canis - Articles
Skin: erythema multiforme
Introduction
- Uncommon, acute, self-limiting eruption of skin and/or mucous membranes.
- Cause: drugs, infections, idiopathic.
- Signs: maculopapular rash, vesiculation, depression, anorexia.
- Diagnosis: history, clinical signs, histopathology.
- Treatment: supportive care +/- immunosuppressive chemotherapy.
- Prognosis: good.
Presenting signs
- Erythema multiforme minor, asymptomatic with a maculopapular rash.
- Erythema multiforme major, systemic illness with fever, depression, anorexia. Vesiculo-bullous and ulcerative mucocutaneous areas, oral mucosae, conjunctivae, pinnae, axillae and groin.
- Both forms acute, symmetrical onset.
- Erythematous macules that spread peripherally while healing centrally → target lesion.
Acute presentation
- Severe vesiculation and bulla formation over a wide area, including oral mucosae, mucocutaneous areas, conjunctivae, pinnae, axillae and groin.
- Pain.
- Fever.
- Anorexia.
- Depression.
Cost considerations
- Diagnostic work-up.
Pathogenesis
Etiology
- A hypersensitivity reaction, perhaps immune complex-mediated.
- Drugs, eg thyroxine Levothyroxine , diethylcarbamazine, levamisole Levamisole , antibacterial drugs Therapeutics: antimicrobial drug , aurothioglucose.
- Infections
- Anal sacculitis Anal sacculitis.
- Bacterial folliculitis Skin: bacterial folliculitis.
- Idiopathic.
Pathophysiology
- Necrotizing condition of the epidermis with an interface reaction.
- Circulating immune complexes are found in man.
Timecourse
- Acute self-limiting disease.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Lewis D T (1998) Life-threatening dermatoses in dogs. Comp Cont Ed Prac Vet 20 (3), 271-283 VetMedResource.
- Delmage D A and Payne-Johnson C E (1991) Erythema multiforme in a Dobermann on trimethoprim sulphamethoxazole therapy. JSAP 32 (12), 635-639 VetMedResource.
- Medleau L, Shanley K J, Rakich P M and Goldschmidt M H (1990) Trimethoprim-sulfonamide-associated drug eruptions in dogs. JAAHA 26 (3), 305-311 VetMedResource.