Resumo
Background: Discoid lupus erythematosus (DLE) is a common canine autoimmune skin disease, in which systemic manifestations are absent. Skin Lesions are usually present on the nasal planum, and characterised by erythema, depigmentation, erosion, ulceration, and crusting. The diagnosis is based on histopathological results, which should demonstrate lymphoplasmacytic lichenoid-interface dermatitis. Human intravenous immunoglobulin (hIVIg) has been used in veterinary medicine to treat cutaneous diseases including erythema multiforme, PF, and severe adverse cutaneous drug reactions. In human medicine, it has been effective to treat DLE. This report firstly describes the clinical response to hIVIg in a dog with DLE resistant to common immunosuppressive drugs. Case: A 5-year-old, intact female Shih Tzu presented with a 1-month history of slowly progressive black crusting on the nasal planum, chin, and claw. Based on the results of a dermatologic examination, superficial pyoderma was diagnosed. The skin lesions did not improve during and after anti-infective treatment. After removing the crusts, a skin biopsy was obtained from the muzzle. Histopathology of lesional skin biopsy specimens revealed lymphoplasmacytic interface dermatitis at the dermoepidermal junction. Microscopic examination also revealed vacuolar changes and pigmentary incontinence of the basal layer as a lichenoid tissue reaction. No mites or fungi were detected on the skin section. The absence of acantholytic cells excluded pemphigus foliaceus, which is also characterised by the lesions of the nasal planum. Based on the distribution of the lesions, histopathology and exclusion of other dermatoses, the dog was diagnosed with DLE. The skin lesions temporarily improved after treatment with prednisolone (2 mg/kg PO q12h). However, after tapering the dose of prednisolone, new black crusts developed on the nasal planum and claw. Although the dog was successively treated with other immunosuppressive drugs, including azathioprine, cyclosporin with dexamethasone, and mycophenolate mofetil, black crusts still remained. Due to the low efficacy of these immunosuppressive drugs, hIVIg was administered at 0.5 g/kg once daily for 4 days, for a total dose of 2 g/kg. During hIVIg administration, the crusted lesions gradually improved. After the hIVIg administration, the dog was treated with prednisolone (1 mg/kg PO q12h). The lesions were almost in complete remission at 21 days after an additional application of prednisolone. The skin lesions did not recur, and the treatment was eventually discontinued after 6 weeks of additional prednisolone application. Discussion: The standard treatment of canine DLE includes glucocorticoids, and second-line immunosuppressive drugs, such as azathioprine and cyclosporine, are usually added in cases resistant to steroids. This case suggests that hIVIg may be beneficial as an adjunctive treatment option for canine DLE, especially when the application of standard immunosuppressive drugs is limited due to adverse effects or low efficacy. There is evidence from several studies that the steroid-sparing effect of hIVIg is significant in human patients. In the current case, the effective dose of prednisolone was reduced to 2 mg/kg/day after hIVIg administration, and prednisolone therapy was finally discontinued completely. The hIVIg appears to lower the daily steroid dose requirement in this dog.
Assuntos
Animais , Feminino , Cães , Lúpus Eritematoso Discoide/terapia , Lúpus Eritematoso Discoide/veterinária , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/uso terapêutico , Doenças Autoimunes/veterináriaResumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned skin from nasal planum were biopsied to histopathologic and DIF evaluation. The kappa (k) coefficient was used to determine the degree of agreement and reliability of the results of both tests. A P-value < 5% was considered to be statistically significant. In Group I, all animals were normal across both the physical and laboratorial evaluation. A diagnosis of canine CCLE was established in 81.8% (9/11) of the animals based on histopathology analysis.[...]
Assuntos
Animais , Cães , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/veterinária , Técnica Direta de Fluorescência para Anticorpo/veterináriaResumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned sk
Resumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned skin from nasal planum were biopsied to histopathologic and DIF evaluation. The kappa (k) coefficient was used to determine the degree of agreement and reliability of the results of both tests. A P-value < 5% was considered to be statistically significant. In Group I, all animals were normal across both the physical and laboratorial evaluation. A diagnosis of canine CCLE was established in 81.8% (9/11) of the animals based on histopathology analysis.[...](AU)
Assuntos
Animais , Cães , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/veterinária , Técnica Direta de Fluorescência para Anticorpo/veterináriaResumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned sk
Resumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned sk
Resumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned sk
Resumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned sk
Resumo
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned sk
Resumo
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.
Resumo
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 casuÃstica 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 perÃodo de 1988 a 2007 é: lupus eritematoso discóide, pênfigo foliáceo, sÃndrome úveo-dermatológica, pênfigo vulgar, lupus eritematoso sistêmico, eritema necrolÃtico 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.
Resumo
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.
Resumo
O Lúpus Eritematoso Discóide (LED) é uma enfermidade benigna da pele que não apresente acometimento sistêmico, caracterizada pela ocorrência de lesões cutâneas faciais. Um cão da raça Pastor Alemão foi atendido apresentando histórico de descamação, alopecia, áreas de hipopigmentação, dermatite ulcerativa, crostas e fissuras no espelho nasal e orelhas. O diagnóstico de LED foi estabelecido pelo histórico, exame clínico e avaliação histopatológica. O tratamento do LED baseou-se no uso de medicamentos imunossupressores, antibacterianos (tópicos e sistêmicos) e bloqueadores solares(AU)
Discoid lupus erythematosus (DLE) is a bening illness confined to skin. A German shepherd dog was consulned with history of scalling off, alopecia, áreas of hypopigmentation, ulcerative dermatitis, crusts and fictions in nasal mirror and ears. Diagnostic of DLE was perfomed by history and evaluation of clinicalç and histopathological exams.the treatment of DLE was based on immunosuppressive drugs, antibacterial therapy (topic and systemic) and solar blocking agents(AU)
Assuntos
Cães , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/fisiopatologia , Lúpus Eritematoso Discoide/terapia , CãesResumo
O Lúpus Eritematoso Discóide (LED) é uma enfermidade benigna da pele que não apresente acometimento sistêmico, caracterizada pela ocorrência de lesões cutâneas faciais. Um cão da raça Pastor Alemão foi atendido apresentando histórico de descamação, alopecia, áreas de hipopigmentação, dermatite ulcerativa, crostas e fissuras no espelho nasal e orelhas. O diagnóstico de LED foi estabelecido pelo histórico, exame clínico e avaliação histopatológica. O tratamento do LED baseou-se no uso de medicamentos imunossupressores, antibacterianos (tópicos e sistêmicos) e bloqueadores solares
Discoid lupus erythematosus (DLE) is a bening illness confined to skin. A German shepherd dog was consulned with history of scalling off, alopecia, áreas of hypopigmentation, ulcerative dermatitis, crusts and fictions in nasal mirror and ears. Diagnostic of DLE was perfomed by history and evaluation of clinicalç and histopathological exams.the treatment of DLE was based on immunosuppressive drugs, antibacterial therapy (topic and systemic) and solar blocking agents