|
© Kirrawee Veterinary Hospital FELINE DISEASES
Pemphigus
Pemphigus is the term referring to a group of skin diseases which
have an autoimmune basis. Autoimmune conditions occur where the
body creates inappropriate antibodies against its own tissues,
in this case the skin. The specific antigen (target) of the antibodies
is thought to be in the space between cells in the epidermis (outer
layer of skin). The antibodies cause a separation of the epidermal cells and the
release of chemicals (vasoactive amines) which increase the leakage
of fluid from blood vessels resulting in swelling, blister formation
and ulceration. Drugs reactions (including worming preparations)
may be a trigger for some cases of pemphigus. There are several forms of pemphigus which are distinguished by
their distribution appearance. Pemphigus foliaceous occurs in both dogs and cats most commonly
between the ages of two and seven. The disease usually begins
on the face and ears followed by the feet and groin. Spread can
take weeks to months. Lesions are characterized by scaling and
crusting with hair loss. Crusting can be very thick and develop
to ulcers especially in cases which also have irritation leading
to self trauma (less than 50%). Pemphigus erythematosus is generally a less severe form of pemphigus
which is mostly confined to the face. It is indistinguishable
from early cases of p. foliaceous with erythema (redness), oozing,
scaling and crusting. Pemphigus vulgaris effects mainly the mucosa (lining of mouth),
mucocutaneous junction (border of skin and mucosa) and nail beds.
This is mainly a condition of dogs with ulcers being the predominant
lesion. Secondary paronychia (infection of the nail bed) can lead
to shedding of the nail. A small number of animals may have systemic
(generalized) illness. Skin biopsies are used to diagnose pemphigus. This via histopathology
(microscopic examination) and immunofluorescence (using stains
which identify antibodies). Treatment of pemphigus is based on immunosuppressive drugs. Corticosteroids
are usually the first line drugs used e.g. Prednisolone 2mg/kg
twice daily. Reports suggest around 40% of animals will respond
to Prednisolone alone. The dose can be tapered in these animals
to the lowest effective dose for maintenance of a symptom free
status. Non responsive cases are treated with additional chemotherapeutic
drugs including Azathioprine (2mgkg daily) ,Chlorambucil (0.2mg/kg
daily). Long term maintenance regimes using low doses of these
drugs may be necessary to keep symptoms under control. Related sites |