RESUMO
An 11-year-old male Golden Retriever was presented for consultation due to a chronic progressive lesion on the nose that had started a year before. The majority of the nasal mucosa was affected, with the disruption of the normal architecture, pigment atrophy and abundant peeling on the rostral plane. Histopathology revealed a band of lichenoid infiltrate at the interface and vacuolation of the cells in the basal layer consistent with a diagnosis of canine discoid lupus erythematosus.
Assuntos
Doenças do Cão , Lúpus Eritematoso Discoide , Masculino , Cães , Animais , Guatemala , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/veterinária , Lúpus Eritematoso Discoide/patologia , Epiderme/patologia , Doenças do Cão/diagnóstico , Doenças do Cão/patologiaRESUMO
Lupus erythematosus complex is an immune-mediated dermatological disease, mainly represented by the generalized and discoid forms. The last form described is milder, as it is limited to the appearance of lesions, usually on the face and in mucocutaneous regions. Its pathophysiology is considered multifactorial, however, continuous exposure to ultraviolet radiation seems to be very relevant to trigger and/or worsen clinical manifestations. DeÞ nitive diagnosis is obtained by histopathological analysis, and treatment is mainly based on immunosuppression and protection against ultraviolet radiation. The objective of this study was to report the case and clinical evolution of a mixed breed bitch, diagnosed with discoid lupus erythematosus. The bitch presented moderate desquamation, crusts and depigmentation restricted to the nasal plane. No other clinical or laboratory Þ ndings were evidenced in the screening tests. Upon conÞ rmation by histopathology, the initial therapy was started with oral prednisolone. The owners were also instructed to avoid exposure to sunlight, as well as to use topical protectors against ultraviolet radiation. The patient presented good response to therapy, showing remission of signs. Other sporadic recurrences were observed later, however, they were controlled only with topical corticosteroids, but always reinforcing the other precautions of environmental management. This work also addressed the risks, beneÞ ts and need to institute ongoing care to control discoid lupus erythematosus. Therapeutic success can vary among patients, as the intensity of the disease can be manifested in varying degrees. Therefore, in those individuals in which the condition is mild, it may be advantageous to opt for more conservative therapies in order to avoid side effects.(AU)
O complexo lúpus eritematoso é uma enfermidade dermatológica imunomediada, sendo principalmente representado pela forma generalizada e discoide. A última descrita é mais branda, pois se limita ao aparecimento de lesões geralmente em face e em regiões muco-cutâneas. Sua Þ - siopatogenia é considerada multifatorial, entretanto, a exposição contínua à radiação ultravioleta parece ser muito relevante para desencadear e/ou agravar as manifestações clínicas. O diagnóstico deÞ nitivo é obtido pela análise histopatológica, e o tratamento se baseia principalmente na imunossupressão e proteção contra a radiação ultravioleta. O objetivo deste trabalho foi relatar o caso e evolução clínica de uma cadela sem raça deÞ nida, diagnosticada com lúpus eritematoso discoide. A mesma apresentou moderada descamação, crostas e despigmentação restritas ao plano nasal. Nenhum outro achado clínico ou laboratorial foi evidenciado nos demais exames de triagem. Após conÞ rmado pela histopatologia, a terapia inicial foi instituída a partir da prednisolona por via oral. Os tutores também foram orientados a evitar exposição a luz solar, bem como, fazer a utilização de protetores tópicos contra a radiação ultravioleta. A paciente teve boa resposta à terapia, apresentando remissão dos sinais. Após este episódio, outras recidivas esporádicas foram observadas, entretanto, controladas apenas com corticoides tópicos, mas sempre reforçando os demais cuidados com o manejo ambiental. Este trabalho também abordou os riscos, benefícios e necessidade de instituir o cuidado contínuo para controle do lúpus eritematoso discoide. O sucesso terapêutico pode variar entre os pacientes, uma vez que a intensidade da doença pode ser manifestada em vários graus. Portanto, naqueles indivíduos em que o quadro é brando, pode ser vantajoso optar por terapias mais conservadoras, a Þ m de evitar seus efeitos colaterais.(AU)
Assuntos
Animais , Feminino , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/veterinária , Cães/lesões , Prednisolona/farmacologia , Doenças do Cão/diagnósticoRESUMO
Background: Discoid lupus erythematosus (DLE) is a common canine autoimmune skin disease, in which systemic manifestations are absent. Skin Lesions are usually present on the nasal planum, and characterised by erythema, depigmentation, erosion, ulceration, and crusting. The diagnosis is based on histopathological results, which should demonstrate lymphoplasmacytic lichenoid-interface dermatitis. Human intravenous immunoglobulin (hIVIg) has been used in veterinary medicine to treat cutaneous diseases including erythema multiforme, PF, and severe adverse cutaneous drug reactions. In human medicine, it has been effective to treat DLE. This report firstly describes the clinical response to hIVIg in a dog with DLE resistant to common immunosuppressive drugs. Case: A 5-year-old, intact female Shih Tzu presented with a 1-month history of slowly progressive black crusting on the nasal planum, chin, and claw. Based on the results of a dermatologic examination, superficial pyoderma was diagnosed. The skin lesions did not improve during and after anti-infective treatment. After removing the crusts, a skin biopsy was obtained from the muzzle. Histopathology of lesional skin biopsy specimens revealed lymphoplasmacytic interface dermatitis at the dermoepidermal junction. Microscopic examination also revealed vacuolar changes and pigmentary incontinence of the basal layer as a lichenoid tissue reaction. No mites or fungi were detected on the skin section. The absence of acantholytic cells excluded pemphigus foliaceus, which is also characterised by the lesions of the nasal planum. Based on the distribution of the lesions, histopathology and exclusion of other dermatoses, the dog was diagnosed with DLE. The skin lesions temporarily improved after treatment with prednisolone (2 mg/kg PO q12h). However, after tapering the dose of prednisolone, new black crusts developed on the nasal planum and claw. Although the dog was successively treated with other immunosuppressive drugs, including azathioprine, cyclosporin with dexamethasone, and mycophenolate mofetil, black crusts still remained. Due to the low efficacy of these immunosuppressive drugs, hIVIg was administered at 0.5 g/kg once daily for 4 days, for a total dose of 2 g/kg. During hIVIg administration, the crusted lesions gradually improved. After the hIVIg administration, the dog was treated with prednisolone (1 mg/kg PO q12h). The lesions were almost in complete remission at 21 days after an additional application of prednisolone. The skin lesions did not recur, and the treatment was eventually discontinued after 6 weeks of additional prednisolone application. Discussion: The standard treatment of canine DLE includes glucocorticoids, and second-line immunosuppressive drugs, such as azathioprine and cyclosporine, are usually added in cases resistant to steroids. This case suggests that hIVIg may be beneficial as an adjunctive treatment option for canine DLE, especially when the application of standard immunosuppressive drugs is limited due to adverse effects or low efficacy. There is evidence from several studies that the steroid-sparing effect of hIVIg is significant in human patients. In the current case, the effective dose of prednisolone was reduced to 2 mg/kg/day after hIVIg administration, and prednisolone therapy was finally discontinued completely. The hIVIg appears to lower the daily steroid dose requirement in this dog.
Assuntos
Animais , Feminino , Cães , Lúpus Eritematoso Discoide/terapia , Lúpus Eritematoso Discoide/veterinária , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/uso terapêutico , Doenças Autoimunes/veterináriaRESUMO
O Lúpus Eritematoso Discoide (LED) é uma doença autoimune que causa alterações no sistema tegumentar dos animais. Ela acomete cães, gatos, equinos e humanos. Sua etiologia ainda não é bem elucidada, mas acredita-se que fatores genéticos, hormonais e ambientais possam possivelmente desencadeá-la. Essa enfermidade é caracterizada por despigmentação, eritema e descamação nas áreas acometidas, podendo em casos crônicos úlceras serem observadas. Seu diagnóstico baseia-se nos resultados obtidos na anamnese, histórico, exame físico e no exame histopatológico. Por se tratar de uma doença autoimune não há cura definitiva, ocorre apenas o controle, que para tal, pode-se utilizar drogas imunossupressoras e restrição solar. Objetiva-se com presente trabalho relatar um caso de Lúpus Eritematoso Discoide em um cão. No caso relatado o animal apresentava lesões com aspecto eritematoso, descamativo e ulcerado, na região nasal, nos lábios e gengiva, região perianal e na região abdominal caudal. O diagnóstico confirmatório da doença foi realizado por meio do exame histopatológico. Como tratamento foi instituído a corticoterapia a base de prednisolona na dose de 2mg/kg, BID, por 10 dias, posteriormente a dose foi reduzida para 1mg/kg, BID, por mais 10 dias e depois 1mg/kg, em dias alternados, também foi recomendado a restrição solar. O animal respondeu positivamente ao tratamento instituído com melhora significativa dos sinais clínicos apresentados. Contudo, deve-se salientar que a terapêutica instituída com objetivo de controle, pois conforme já foi mencionado não há cura definitiva para a enfermidade.(AU)
Discoid Lupus Erythematosus (LED) is an autoimmune disease that causes changes in the integumentary system of animals. It affects dogs, cats, horses and humans. Its etiology is still not well understood, but it is believed that genetic, hormonal and environmental factors may possibly trigger it. This disease is characterized by depigmentation, erythema and desquamation in the affected areas, and in chronic cases ulcers may be observed. Its diagnosis is based on the results obtained in the anamnesis, history, physical examination and histopathological examination. Because it is an autoimmune disease, there is no definitive cure, only control occurs, for which, immunosuppressive drugs and solar restriction can be used. The objective of this work is to report a case of Discoid Lupus Erythematosus in a dog. In the case reported, the animal presented lesions with an erythematous, scaly and ulcerated aspect, in the nasal region, on the lips and gums, perianal region and in the caudal abdominal region. The confirmatory diagnosis of the disease was performed by means of histopathological examination. As treatment, prednisolone-based corticosteroids were administered at a dose of 2mg / kg, BID, for 10 days, then the dose was reduced to 1mg / kg, BID, for another 10 days and then 1mg / kg, every other day, as well. solar restriction was recommended. The animal responded positively to the treatment instituted with a significant improvement in the clinical signs presented. However, it should be noted that the therapy instituted for the purpose of control, as as already mentioned, there is no definitive cure for the disease.(AU)
Assuntos
Animais , Cães , Doenças do Cão , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/terapia , Lúpus Eritematoso Discoide/veterinária , Corticosteroides/uso terapêuticoRESUMO
O Lúpus Eritematoso Discoide (LED) é uma doença autoimune que causa alterações no sistema tegumentar dos animais. Ela acomete cães, gatos, equinos e humanos. Sua etiologia ainda não é bem elucidada, mas acredita-se que fatores genéticos, hormonais e ambientais possam possivelmente desencadeá-la. Essa enfermidade é caracterizada por despigmentação, eritema e descamação nas áreas acometidas, podendo em casos crônicos úlceras serem observadas. Seu diagnóstico baseia-se nos resultados obtidos na anamnese, histórico, exame físico e no exame histopatológico. Por se tratar de uma doença autoimune não há cura definitiva, ocorre apenas o controle, que para tal, pode-se utilizar drogas imunossupressoras e restrição solar. Objetiva-se com presente trabalho relatar um caso de Lúpus Eritematoso Discoide em um cão. No caso relatado o animal apresentava lesões com aspecto eritematoso, descamativo e ulcerado, na região nasal, nos lábios e gengiva, região perianal e na região abdominal caudal. O diagnóstico confirmatório da doença foi realizado por meio do exame histopatológico. Como tratamento foi instituído a corticoterapia a base de prednisolona na dose de 2mg/kg, BID, por 10 dias, posteriormente a dose foi reduzida para 1mg/kg, BID, por mais 10 dias e depois 1mg/kg, em dias alternados, também foi recomendado a restrição solar. O animal respondeu positivamente ao tratamento instituído com melhora significativa dos sinais clínicos apresentados. Contudo, deve-se salientar que a terapêutica instituída com objetivo de controle, pois conforme já foi mencionado não há cura definitiva para a enfermidade.
Discoid Lupus Erythematosus (LED) is an autoimmune disease that causes changes in the integumentary system of animals. It affects dogs, cats, horses and humans. Its etiology is still not well understood, but it is believed that genetic, hormonal and environmental factors may possibly trigger it. This disease is characterized by depigmentation, erythema and desquamation in the affected areas, and in chronic cases ulcers may be observed. Its diagnosis is based on the results obtained in the anamnesis, history, physical examination and histopathological examination. Because it is an autoimmune disease, there is no definitive cure, only control occurs, for which, immunosuppressive drugs and solar restriction can be used. The objective of this work is to report a case of Discoid Lupus Erythematosus in a dog. In the case reported, the animal presented lesions with an erythematous, scaly and ulcerated aspect, in the nasal region, on the lips and gums, perianal region and in the caudal abdominal region. The confirmatory diagnosis of the disease was performed by means of histopathological examination. As treatment, prednisolone-based corticosteroids were administered at a dose of 2mg / kg, BID, for 10 days, then the dose was reduced to 1mg / kg, BID, for another 10 days and then 1mg / kg, every other day, as well. solar restriction was recommended. The animal responded positively to the treatment instituted with a significant improvement in the clinical signs presented. However, it should be noted that the therapy instituted for the purpose of control, as as already mentioned, there is no definitive cure for the disease.
Assuntos
Animais , Cães , Corticosteroides/uso terapêutico , Doenças do Cão , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/terapia , Lúpus Eritematoso Discoide/veterináriaRESUMO
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned skin from nasal planum were biopsied to histopathologic and DIF evaluation. The kappa (k) coefficient was used to determine the degree of agreement and reliability of the results of both tests. A P-value < 5% was considered to be statistically significant. In Group I, all animals were normal across both the physical and laboratorial evaluation. A diagnosis of canine CCLE was established in 81.8% (9/11) of the animals based on histopathology analysis.[...](AU)
Assuntos
Animais , Cães , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/veterinária , Técnica Direta de Fluorescência para Anticorpo/veterináriaRESUMO
Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology.Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned skin from nasal planum were biopsied to histopathologic and DIF evaluation. The kappa (k) coefficient was used to determine the degree of agreement and reliability of the results of both tests. A P-value < 5% was considered to be statistically significant. In Group I, all animals were normal across both the physical and laboratorial evaluation. A diagnosis of canine CCLE was established in 81.8% (9/11) of the animals based on histopathology analysis.[...]
Assuntos
Animais , Cães , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/veterinária , Técnica Direta de Fluorescência para Anticorpo/veterináriaRESUMO
The objectives of this study were to do a survey of the autoimmune skin diseases and update the records regarding the occurrence of discoid lupus erythematosus in canine and feline populations attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP - Botucatu, including species, gender, breed, age, location and characteristic of the lesions. Results have shown that the order of occurrence, regarding the number of cases of autoimmune skin diseases in the animals attended by the Dermatology Service in the period from 1988 to 2007 was: discoid lupus erythematosus, pemphigus folliaceus, uveo-dermatologic syndrome, pemphigus vulgaris, systemic lupus erythematosus, necrolytic migratory erythema, multiforme erythema and plasmacytic pododermatitis. All the animals with discoid lupus erythematosus were dogs and most of them were mongrel females. More frequently breeds affected by discoid lupus erythematosus were german shepherd and akita and the mean age was 56 months. Most lesions were located in nasal planum, narines and periocular area and were characterized by crusting, depigmentation and erythema.
Os objetivos do presente trabalho teve como objetivo fazer um levantamento da casuística de doenças dermatológicas auto-imunes e atualizar os dados referentes à ocorrência de lupus eritematoso discóide na população canina e felina atendida pelo Serviço de Dermatologia Veterinária da FMVZ-UNESP, campus de Botucatu, incluindo a espécie, sexo, raça, idade, localização e caracterização das lesões. Com a análise dos resultados, concluiu-se que a ordem de ocorrência de acordo com o número de casos de doenças dermatológicas auto-imunes nos animais atendidos pelo setor de dermatologia no período de 1988 a 2007 é: lupus eritematoso discóide, pênfigo foliáceo, síndrome úveo-dermatológica, pênfigo vulgar, lupus eritematoso sistêmico, eritema necrolítico migratório, eritema multiforme e pododermatite plasmocitária. Dos animais com lupus eritematoso discóide, todos eram da espécie canina, sendo a maioria fêmea e sem definição racial. As raças mais acometidas por lupus eritematoso discóide foram: Pastor Alemão e Akita e a média das idades foi de 56 meses. Notou-se que a maioria das lesões era localizada em plano nasal, narinas e região periocular. As lesões mais comumente observadas foram: crosta, despigmentação e eritema.