin lesions and serum biochemical findings returned the relatively normal levels compared the admission, the cat died after 2 weeks of treatment and necropsy performed. At necropsy, marked cachexia, loss of skin elasticity and decreased skin thickness were observed. During the examination of abdominal cavity of the cat, there was a mass 0.5x0.5 cm in diameter, hard and grayish color was diagnosed at the pancreas...(AU)

Eritema necrolítico migratório (dermatite necrolítica superficial)em uma cadela diabética: síndorme do glucagonoma? / Necrolitic migratory erithema (superficial necrolytic dermatitis) in a diabetic bitch: glucagonoma syndrome?

O eritema necrolítico migratório é uma síndrome cutânea rara em humanos e cães muitas vezes associadaà presença de tumores pancreáticos produtores de glucagon. Pacientes com esta síndrome apresentamfrequentemente, além das alterações dermatológicas associadas à necrose epidérmica, a perda de peso e o diabetes mellitus, como consequência da hiperglucagonemia. Apenas um caso de síndrome do glucagonoma canino foi relatado até o momento na literatura nacional e aproximadamente dez casosexistem na literatura mundial. Relatamos um caso de eritema necrolítico migratório em uma cadeladiabética da raça Cocker Spaniel com oito anos de idade e quadro clínico compatível com a síndromedo glucagonoma. (AU)

The necrolytic migratory erythema is a rare skin syndrome in humans and dogs often associated with the presence of glucagon-producing pancreatic tumors. Patients with this syndrome develop epidermal necrosis generally associated with weight loss and diabetes mellitus as a consequence of hyperglucagonemia.Only one case of canine glucagonoma syndrome has been reported so far in the nacional literature and there are about ten cases all over the world. We report a case of necrolytic migratory erythema in an eight year-old, female, diabetic Cocker Spaniel dog with a clinical history compatible withthe glucagonoma syndrome. (AU)

Eritema necrolítico migratório (dermatite necrolítica superficial)em uma cadela diabética: síndorme do glucagonoma? / Necrolitic migratory erithema (superficial necrolytic dermatitis) in a diabetic bitch: glucagonoma syndrome?

O eritema necrolítico migratório é uma síndrome cutânea rara em humanos e cães muitas vezes associadaà presença de tumores pancreáticos produtores de glucagon. Pacientes com esta síndrome apresentamfrequentemente, além das alterações dermatológicas associadas à necrose epidérmica, a perda de peso e o diabetes mellitus, como consequência da hiperglucagonemia. Apenas um caso de síndrome do glucagonoma canino foi relatado até o momento na literatura nacional e aproximadamente dez casosexistem na literatura mundial. Relatamos um caso de eritema necrolítico migratório em uma cadeladiabética da raça Cocker Spaniel com oito anos de idade e quadro clínico compatível com a síndromedo glucagonoma.

The necrolytic migratory erythema is a rare skin syndrome in humans and dogs often associated with the presence of glucagon-producing pancreatic tumors. Patients with this syndrome develop epidermal necrosis generally associated with weight loss and diabetes mellitus as a consequence of hyperglucagonemia.Only one case of canine glucagonoma syndrome has been reported so far in the nacional literature and there are about ten cases all over the world. We report a case of necrolytic migratory erythema in an eight year-old, female, diabetic Cocker Spaniel dog with a clinical history compatible withthe glucagonoma syndrome.

Incidence of the autoimmune dermatosis in dogs and cats and retrospective study of 40 cases of discoid lupus erythematosus attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP Botucatu / Incidência das dermatopatias auto-imunes em cães e gatos e estudo retrospectivo de 40 casos de lupus eritematoso discóide atendidos no serviço de dermatologia da Faculdade de Medicina Veterinária e Zootecnia da UNESP Botucatu

The objectives of this study were to do a survey of the autoimmune skin diseases and update the records regarding the occurrence of discoid lupus erythematosus in canine and feline populations attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP - Botucatu, including species, gender, breed, age, location and characteristic of the lesions. Results have shown that the order of occurrence, regarding the number of cases of  autoimmune skin diseases in the animals attended by the Dermatology Service in the period from 1988 to 2007 was: discoid lupus erythematosus, pemphigus folliaceus, uveo-dermatologic syndrome, pemphigus vulgaris, systemic lupus erythematosus, necrolytic migratory erythema, multiforme erythema and plasmacytic pododermatitis. All the animals with discoid lupus erythematosus were dogs and most of them were mongrel females. More frequently breeds affected by discoid lupus erythematosus were german shepherd and akita and the mean age was 56 months. Most lesions were located in nasal planum, narines and periocular area and were characterized by crusting, depigmentation and erythema.

Os objetivos do presente trabalho teve como objetivo fazer um levantamento da casuística de doenças dermatológicas auto-imunes e atualizar os dados referentes à ocorrência de lupus eritematoso discóide na população canina e felina atendida pelo Serviço de Dermatologia Veterinária da FMVZ-UNESP, campus de Botucatu, incluindo a espécie, sexo, raça, idade, localização e caracterização das lesões. Com a análise dos resultados, concluiu-se que a ordem de ocorrência de acordo com o número de casos de doenças dermatológicas auto-imunes nos animais atendidos pelo setor de dermatologia no período de 1988 a 2007 é: lupus eritematoso discóide, pênfigo foliáceo, síndrome úveo-dermatológica, pênfigo vulgar, lupus eritematoso sistêmico, eritema necrolítico migratório, eritema multiforme e pododermatite plasmocitária. Dos animais com lupus eritematoso discóide, todos eram da espécie canina, sendo a maioria fêmea e sem definição racial. As raças mais acometidas por lupus eritematoso discóide foram: Pastor Alemão e Akita e a média das idades foi de 56 meses. Notou-se que a maioria das lesões era localizada em plano nasal, narinas e região periocular. As lesões mais comumente observadas foram: crosta, despigmentação e eritema.

Incidence of the autoimmune dermatosis in dogs and cats and retrospective study of 40 cases of discoid lupus erythematosus attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP – Botucatu / Incidência das dermatopatias auto-imunes em cães e gatos e estudo retrospectivo de 40 casos de lupus eritematoso discóide atendidos no serviço de dermatologia da Faculdade de Medicina Veterinária e Zootecnia da UNESP – Botucatu

The objectives of this study were to do a survey of the autoimmune skin diseases and update the records regarding the occurrence of discoid lupus erythematosus in canine and feline populations attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP - Botucatu, including species, gender, breed, age, location and characteristic of the lesions. Results have shown that the order of occurrence, regarding the number of cases of  autoimmune skin diseases in the animals attended by the Dermatology Service in the period from 1988 to 2007 was: discoid lupus erythematosus, pemphigus folliaceus, uveo-dermatologic syndrome, pemphigus vulgaris, systemic lupus erythematosus, necrolytic migratory erythema, multiforme erythema and plasmacytic pododermatitis. All the animals with discoid lupus erythematosus were dogs and most of them were mongrel females. More frequently breeds affected by discoid lupus erythematosus were german shepherd and akita and the mean age was 56 months. Most lesions were located in nasal planum, narines and periocular area and were characterized by crusting, depigmentation and erythema.

Os objetivos do presente trabalho teve como objetivo fazer um levantamento da casuística de doenças dermatológicas auto-imunes e atualizar os dados referentes à ocorrência de lupus eritematoso discóide na população canina e felina atendida pelo Serviço de Dermatologia Veterinária da FMVZ-UNESP, campus de Botucatu, incluindo a espécie, sexo, raça, idade, localização e caracterização das lesões. Com a análise dos resultados, concluiu-se que a ordem de ocorrência de acordo com o número de casos de doenças dermatológicas auto-imunes nos animais atendidos pelo setor de dermatologia no período de 1988 a 2007 é: lupus eritematoso discóide, pênfigo foliáceo, síndrome úveo-dermatológica, pênfigo vulgar, lupus eritematoso sistêmico, eritema necrolítico migratório, eritema multiforme e pododermatite plasmocitária. Dos animais com lupus eritematoso discóide, todos eram da espécie canina, sendo a maioria fêmea e sem definição racial. As raças mais acometidas por lupus eritematoso discóide foram: Pastor Alemão e Akita e a média das idades foi de 56 meses. Notou-se que a maioria das lesões era localizada em plano nasal, narinas e região periocular. As lesões mais comumente observadas foram: crosta, despigmentação e eritema.

Incidence of the autoimmune dermatosis in dogs and cats and retrospective study of 40 cases of discoid lupus erythematosus attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP Botucatu / Incidência das dermatopatias auto-imunes em cães e gatos e estudo retrospectivo de 40 casos de lupus eritematoso discóide atendidos no serviço de dermatologia da Faculdade de Medicina Veterinária e Zootecnia da UNESP Botucatu

The objectives of this study were to do a survey of the autoimmune skin diseases and update the records regarding the occurrence of discoid lupus erythematosus in canine and feline populations attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP - Botucatu, including species, gender, breed, age, location and characteristic of the lesions. Results have shown that the order of occurrence, regarding the number of cases of  autoimmune skin diseases in the animals attended by the Dermatology Service in the period from 1988 to 2007 was: discoid lupus erythematosus, pemphigus folliaceus, uveo-dermatologic syndrome, pemphigus vulgaris, systemic lupus erythematosus, necrolytic migratory erythema, multiforme erythema and plasmacytic pododermatitis. All the animals with discoid lupus erythematosus were dogs and most of them were mongrel females. More frequently breeds affected by discoid lupus erythematosus were german shepherd and akita and the mean age was 56 months. Most lesions were located in nasal planum, narines and periocular area and were characterized by crusting, depigmentation and erythema.

Os objetivos do presente trabalho teve como objetivo fazer um levantamento da casuística de doenças dermatológicas auto-imunes e atualizar os dados referentes à ocorrência de lupus eritematoso discóide na população canina e felina atendida pelo Serviço de Dermatologia Veterinária da FMVZ-UNESP, campus de Botucatu, incluindo a espécie, sexo, raça, idade, localização e caracterização das lesões. Com a análise dos resultados, concluiu-se que a ordem de ocorrência de acordo com o número de casos de doenças dermatológicas auto-imunes nos animais atendidos pelo setor de dermatologia no período de 1988 a 2007 é: lupus eritematoso discóide, pênfigo foliáceo, síndrome úveo-dermatológica, pênfigo vulgar, lupus eritematoso sistêmico, eritema necrolítico migratório, eritema multiforme e pododermatite plasmocitária. Dos animais com lupus eritematoso discóide, todos eram da espécie canina, sendo a maioria fêmea e sem definição racial. As raças mais acometidas por lupus eritematoso discóide foram: Pastor Alemão e Akita e a média das idades foi de 56 meses. Notou-se que a maioria das lesões era localizada em plano nasal, narinas e região periocular. As lesões mais comumente observadas foram: crosta, despigmentação e eritema.