Equis ISSN 2398-2977

Pemphigus foliaceus

Contributor(s): Cody Coyne, Timothy Nuttall, David Senter

Introduction

  • The most common auto-immune skin disease of the horse.
  • Cause: abnormal immune response.
  • Signs: widespread vesicles, pustules and crusts.
  • Diagnosis: skin biopsy, cytology.
  • Treatment: immunosuppressive agents.
  • Prognosis: guarded to good. May need lifelong treatment.

Pathogenesis

Etiology

  • Abnormal immune response.

Predisposing factors

General
  • Hereditary predisposition.

Specific

  • Certain drugs, vaccines or stressful situations, eg pregnancy, may trigger the disease.

Pathophysiology

  • Abnormal immune response resulting in auto-antibodies directed against surface proteins on the keratinocyte, which provide intercellular adherence    →   loss of intercellular cohesion   →    acantholysis and blister formation.
  • The disease usually occurs spontaneously, but may be triggered by drugs, vaccines or stressful situations.

Type II hypersensitivity

  • Believed to be the immune reaction occurring in this disease.
  • Characterized by the binding of antibodies (with or without complement) to antigens on body tissues resulting in cytotoxicity or cytolysis.
  • In pemphigus foliaceus the auto-antibodies are directed against desmosomal antigens.
  • Pustules or vesicles are the primary lesions and are transient; they are easily ruptured, forming a crust.
  • The disease may be exacerbated by exposure to ultraviolet light.

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.
  • Zabel S et al (2005) Review of 15 cases of pemphigus foliaceus in horses and a survey of the literature. Vet Rec 157 (17), 505-509 PubMed.
  • Lloyd D et al (2000) Stannards illustrated equine dermatology notes: Immunologic diseases. Vet Derm 11 (3), 163-178 Wiley Online Library.
  • Johnson P J (1997) Pemphigus foliaceus in a horse. Vet Allergy Clin Immunol (4), 131-134 VetMedResource.
  • Fadok V A (1995) An overview of equine dermatoses characterized by scaling and crusting. Vet Clin North Am Eq Pract Derm 11 (1), 43-51 PubMed.
  • Scott D W (1994) Marked acantholysis associated with dermatophytosis due to Trichophyton equinum in two horses. Vet Derm (3), 105-110 VetMedResource.

Other sources of information

  • Scott D W (1988) Large Animal Dermatology. W B Saunders. USA.


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