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Dog: Autoimmune Skin Diseases

General information

Other common/scientific names: pemphigus foliaceus (PF), pemphigus vulgaris, pemphigus erythematosus (PE), systemic lupus erythematosus (SLE), discoid lupus erythematosus (DLE), bullous pemphigoid

An autoimmune skin disease is a condition where the dog’s immune system recognizes its own skin as foreign and produces antibodies against different components of the skin. The specific diseases listed above differ in which component is attacked. When a certain component is destroyed, inflammation and secondary infection result.

Causes

The cause for autoimmune skin disease is unknown. Genetic predisposition, medications, UV light exposure, infectious agents or a combination of these factors may play a role.

Cardinal symptom

  • Blisters
  • Pustules

Symptoms

Most of the autoimmune skin diseases develop blisters which rupture and ulcerations which form a scab. Secondary bacterial infections are common causing pustules and crusting of the skin. The lesions are seen in the oral cavity, on the skin and the mucocutaneous junctions. Itchiness is variable. Signs will vary depending on the specific disease:

  • Pemphigus Foliaceus: The most common autoimmune disease in dogs. Eyes, ears, footpads, groin and bridge of the nose are affected. These areas are very painful. Fever and lack of appetite are common. The Akita is more prone to the disease.
  • Pemphigus Vulgaris: Severe, erosive lesions which can affect the oral cavity and skin. These dogs are painful with systemic signs of a fever, lack of appetite and weight loss.
  • Pemphigus Erythematosus: Lesions are only on the head. Dogs do not develop a fever or lack of appetite.
  • Systemic Lupus Erythematosus: This disease can attack the skin, heart, lungs, kidneys, joints and nervous system. Skin lesions involve the face, ears and limbs. The oral cavity and mucocutaneous junctions are also affected. These dogs can show other clinical signs depending on which organ is affected.
  • Discoid Lupus Erythematosus: Signs of the disease are limited to the nose and face. UV light may be a trigger. Brittany Spaniels and Collies are more susceptible. This is a much less severe disease than pemphigus foliaceus or systemic lupus.
  • Bullous Pemphigoid: Lesions can be widespread but tends to affect the skin in the groin. Skin resembles a severe scald.

Abb. GFKWW99E
Abb. GFKWW99E: Pemphigus foliaceus.
This is a photograph of a dog with a mild case of pemphigus foliaceus on its nose.

Diagnosis

An initial diagnosis of an autoimmune skin disease can be made from a physical examination. However, a skin biopsy is needed to confirm the diagnosis. This involves obtaining a sample of the skin and submitting it to a laboratory. This skin sample is examined and the type and pattern of cells will determine which autoimmune disease is present. Other specialized immune blood tests may be needed if the biopsy is inconclusive. Once the diagnosis has been made, a complete blood count (CBC), serum biochemistry panel and urinalysis should be performed to obtain baseline values. These tests are then repeated during treatment to monitor any medication side effects.

Treatment

Treatment involves therapies which suppress the immune system. Dogs with mild cases can respond to topical ointments and reduced UV light exposure. However, most cases of autoimmune skin disease need one or more of these medications:

Prognosis

Autoimmune diseases cannot be cured. Most forms will require lifelong medication and monitoring which can be frustrating, costly and debilitating. The actual prognosis will depend on the specific disease. Pemphigus erythematosus, discoid lupus erythematosus and bullous pemphigoid tend to have a better prognosis while pemphigus vulgaris and systemic lupus erythematosus have a poorer prognosis.

Update version: 4/24/2014, © Copyright by www.enpevet.de
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