Transcript Pemphigus
Pemphigus It can really get under your skin By Tammy Chamness Autoimmune disease Characterized by the presences of autoantibodies that are produced by the immune system, but act against the body’s healthy cells and tissues . In effect, the body is attacking itself. Pemphigus • General designation for a group of autoimmune skin diseases that involve ulceration, crusting of the skin and also formation of fluid-filled sacs and cysts (vesicles), plus pus filled lesions (pustules). • Some types of pemphigus can also affect the skin tissue of the gums. • Acantholysis: is a hallmark sign, where the skin cells separate and break down because of tissue-bound antibody deposits in the space between cells. • Severity of the disease depends on how deeply the autoantibody deposits into the skin layer. Pemphigus foliaceus • PF is typically seen in middle aged cats and dogs • Causes pustules and crustingon the skin surface • Skin under the crustiness may be painful and itchy • May start on face and ears but can spread to other parts of the body • Thickening and cracking of the pads may occur and in cats, the claw fold is commonly affected • Gums and lips may be affected • Swollen lymph nodes, generalized swelling, depression, and fever can occur but animals are otherwise healthy Pemphigus erythematosus • PE is very similar to PF • Both are very common • PE is less afflictive • Lesions usually confined to the head, face and footpads • Loss of pigmentation in the lips is more common than with other forms of pemphigus Pemphigus vulgaris • Most severe of the pemphigus types • Ulcers, both shallow and deep, blisters, crusted skin, very itchy and painful • Fever, depression and anorexia may occur if animal has mouth ulcers • Underarm and groin areas are often involved • Secondary pyoderma and lymphadenopathy • Ulcerative paronychia and onychomadesis Pemphigus vegetans • Rarest form of all types of pemphigus • Ulcerative, erosive and crusting of skin • Bacterial folliculitis and deep pyoderma • Fungal granulomatous disease • Pustule groups join to form larger patches of oozing lesions • Few symptoms of general illness like fever or depression • Mouth is not usually affected Causes • Autoantibodies: the body creates antibodies that react to healthy tissue and cells as though they are pathogenic or diseased • Excessive sun exposure • Certain breeds appear to have a hereditary predisposition Diagnosis • Thorough physical exam and complete history of onset of symptoms • Blood chemical profile, complete blood count (which usually has normal results), urinalysis and an electrolyte panel • Any incidents that might have precipitated symptoms should be reported Diagnosis continued. Skin exam: • Positive diagnosis will shoe acantholytic cells (separated cells) and neutrophils (white blood cells) are founs • Very crucial part of exam • Tissue sample for examination (biopsy) • Pustules and crust aspirates (fluid) should be wiped onto slide for diagnosis • Bacterial culture may be used for identification and treatment of secondary skin infections Treatment • Immunosuppressive drugs: the immune system needs to be suppressed to treat the problem • Corticosteroids like prednisone are used in high doses for this reason (even know they are very effective, they do present side effects) • Other immunosuppressive drugs can be used to help lower the dose of corticosteroids i.e. azathioprine • Antibiotics to help with secondary infections • Topical steroids may provide relief if disease is diagnosed in early stages Remission is possible but care must be taken to protect your animal from excessive sun exposure since this can worsen the condition References • Skin Disease, Autoimmune (Pemphigus) in Dogs. PetMD. Retrieved from http://www.petms.com/dog/conditions/skin/c_dg_pemphigus • Pemphigus Foliaceus. SkinVetClinic. Retrieved from http://www.skinvetclinic.com/pemphigusfoliaceus.html • Squires, R. & Macintrie, D. Skin: pemphigus vegetans. Vetstream. Retrieved from https://www.vetstream.com/canis/Content/Disease/dis00224 • Squires, R. & Macintrie, D. Skin: pemphigus vulgaris. Vetstream. Retrieved from https://www.vetstream.com/canis/Content/Disease/dis00225