I am confident that the condition diagnosed by your vet is pemphigus
erythematosus, which has symptoms similar to lupus. Pemphigus
erythematosus is also known as Senear-Usher syndrome and as
panepidermal pustular pemphigus.
Pemphigus erythematosus is an inherited autoimmune skin disorder in
which the immune system, which is supposed to recognize and attack
foreign proteins, malfunctions in such a way as to cause harm to the
body's own tissues. Although the disorder is not common, it affects
dogs of certain breeds more than others. Dogs of the collie family are
particularly likely to be affected by pemphigus erythematosus.
The good news is that pemphigus erythematosus is the mildest form of
the pemphigus disorders, and several effective medications are
available. With prompt diagnosis and treatment, your dog may be able
to live a full and normal life.
I have gathered some information that will help you to understand the
disease and the treatment options.
==================================
WHAT IS PEMPHIGUS ERYTHEMATOSUS?
==================================
"There are several related immune mediated skin disorders called
pemphigus complex. These have a common mechanism of action in which
the body produces antibodies against the outer layer of the skin (the
epidermis). Pemphigus foliaceus is the most common of these diseases
in the dog. It is seen more often in Akitas, chow chows, dachsund,
bearded collies, Doberman pinscher, schipperke, Finnish spitz and
Newfoundland dogs. Pemphigus erythematosus is second most common and
may just be a milder form of pemphigus foliaceus. It is seen more
commonly in collies, Shetland sheepdogs and German shepherds."
Foothills Animal Hospital: Pemphigus
http://www.bobmckee.com/Client%20Info/Skin/pemphigus.html
"In pemphigus, the autoimmune system is directed against the skin
itself. Affected dogs have what looks like a rash at onset that
develops into blisters and then pustules. Finally, the dog is left
with crusty sores on the non-furred areas of skin--the pads, nose,
lips, and eye rims. Occasionally, all the skin is involved, but this
is less common. Because the produce pigment-production cells in the
skin may be affected also, color may disappear from involved areas.
An affected dog may show signs that he doesn't feel well; he may seem
tired and depressed. He may also be stiff from swollen joints. The
disease shows no sex preference and is usually seen in mature dogs
(over two).
Diagnosis is made by skin biopsy. Thyroid panels should be run also
because... affected dogs often also have thyroid disease and need
supplementation."
Akita Club: Pemphigus
http://www.akitaclub.org/web/health/pemphigus.html
"Pemphigus Erythematosus...
Rare in dogs and cats
Benign form of Pemphigus foliaceus
Some similarities to Systemic Lupus Erythematosus...
Lesions - similar to Pemphigus foliaceus...
Distribution
Face and ears - only (no lesions on body or feet)
Oral cavity is not involved"
Univ of Tennessee Veterinary Dermatology: Autoimmune Skin Disorders
http://www.utskinvet.org/vinmodb2004/Autoimmune_Skin_Disorders.htm#Pemphigus_Erythematosus
"Pemphigus erythematosus (dog and cat)
Discharging sores
Crusting
Itchiness (pruritus)
Affects mainly the skin around the eyes, the ears and on the bridge of the nose.
The disease gets worse if the skin is exposed to sunlight"
ProVet Pet Health Information: Autoimmune Diseases
http://www.provet.co.uk/petfacts/healthtips/autoimmunedisease.htm
"Pemphigus foliaceous and pemphigus erythernatosus are autoimmune skin
diseases characterized by the development of autoantibodies against
the intercellular cement (glycocalyx) of the stratified squamous
epithelium. When autoantibodies bind to the glycocalyx, a series of
enzymatic reactions occur that destroy the adhesions of the epidermal
cells to one another...
Clinically, pemphigus foliaceus and pemphigus erythematosus are very
similar. From a practical perspective, the principal difference is
that pemphigus erythematosus is limited in distribution to head and
face. Pemphigus foliaceus is more generalized and will involve the
bead, face, ears, paws, and trunk. These diseases are characterized by
the formation of pustules and vesicles in the haired and thinly haired
areas."
Max's House: Pemphigus Foliaceus/Erythematosus
http://maxshouse.com/Diseases_of_the_Skin/pemphigus_foliaceus.htm
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TREATMENT OF PEMPHIGUS ERYTHEMATOSUS
======================================
"A combination of tetracycline and niacinamide has been used with some
success in dogs with p. erythematosus."
Canine Inherited Disorders Database: What is pemphigus?
http://www.upei.ca/~cidd/Diseases/immune%20disorders/pemphigus.htm
"Treatment of pemphigus erythematosus and pemphigus vegetans may not
be necessary or is usually possible with topical corticosteroids or
low to medium dosages of prednisone."
Vet Info: Pemphigus
http://www.vetinfo.com/dpemph.html
"The treatment of these disorders is immunosuppressives. Prednisone
and prednisolone are used in combination with azathioprine.
(Azathioprine is too bone marrow toxic for cats and chlorambucil is
substituted.) Six to eight weeks of aggressive immunosuppresive
therapy is generally needed to bring cases to clinical remission with
slow tapering."
Dermatologic Society of Greater New York: Veterinary Dermatology
http://www.dermsociety.org/default.asp?id=3&aui=sa&aid=82
"Cyclosporine blocks the proliferation of activated T lymphocytes by
inhibiting interleukin-2, gene activation, and RNA transcription.
Although cyclosporine is extremely effective at preventing organ
transplantation rejection in humans, extralabel use for treatment of
immune-mediated dermatoses and epitheliotropic lymphoma (mycosis
fungoides) in animals has been less successful. It may be used in
cases of pemphigus foliaceus, pemphigus erythematosus, and lupus
erythematosus that are not responsive to other therapy."
Merck Veterinary Manual: Immunomodulators
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/190408.htm&word=pemphigus%2cerythematosus
"Pemphigus is an autoimmune skin disease that can present in a variety
of forms and can be a challenging disease to manage and treat... The
most current commonly used therapeutics (glucocorticoids,
azathioprine, chlorambucil and tetracycline and niacinamide); current
alternative therapeutics (cyclosporin and tacrolimus and mycophenolate
mofetil) and additional alternative therapeutics (cyclophosphamide,
chrysotherapy, dapsone, sulfasalazine and intravenous immunoglobulin
(IVIG) therapy).
Veterinary Dermatology: Pemphigus: Current Therapy
http://www.ingenta.com/isis/searching/Expand/ingenta?pub=infobike://bsc/vderm/2004/00000015/00000002/art00004
"Cyclosporin has been increasingly used for the treatment of skin
diseases in small animals. Reported uses include the treatment of
atopy, cutaneous lupus erythematosus, feline acquired alopecia
resembling pseudopelade of humans, pemphigus erythematosus, pemphigus
foliaceus, perianal fistulae and sebaceous adenitis. In addition,
cyclosporin has been used anecdotally for several other skin diseases.
Few side effects have been noted at doses therapeutic for dermatologic
diseases."
Cyclosporin Applications in Small Animal Dermatology
http://www.ingenta.com/isis/searching/Expand/ingenta?pub=infobike://bsc/vderm/2003/00000014/00000001/art00001
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Google search strategy:
Google Web Search: pemphigus erythematosus canine OR dogs
://www.google.com/search?hl=en&ie=UTF-8&q=+pemphigus+erythematosus+canine+OR+dogs
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Do keep in mind that Google Answers is not a source of authoritative
medical advice; the material I've posted above should not be viewed as
a diagnosis nor as a substitute for the services of a veterinary
professional.
Please let me know if anything I've said is unclear, or if a link does
not work for you. I'll be glad to offer further assistance before you
rate my answer.
Sincere best wishes to you and your dog. I have three beautiful dogs,
and I know how distressing it can be to deal with a pet's illness. I
hope that the information I've gathered is helpful.
~pinkfreud |