Canis ISSN: 2398-2942

Skin: bullous pemphigoid

Contributor(s): Prof Douglass Macintire, Richard Squires

Introduction

  • Only disease in the Pemphigoid complex recognized in veterinary medicine.
  • Cause: rare, auto-immune, vesiculobullous, ulcerative condition resulting from breakdown in dermo-epidermal adhesion.
  • Signs: pruritus, widespread lesions of skin and mucous membranes, anorexia, paronychia.
  • Diagnosis: history, clinical signs, skin biopsy, immunofluorescence.
  • Treatment: fluid therapy, shock therapy, antibacterial drug therapy.
  • Prognosis: guarded to poor.

Pathogenesis

Etiology

  • Unknown.

Predisposing factors

General
  • In some cases the pathogenesis may involve drug administration.
  • Sulfonamides, penicillins and furosemide have been associated.
  • UV light may also be a factor.

Pathophysiology

  • Auto-antibody against an antigen of the skin and mucosa at the basement membrane level → sub-epidermal vesicle formation.
  • Bullous pemphigoid auto-antibodies → bind with hemidesmosomes of epidermal basal cells and lamina lucida of the basement membrane.
  • Complement fixation and activation → attraction of neutrophils and eosinophils → release of proteolytic enzymes → disrupts dermo-epidermal adhesion → subepidermal vesicle formation.

Timecourse

  • Can occur suddenly at any age.

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.
  • White S D, Rosychuk R A, Reinke S I et al (1992) Use of tetracycline and niacinamide for treatment of autoimmune skin disease in 31 dogs. JAVMA 200 (10), 1497-1500 PubMed.
  • Carlotti D (1989) Proceedings of 1987 symposium on skin disease at Lanwade Hall, Newmarket. JSAP 30, 223-227.
  • Johnson B W & Campbell K L (1989) Dermatoses of the canine eyelid. Comp Cont Ed Pract Vet 11 (4), 385-394 VetMedResource.
  • Griffin C E (1987) Diagnosis and management of primary autoimmune skin diseases - a review. Sem Vet Med Surg 2 (3), 173-185 PubMed.


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