Canine facial eosinophilic furunculosis in a dog

Canine facial eosinophilic furunculosis (FEF) is a hyperacute dermatopathy especially of the nasal bridge of dogs and is probably associated with type I hypersensitivity secondary to arthropod bites. The aim of this study is to report on a FEF case in a four-year-old female free-roaming mixed-breed dog showing papules on the nasal bridge that evolved to an ulcerated plaque. No other clinical, hematological, or biochemical alterations were detected. Cytology revealed eosinophilic and neutrophilic inflammation associated with bacterial infection. Punch biopsies were obtained for histopathological and microbiological analysis. Histopathology revealed marked, acute, multifocal to coalescent granulomatous eosinophilic furunculosis, and mild, acute, multifocal eosinophilic folliculitis. Microbiology revealed growth of coagulase-positive Staphylococcus sp. Clinical and histopathological findings were suggestive of facial eosinophilic folliculitis and furunculosis. Complete remission of the lesions was obtained after treatment. This condition is hyperacute, progressive, with a papular and erosive to ulcerative pattern, good prognosis, and its development is linked to arthropod bites. Furthermore, anti-inflammatory therapy is effective in treating the disease.(AU)

Eosinophilic folliculitis in a dog

Background: Canine eosinophilic folliculitis is a dermatological disease of acute onset with development of erosive to ulcerative papular lesions, especially on the nasal bridge, that may cause severe skin abnormalities leading to discomfort and pain to the patient. The aim of this report was to characterize a case of a canine eosinophilic folliculitis with papular, ulcerative and crusting dermatitis on the nasal bridge, papules on eyelid and pinna, with confirmed diagnosis based on aspiration cytology, history and response to immunosuppressive therapy with glucocorticoid. Case: An 1-year-old intact Daschund was attended showing an acute onset (over 4 h) of generalized urticarial reaction and nonpruriginous lesion at the muzzle with mild serosanguineous exudate, which persisted for 96 h when the dog was evaluated. It was observed a papular and ulcerative dermatitis with serosanguineous exudate and hematic crusts at nasal bridge, papules measuring 2 mm in diameter in the medial and lateral canthus of the left eyelid, ulcerative papule with hematic crust in the border of left ear pinna, multifocal papules on the skin, dyskeratosis and generalized hair loss. The patient was anesthetized for blood sampling (CBC and serum biochemistry), lesions fine-needle aspiration, scraping and imprint for cytological examination, bacterial culture and nasal turbinates radiography. Fragments for histopathological evaluation were also collected. Erythrogram and platelet evaluation were unremarkable. Leukogram revealed leukocytosis (neutrophilia, lymphocytosis, monocytosis and eosinophilia). Serum biochemistry revealed hyperalbuminemia and discrete hyperproteinemia; values of alanine aminotransferase, creatinine and globulins were within normal range. In cytological examination, intense cellularity was observed with predominance of eosinophils (60%), neutrophils (35%), macrophages performing cytophagocytosis (5%) and degenerated cells. There was no bacterial growth within 48 h after incubation of nasal bridge lesion swab. There were no abnormalities identified at radiographic evaluation of nasal turbinates. As the patient was already with antibiotic therapy and steroidal anti-inflammatory, it was opted to maintain it, since interruption between the day of examination and laboratory results could cause more prejudice than benefit, corticosteroid dose, however, was readjusted (prednisone 2 mg/kg/per os/every 24h). After 1 week of treatment the owner reported significant improvement of clinical signs without any further complaint. Discussion: Typically, type I hypersensitivity reactions such as insect bites do not exceed clinical signs of erythema, local edema and pruritus, with spontaneous remission of clinical signs within few hours after exposure to the antigen. Eosinophilic folliculitis, however, may cause more severe clinical alterations, such as pain, apathy and hyporexia. Nasal bridge is the predominant site described to be affected in cases of eosinophilic folliculitis, being auricular pinna, thorax and limbs considered atypical presentations which can delay proper diagnosis, since in endemic regions for diseases such as visceral leishmaniasis, infectious etiology may be listed first. Differential diagnosis also includes superficial pyoderma, juvenile cellulitis, pemphigus foliaceus and pharmacodermia. The case described in this report emphasize the importance of an accurate diagnosis as well as an early and adequate treatment in order to promote satisfactory response. Also, highlights inadequate use of antimicrobials as a direct consequence of lack of laboratorial investigation.

Canine eosinophilic furunculosis / Furunculose eosinofílica canina

Background: The eosinophilic furunculosis is an uncommon skin disease that affects young dogs aged between two and five years. Sex predilections are not noted. Most reported cases have been in large breeds with abundant access to the outdoors like public gardens and parks. The exact pathogenesis remains unknown but the pattern of lesions development suggests involvement reaction to insect bites and arthropods. The time between contact with the agent and the appearance of lesions is short, often less than 24 h. The skin lesions appear suddenly in the face, usually on the dorsal muzzle and/ or periocular region, pinnae and lips. More rarely on the trunk, chest and legs and it is characterized by predominantly hemorrhagic ulcers with edema. Pustules, nodules and plaques rapidly fistulate and drain serosanguinous exudates. Pruritus is variable, but may be severe. Severely affected dogs may be febrile, lethargic and anoretic. Peripheral blood eosinophilia is seen in the majority of cases. Clinical differential diagnosis include demodicosis, dermatophytosis, nasal deep bacterial folliculitis and furunculosis, pemphigus foliaceus, pemphigus erythematosus and drug reactions. None of these diseases share the fulminant rapid onset of eosinophilic furunculosis. The diagnosis is based on history, clinical signs, cytology and skin biopsies. The treatment involves oral steroids until complet

Background: The eosinophilic furunculosis is an uncommon skin disease that affects young dogs aged between two and five years. Sex predilections are not noted. Most reported cases have been in large breeds with abundant access to the outdoors like public gardens and parks. The exact pathogenesis remains unknown but the pattern of lesions development suggests involvement reaction to insect bites and arthropods. The time between contact with the agent and the appearance of lesions is short, often less than 24 h. The skin lesions appear suddenly in the face, usually on the dorsal muzzle and/ or periocular region, pinnae and lips. More rarely on the trunk, chest and legs and it is characterized by predominantly hemorrhagic ulcers with edema. Pustules, nodules and plaques rapidly fistulate and drain serosanguinous exudates. Pruritus is variable, but may be severe. Severely affected dogs may be febrile, lethargic and anoretic. Peripheral blood eosinophilia is seen in the majority of cases. Clinical differential diagnosis include demodicosis, dermatophytosis, nasal deep bacterial folliculitis and furunculosis, pemphigus foliaceus, pemphigus erythematosus and drug reactions. None of these diseases share the fulminant rapid onset of eosinophilic furunculosis. The diagnosis is based on history, clinical signs, cytology and skin biopsies. The treatment involves oral steroids until complet

Furunculose eosinofílica canina / Canine eosinophilic furunculosis

Background: The eosinophilic furunculosis is an uncommon skin disease that affects young dogs aged between two and five years. Sex predilections are not noted. Most reported cases have been in large breeds with abundant access to the outdoors like public gardens and parks. The exact pathogenesis remains unknown but the pattern of lesions development suggests involvement reaction to insect bites and arthropods. The time between contact with the agent and the appearance of lesions is short, often less than 24 h. The skin lesions appear suddenly in the face, usually on the dorsal muzzle and/ or periocular region, pinnae and lips. More rarely on the trunk, chest and legs and it is characterized by predominantly hemorrhagic ulcers with edema. Pustules, nodules and plaques rapidly fistulate and drain serosanguinous exudates. Pruritus is variable, but may be severe. Severely affected dogs may be febrile, lethargic and anoretic. Peripheral blood eosinophilia is seen in the majority of cases. Clinical differential diagnosis include demodicosis, dermatophytosis, nasal deep bacterial folliculitis and furunculosis, pemphigus foliaceus, pemphigus erythematosus and drug reactions. None of these diseases share the fulminant rapid onset of eosinophilic furunculosis. The diagnosis is based on history, clinical signs, cytology and skin biopsies. The treatment involves oral steroids until complete remission of lesions and the antibiotic therapy is indicated in cases of associated bacterial infection. Case: The patient was a 4-year-old, male Pit Bull dog attended in a small animal clinic in Niteroi-Rio de Janeiro, which presented ulcerated, exudative lesions on the dorsal muzzle and right leg. After sedation, clinical examination was performed and an exudate was collected from the ulcerated skin lesion for cytopathological analysis .The slide containing the lesion impression was stained by a quick panoptic method. In order to collect samples, the dog was sedated with a combination of ketamine hydrochloride and acepromazine and a skin fragment was collected from the nasal bridge lesion with a 6 mm punch after local anesthesia with 2% lidocaine hydrochloride. The specimen was fixed in 10% buffered formalin and sent for histopathological analysis. The cytopathological exam revealed a marked eosinophilic inflammation. Histopathological examination revealed ulcerated skin. The epidermis was moderately acanthotic with mild espongiosis and the dermis was characterized by intense eosinophilic folliculocentric inflammations. An extensive folicular rupture, eosinophilic mural foliculitis were presented and PAS staining did not identify fungal structures. Oral prednisone (2 mg/Kg) at 24h intervals was prescribed until complete remission of the lesions. After fifteen days of glucocorticoids therapy, involution of the skin lesions was observed by physical examination and was also reported by the owner. Discussion: The eosinophilic furunculosis is an acute, severe predominantly facial disease of outdoor dogs, which occurrence is rare. The diagnosis and treatment of this disease are frequently neglected because they are not included in the differential diagnosis of diverse cutaneous infections. In view of the scarcity of reports and to alert veterinarians that the disease should be included in the differential diagnosis with other bacterial diseases, this report described a case of canine eosinophilic furunculosis.

DIAGNÓSTICO DAS DOENÇAS DERMATOLÓGICAS EM PEQUENOS ANIMAIS: PRINCIPAIS DESAFIOS.

As doenças dermatológicas em pequenos animais podem ser consideradas um desafio para tutores, clínicos e patologistas. O objetivo desse estudo foi a pesquisa de condições que interferem no diagnóstico das dermatopatias não neoplásicas em cães e gatos. Esse trabalho foi dividido em três partes. Na primeira e na segunda parte do trabalho foram aplicados dois questionários, o primeiro a médicos veterinários de onze cidades do estado do Paraná e o segundo a tutores de pequenos animais com doença dermatológica em um hospital veterinário. Na terceira parte do trabalho foi realizada a avaliação dos aspectos histopatológicos que possam ser utilizados para a diferenciação das dermatopatias não neoplásicas em cães e gatos, fazendo sua correlação com os achados clínicos. Na primeira etapa do trabalho foi observado que a principal dificuldade encontrada na rotina dermatológica foi comprometimento do tutor do animal (54,95%). Recidivas de até 30% foram relatadas por 40% dos clínicos. Houve predomínio de tutores de classe média nos atendimentos clínicos (56%) e a maioria dos clínicos (84%) já utilizou o exame histopatológico e espera do mesmo a obtenção de diagnóstico (73,44%) e maior rapidez para o resultado (27,91%). Como principal sugestão na obtenção do diagnóstico foi a realização de exames complementares (48,33%). Na segunda etapa do trabalho foi observado que a maioria dos tutores buscou tratamento em até um mês (54%) do início da doença, entretanto 16% aguardaram dois meses e 30%, mais de seis meses para iniciarem um tratamento. Apenas 38% dos tutores relataram melhora do animal após o tratamento. Os tutores que não realizaram o tratamento (12%) justificaram o fato principalmente devido ao tratamento ser muito caro (33,33%) e por acharem que não estava melhorando (33,33%). A maioria dos tutores (60%) relata que não foi solicitada a realização de qualquer tipo de exame complementar antes do início do tratamento. Na terceira etapa da pesquisa, 40 animais foram biopsiados, e destes 95% eram cães e 5% eram gatos. Nos exames realizados em cães, 45% eram dermatopatias alérgicas, 12,5% eram imunomediadas, 7,5% eram endócrinas e 5% eram parasitárias. Outras dermatopatias totalizaram em 10% e os casos inconclusivos chegaram a 15%. Entre os cães alérgicos 38,89% eram sem raça definida. Segundo os tutores a doença alérgica iniciou entre menos de 1 ano a 3 anos de idade (66,67%) do animal e as primeiras lesões que surgiram eram principalmente eritematosas (27,78%), formavam crostas na pele (27,78%) em região ventral (44,44%) e membros (27,78%). Apenas 44,44% dos cães alérgicos chegaram ao diagnóstico definitivo, em 27,78% pacientes foram realizados protocolos diferentes e 27,78% dos cães não retornaram a consulta clínica. Entre os animas que chegaram ao diagnóstico, 50% foram compatíveis com hipersensibilidade alimentar, 37,5% com dermatite alérgica a picada de pulga e 12,5% com dermatite de contato. O principal ponto avaliado na histopatologia dos animais alérgicos foi o padrão inflamatório. As dermatopatias imunomediadas encontradas foi o lúpus eritematoso discóide (lesão em plano nasal e dorsal do focinho) e o pênfigo foliáceo (tronco, membros, cabeça e coxim). No exame histopatológico foi visualizado infiltrado inflamatório linfoplasmocitário em faixa e pústula eosinofília, respectivamente para essas doenças. A dermatopatia endócrina encontrada foi o hipotireoidismo (alopecia e hiperpigmentação generalizada) com predomínio de folículos telogênicos no exame histopatológico. Nos animais com dermatopatia parasitária (lesões em abdome, membros, dígitos, períneo, tórax e cauda) foi observado foliculite linfoplasmocitária estruturas intrafoliculares compatíveis com Demodex sp. no exame histopatológico. As outras dermatopatias encontradas foram a alopecia por diluição de cor, furunculose interdigital, acne canina e piodermite dos calos em um mesmo animal, Acanthosis Nigricans do Dachshund e reação a corpo estranho (granuloma causado por ceratina). As doenças dos felinos foram dermatite atópica (lesões em cabeça e bilateral flanco) e criptococose cutânea (lesões em face e base da orelha). Na histopatologia havia dermatite ulcerativa mastocitária e eosinofílica perivascular a intersticial e dermatite ulcerativa e piogranulomatosa com estruturas leveduriformes intralesionais, respectivamente. Concluímos que a dificuldade encontrada no diagnóstico das dermatopatias é por falta de padronização e/ou conhecimentos do médico veterinário e falha na comunicação entre o patologista, o clínico e o tutor do animal.

Dermatological diseases in small animals can be considered a challenge for tutors, clinicians and pathologists. The objective of this study was to investigate conditions that interfere in the diagnosis of non-neoplastic dermatopathies in dogs and cats. This work was divided into three parts. In the first and second part of the study, two questionnaires were applied, the first to veterinarian physician from 11 cities in the state of Paraná and the second to tutors of small animals with dermatological disease in a veterinary hospital. In the third part of the study, the evaluation of the histopathological aspects that could be used for the differentiation of non-neoplastic dermatopathies in dogs and cats was carried out, correlating with the clinical findings. In the first stage of the study, it was observed that the main difficulty found in the dermatological routine was commitment of the animal guardian (54.95%). Relapses of up to 30% were reported by 40% of clinicians. There was a predominance of middle-class tutors in clinical consultations (56%) and the majority of clinicians (84%) had already used the histopathological examination and expected diagnosis (73.44%) and faster results (27.91%). The main suggestion in the diagnosis was the performance of complementary tests (48.33%). In the second stage of the study, it was observed that most of the tutors sought treatment in up to one month (54%) of the onset of the disease, however, 16% waited two months and 30%, more than six months to start treatment. Only 38% of tutors reported improvement of the animal after treatment. The tutors who did not perform the treatment (12%) justified the fact mainly because the treatment was very expensive (33.33%) and because they thought it was not improving (33.33%). Most tutors (60%) report that no further type of examination was required prior to initiation of treatment. In the third stage of the research, 40 animals were biopsied, and these 95% were dogs and 5% were cats. In the examinations performed in dogs, 45% were allergic dermatopathies, 12.5% were immunomediated, 7.5% were endocrine and 5% were parasitic. Other dermatopathies totaled 10% and the inconclusive cases reached 15%. Among the allergic dogs 38.89% were undefined. According to the tutors the allergic disease started between less than 1 year to 3 years of age (66.67%) of the animal and the first lesions that appeared were mainly erythematous (27.78%), formed skin crusts (27.78% ) in the ventral region (44.44%) and limbs (27.78%). Only 44.44% of the allergic dogs arrived at the definitive diagnosis, 27.78% of the patients had different protocols, and 27.78% of the dogs did not return to the clinic. Among the groups that arrived at the diagnosis, 50% were compatible with food hypersensitivity, 37.5% with allergic dermatitis to flea bite and 12.5% with contact dermatitis. The main point evaluated in the histopathology of allergic animals was the inflammatory pattern. The immune-mediated skin diseases were discoid lupus erythematosus (lesion in the nasal and dorsal plane of the muzzle) and pemphigus foliaceus (trunk, limbs, head and cushion). In the histopathological examination, inflammatory lymphoplasmacytic infiltrate in the band and pustule eosinophilia were visualized, respectively, for these diseases. The endocrine dermatopathy found was hypothyroidism (alopecia and generalized hyperpigmentation) with a predominance of telogenic follicles in histopathological examination. In animals with parasitic dermatopathy (lesions in abdomen, limbs, digits, perineum, thorax and tail) we observed lymphoplasmacytic folliculitis intrafollicular structures compatible with Demodex sp. Histopathological examination. The other dermatopathies found were color-diluted alopecia, interdigital furunculosis, canine acne and callus pyoderma in the same animal, Dachshund's Acanthosis Nigricans and foreign body reaction (granuloma caused by keratin). Feline diseases were atopic dermatitis (lesions on the head and bilateral flank) and cutaneous cryptococcosis (lesions on the face and base of the ear). In the histopathology there was ulcerative mastocytoma and eosinophilic perivascular to interstitial dermatitis and ulcerative and piogranulomatous dermatitis with intralesional yeast structures, respectively. We conclude that the difficulty found in the diagnosis of dermatopathies is due to the lack of standardization and / or knowledge of the veterinarian and the lack of communication between the pathologist, clinician and animal guardian.

Canine eosinophilic furunculosis / Furunculose eosinofílica canina

Background: The eosinophilic furunculosis is an uncommon skin disease that affects young dogs aged between two and five years. Sex predilections are not noted. Most reported cases have been in large breeds with abundant access to the outdoors like public gardens and parks. The exact pathogenesis remains unknown but the pattern of lesions development suggests involvement reaction to insect bites and arthropods. The time between contact with the agent and the appearance of lesions is short, often less than 24 h. The skin lesions appear suddenly in the face, usually on the dorsal muzzle and/ or periocular region, pinnae and lips. More rarely on the trunk, chest and legs and it is characterized by predominantly hemorrhagic ulcers with edema. Pustules, nodules and plaques rapidly fistulate and drain serosanguinous exudates. Pruritus is variable, but may be severe. Severely affected dogs may be febrile, lethargic and anoretic. Peripheral blood eosinophilia is seen in the majority of cases. Clinical differential diagnosis include demodicosis, dermatophytosis, nasal deep bacterial folliculitis and furunculosis, pemphigus foliaceus, pemphigus erythematosus and drug reactions. None of these diseases share the fulminant rapid onset of eosinophilic furunculosis. The diagnosis is based on history, clinical signs, cytology and skin biopsies. The treatment involves oral steroids until complet

Background: The eosinophilic furunculosis is an uncommon skin disease that affects young dogs aged between two and five years. Sex predilections are not noted. Most reported cases have been in large breeds with abundant access to the outdoors like public gardens and parks. The exact pathogenesis remains unknown but the pattern of lesions development suggests involvement reaction to insect bites and arthropods. The time between contact with the agent and the appearance of lesions is short, often less than 24 h. The skin lesions appear suddenly in the face, usually on the dorsal muzzle and/ or periocular region, pinnae and lips. More rarely on the trunk, chest and legs and it is characterized by predominantly hemorrhagic ulcers with edema. Pustules, nodules and plaques rapidly fistulate and drain serosanguinous exudates. Pruritus is variable, but may be severe. Severely affected dogs may be febrile, lethargic and anoretic. Peripheral blood eosinophilia is seen in the majority of cases. Clinical differential diagnosis include demodicosis, dermatophytosis, nasal deep bacterial folliculitis and furunculosis, pemphigus foliaceus, pemphigus erythematosus and drug reactions. None of these diseases share the fulminant rapid onset of eosinophilic furunculosis. The diagnosis is based on history, clinical signs, cytology and skin biopsies. The treatment involves oral steroids until complet