Issue Description Canine pemphigus causes blistering eruptions
primarily affecting the face, ears, and oral cavity. Several subtypes
exist. Pemphigus is caused by an abnormal immune response that causes
skin cells to separate. Other Names Pemphigus
Types of Pemphigus The subtypes of pemphigus include Pemphigus
foliaceus, pemphigus vulgaris, pemphigus erythematosus and pemphigus
vegetans. In addition, dogs may be affected by several related immune
mediated skin disorders called pemphigus complex.
Pemphigus foliaceus�€”most common type of pemphigus seen in dogs
Pemphigus vulgaris�€”second most common type; usually causes the
most severe symptoms, including ulcerations around the mouth, anus,
prepuce, nose and vagina. Secondary complications are likely.
Pemphigus erythemtosus�€”usually symptoms are confined to the head
and feet and the ANA test is positive in 50 percent of cases.
Pemphigus vetetans�€”considered a less severe form of pemphigus
vulgaris with warty growths similar to that seen in viral papillomas
that occasionally form ulcers.
Breeds Commonly Affected
Pemphigus eyrthematosus is more likely to affect Collies, Shetland
Sheepdogs and German Shepherds. Pemphigus is most likely in
middle-aged dogs (4 years).
Symptoms Pemphigus disorders cause scaling of the skin,
scabs, and pustules with crusting. Early on, lesions are often limited
to the head, including the skin near the ears and mouth, and the feet,
including the planum and nailbed. As the diseases progress, lesions
spread to other parts of the body and blisters form. Blisters in
pemphigus can rupture easily, leaving a generalized crusting, and may
be hard to detect.
The nose in pemphigus is also
susceptible to pigment loss, similar to the changes seen in canine
lupus. Other symptoms include fever and loss of appetite. When the
foot pads are affected, difficulty in walking may be observed.
Diagnosis A physical examination reveals the presence of
blistering eruptions in pemphigoid disorders. The presence of mouth
lesions is highly suggestive of pemphigus. A biopsy of the lesion is
necessary for a definitive diagnosis of the subtype.
important to determine the subtype present to determine the prognosis
and optimal course of treatment. It's also important to differentiate
pemphigus from discoid lupus erythematosus. Immunohistochemical or
direct immunofluorescent testing may also be used to determine
desmoglein distribution. An altered distribution is seen in some cases
of pemphigus foliaceus.
Blood tests for desmoglein and
anti-plakin antibodies can also be used to help diagnose pemphigus.
Treatment Most cases of pemphigus require the lifelong
use of oral corticosteroids, such as prednisone and prednisolone,
along with immunosuppressant medications such as azathioprine. Topical
corticosteroids and tacrolimus are also used. After the symptoms are
brought into control, the starting dosage can usually be lowered.
Because these medications can cause serious side effects, the lowest
dose needed to keep symptoms in control is used.
been reports of improvement noted with dietary changes, including a
raw foods diet. Because sunburn can exacerbate symptoms, sun should be
avoided and canine sun blocks are recommended.