ISSN 2398-2969      

Skin: pemphigus foliaceus

icanis

Introduction

  • Uncommon autoimmune skin disease characterized by subcorneal pustules.
  • Most common type of pemphigus and most common autoimmune skin disease overall in dogs.
  • Cause: varied and incompletely understood; thought to be an autoimmune skin disease resulting from autoantibodies directed against desmoglein 1 (intracellular substance), causing acantholysis of keratinocytes; drug-induced disease rarely involved.
  • Signs: skin pustules, crusting lesions, maybe secondary bacterial folliculitis. Variably pruritic.
  • Diagnosis: history, clinical signs, histopathology, cytology.
  • Treatment: immunosuppressive chemotherapy.
  • Prognosis: reasonable, may need lifelong treatment. A survival rate of 61% is published. The commonest reason for death from pemphigus is side effects from medium-high doses of corticosteroids.
Print off the owner factsheet Pemphigus to give to your client.

Pathogenesis

Predisposing factors

General

  • Spontaneous development (Chow Chow, Japanese Akita).
  • Drug-induced (Labrador Retriever, Dobermann): history of chronic pruritic or allergic skin disease with sudden worsening of signs.
  • Pemphigus foliaceous lesions have been associated with topical parasiticide application. 
  • Has been associated with carprofen administration in 2 cases.

Pathophysiology

  • See also pemphigus vulgaris Skin: pemphigus vulgaris.
  • Pemphigus antibody Pemphigus antibodies is likely to be slightly different between different types of pemphigus.
  • Concurrent vasculopathy in a high percentage of canine pemphigus foliaceous cases has recently been published and may worsen the prognosis. 

Timecourse

  • Progresses from focal to multifocal/generalized within 6 months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Zhou Z, Corner S, Petersen A et al (2021) Clinical presentation, treatment and outcome in dogs with pemphigus foliaceus with and without vasculopathic lesions: an evaluation of 41 cases. Vet Derm 32(5), 503-e139 PubMed.  
  • Bizikova P, Olivry T (2015) Oral glucocorticoid pulse therapy for induction of treatment of canine pemphigus foliaceus – a comparative study. Vet Derm 26, 354 PubMed.
  • Bizikova P, Linder K E, Olivry T (2014) Fipronil–amitraz–S-methoprene-triggered pemphigus foliaceus in 21 dogs: clinical, histological and immunological characteristics. Vet Derm 25(2), 103 PubMed
  • Oberkirchner U, Linder K E, Dunston S et al (2011) Metaflumizone–amitraz (Promeris)-associated pustular acantholytic dermatitis in 22 dogs: evidence suggests contact drug-triggered pemphigus foliaceus. Vet Derm 22(5), 436-438 PubMed.  
  • Mueller R S, Krebs I, Power H T et al (2006) Pemphigus foliaceus in 91 dogs.J Am Anim Hosp Assoc42, 189-196 PubMed.  
  • Gomez S M, Morris D O, Rosenbaum M R et al (2004) Outcome and complications associated with treatment of pemphigus foliaceus in dogs: 43 cases (1994–2000).JAVMA224, 1312-1316 PubMed
  • Jackson H (1999) Common cutaneous diseases of the canine foot. In Practice 21 (2), 54-61 VetMedResource.
  • Shinya K, Nomura K, Wada S, Morioka H & Umermura T (1996) Pemphigus foliaceus with typical histological and immunohistological findings in a dog. J Vet Med Sci 58 (8), 815-817 PubMed.
  • Carlotti D (1989) Proceedings of 1987 symposium on skin disease at Lanwade Hall, Newmarket. JSAP 30, 223-227.
  • Carlotti D (1989) Autoimmune mediated skin disease. JSAP 30 (4), 223-227 VetMedResource.
  • Johnson B W & Campbell K L (1989) Dermatoses of the canine eyelid. Comp Cont Ed Pract Vet 11 (4), 385-394 VetMedResource.
  • Noxon J O & Myers R K (1989) Pemphigus foliaceus in 2 Shetland sheepdog litter mates. JAVMA 194 (4), 545-546 PubMed.
  • Beale K M (1988) Azathioprine for treatment of immune-mediated diseases of dogs and cats. JAVMA 192 (9), 1316-1318 PubMed.

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