Fig 12 - available from: BMC Veterinary Research
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Histopathology of generalized canine discoid lupus erythematosus (a): in a skin biopsy from the trunk, a cell-rich lymphocytic interface dermatitis is present with prominent pigmentary incontinence. While epidermal atrophy (not shown) is classically seen in areas of prominent interface change, epidermal hyperplasia (shown here) can occur in chronic smoldering areas of lesions. 200X (b): inset box from image "a", lymphocytes infiltrate predominately the basal layer in conjunction with basal cell vacuolation, apoptosis, and loss. 400X (c): some chronic lesions develop mild subepidermal fibrosis with a paucity of inflammation, while retaining pigmentary incontinence. 100X (d): inset box from image "c", higher magnification image shows mild subepidermal fibrosis, few inflammatory cells and prominent pigmentary incontinence. 400X
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Since the first description of discoid lupus erythematosus (LE) in two dogs in 1979, the spectrum of canine cutaneous lupus erythematosus (CLE) variants has expanded markedly.
In this review, we first propose an adaptation of the Gilliam-Sontheimer classification of CLE for dogs. We then review the signalment, clinical signs, laboratory and histopa...
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p class="abstract">Discoid lupus erythematosus (DLE) is an autoimmune disease characterized by atrophic and discoid plaques over sun-exposed areas of skin and is the most common form of chronic cutaneous lupus erythematosus. Vitiligo is also an autoimmune disease known to be associated with other autoimmune conditions. However coexistence of DLE an...
Citations
... The currently recognized variants of canine chronic cutaneous lupus erythematosus (canine CCLE) include exfoliative lupus erythematosus (ECLE), mucocutaneous lupus erythematosus (MCLE), facial discoid lupus erythematosus (FDLE) and generalized discoid lupus erythematosus (GDLE). These variants share their chronic or recurrent nature of cutaneous lesions and are unified by a lupus-specific histopathology, i.e. a lymphocytic-rich interface dermatitis with basal keratinocyte damage (apoptosis, vacuolation) (Olivry et al., 2018). ...
... This dog's disease may be an atypical and crossover variant of canine CCLE (mixed mucocutaneous LE and generalized DLE). Crossover variants of canine CCLE are anecdotally mentioned and have to be characterized to add to the expanding phenotypic spectrum of canine CCLE (Olivry, 2018). The Spanish Greyhound had, in addition to its ulcerative claw fold disease, small ulcers on the medial canthus of the eyes, erosions around both lower lips, and an anal ulcer. ...
In this study, the signalment, clinical signs, histopathological findings and treatment outcome of four dogs with chronic ulcerative paronychia, that presented clinical and microscopic characteristics of the mucocutaneous variant of canine chronic cutaneous lupus erythematosus are described. The Greyhounds in the case series had a symmetric claw fold involvement, either exclusively or as major clinical presentation.
... Nevertheless, they should be used with careful monitoring because glucocorticoids, azathioprine, and chlorambucil may have severe systemic adverse effects for long-term use. Since 1992, combining the tetracycline family alone or with niacinamide has been reported to be effective for managing canine immune-mediated dermatosis, including DLE (1,3,14,17). This treatment has been used as a safer alternative to oral immunosuppressive drugs and as a steroid-sparing agent (4,11). ...
... DLE is a relatively common canine autoimmune skin disease with no systemic manifestations (8,11). Recently, DLE has been classified as a subtype of chronic cutaneous lupus erythematosus (CCLE) and further subdivided into FDLE and generalized DLE (GDLE) (14). In FDLE, skin lesions are limited to the face and neck, whereas the skin lesions in GDLE also appear below the neck (14). ...
... Recently, DLE has been classified as a subtype of chronic cutaneous lupus erythematosus (CCLE) and further subdivided into FDLE and generalized DLE (GDLE) (14). In FDLE, skin lesions are limited to the face and neck, whereas the skin lesions in GDLE also appear below the neck (14). The initial skin lesions in FDLE include depigmentation, erythema, and scaling that progress into ulcerations, erosions, and crusts. ...
... Autoantibodies target healthy skin cell components, particularly nuclear structures and ribosomal proteins, initiating the inflammatory cascade. Pro-inflammatory cytokines, like IL-6 and TNF-alpha, act as amplifiers, recruiting inflammatory cells and boosting their destructive tendencies, leading to tissue damage and visible lesions (2,3). The Complement cascade also plays a crucial role in DLE as it perforates cell membranes, raising more tissue damage. ...
... The lesions are most common on the nose and ears, but they can also occur on the limbs, genitals, and mouth. The definitive diagnosis of DLE is made by physical examination, medical history, and histopathological examination (2,4,5). ...
... Its origins are shrouded in a mix of genetics, infections, hormones, and sun exposure (1). This autoimmune disease presents as scaly, discolored patches typically on the nose, but sometimes venturing to ears, lips, and beyond (2,19). Diagnosis involves piecing together the clinical signs, skin tests, and bloodwork (19), though specific autoantibody tests often elude DLE's grasp (4). ...
Discoid lupus erythematosus (DLE) is a common autoimmune skin disease in dogs. Conventional treatments, such as corticosteroids, can be effective but often have side effects. This case report presents a successful use of cannabinoid therapy (CT) in a dog with DLE resistant to conventional treatment. A 2-year-old mixed-breed dog with a history of DLE presented with worsening lesions despite treatment with corticosteroids and other medications. Liver enzymes levels were elevated, indicating corticosteroid-induced side effects. CT with a CBD-rich full spectrum Cannabis oil was initiated. The dosage was gradually adjusted until the minimum effective dose was found. Within a few weeks of starting CT, the dog showed significant improvement in skin lesions and in liver enzymes levels. After 1 year, the dog remains clinically stable on a low dose of full-spectrum CBD-rich oil. No evidence of DLE recurrence was observed. This case suggests that CT may be a viable alternative or complementary therapy for DLE in dogs, particularly for those experiencing adverse effects from conventional treatments. Further research is warranted to confirm the efficacy and safety of CT for DLE management in dogs.
... Pruritus and pain can be variably present. 1 In MCLE the genital and anal/perianal areas are predominantly affected by erosions and ulcers. 2 Despite differing clinical appearances, variants of CCLE share a histological pattern of cell-rich interface dermatitis with basal keratinocyte vacuolation and damage (including apoptosis). 3 In the literature, neither the greyhound breed nor interdigital pedal lesions have so far been described. This report describes the clinical and histopathological characteristics and treatment of a form of CCLE, primarily affecting the interdigital spaces in two unrelated greyhound dogs, who had not travelled outside the UK. ...
... These have traditionally consisted of calcineurin inhibitors, both orally and topically. 3,8 More recently, oclacitinib, a Janus kinase inhibitor, has led to the complete remission of lesions in 100% of dogs suffering from ECLE and MCLE, and 75% of dogs with FDLE. 9 As per the manufacturers data sheet (Apoquel; Zoetis) periodic complete blood counts and serum biochemical evaluation should be performed in patients receiving long-term therapy. In both of our cases, quick improvement and complete resolution of the cutaneous lesions was possible with treatment regimens already described for other variants of CCLE. ...
... A positive ANA titre can be a risk factor in people with GDLE for the subsequent development of systemic lupus erythematous, yet the same has not been consistently demonstrated in dogs. 1 Further investigations, such as the lupus band test, which assesses immunoglobulin and activated complement deposition at the dermo-epidermal basement membrane zone, should be performed. A positive lupus band of immunoglobulin (Ig)G and IgM is found in around 90% of people and dogs with GDLE, 3 and IgG has been demonstrated in a case of MCLE. 10 These additional tests may allow further characterisation of this novel presentation. ...
Canine cutaneous lupus erythematosus (CCLE) is a well‐described, yet uncommon, autoimmune disease which can present clinically with different variants. This case report describes the clinical and histopathological presentation, and treatment response, of CCLE affecting a novel location, the interdigital skin, in two unrelated greyhounds. image
... CDLE is an autoimmune condition with an unclear aetiology. Available reports are insufficient to conclude the epidemiology of the disease in dogs (Olivry et al., 2018), and further studies are required to provide a better understanding of the pathogenesis, prognosis and optimal treatment (Banovic, 2019;Bryden et al., 2005). Predispositions in the German Shepherd Dog suggest a genetic component (Olivry et al., 2018). ...
... Available reports are insufficient to conclude the epidemiology of the disease in dogs (Olivry et al., 2018), and further studies are required to provide a better understanding of the pathogenesis, prognosis and optimal treatment (Banovic, 2019;Bryden et al., 2005). Predispositions in the German Shepherd Dog suggest a genetic component (Olivry et al., 2018). ...
... chronic skin lesion, and the presentation in this patient was typical for FDLE which preferentially affects the nasal planum (Olivry et al., 2018). ...
Geriatric Golden Retriver was brought to the clinic for a large lesion that involves the nasal plane with atrophic characteristics. The histopathological investigation evidences lymphocytic interphase dermatitis, with basal keratinocyte degeneration, loss of basal cells and basement membrane thickening. This lesion was congruent with discoid lupus erythematosus. The case was approached with topical tacrolimus and azathioprine as immunosuppressant therapeutic, and avoidance to sun exposure was recommended for at least 3 months. Therapeutic protocol was fulfilled for no more than 2 weeks, and no improvement was achieved. image
... GSDs also are predisposed to the development of both facial DLE as well as MCP, both diseases that can involve the nasal planum. 7,8 Differentiation between facial DLE and MCP can be difficult both clinically and with histopathologically. 9 In cases of facial DLE, dogs present with depigmentation, atrophy, erythema, scaling, and variable crusting, erosion and scarring. These lesions, often worsened by UV light, typically are restricted to the face, particularly the nasal planum, and also may be found on the muzzle, lips, ears and periocular skin. ...
Background
Dermal arteritis of the nasal philtrum (DANP) has been described in large‐breed dogs.
Objectives
To characterise clinically distinct, discrete fissures of the dorsolateral nasal alae associated with severe bleeding in German shepherd dogs (GSDs).
Animals
Fourteen privately owned GSDs with linear rostrolateral nasal alar fissures and a histopathological diagnosis of nasal vasculopathy.
Materials and Methods
Retrospective analysis of medical records and histological slides.
Results
Mean age of onset was 6 years. Before biopsy, episodic arteriolar bleeding was noted in 11 of the 14 (79%) dogs. Slide analysis revealed enlarged nasal arterioles with expanded vascular tunics and luminal stenosis beneath ulcers. Histopathological lesions consistent with mucocutaneous pyoderma and/or facial discoid lupus erythematosus were present in 5 of the 14 (36%) dogs. Enlarged arterioles stained blue with Alcian blue and Masson's trichrome stains, consistent with deposition of mucin and collagen, respectively. Immunohistochemical stains (neutrophil myeloperoxidase, IBA1, CD3) were performed. CD3 was negative for all dogs, whilst neutrophil myeloperoxidase and IBA1 occasionally demonstrated intramural neutrophils (3 of the 14 dogs, 21%) or histiocytes (1 of the 14 dogs, 7%) in altered vessels, respectively. All dogs underwent medical management and/or surgical excision. Treatments included tacrolimus, prednisone, ciclosporin‐modified, pentoxifylline, antimicrobials and doxycycline/niacinamide. No dogs were treated with antimicrobials alone. For seven dogs with long‐term follow‐up, treatment response was complete in five (71%) and partial in two (29%), with six of the seven (86%) receiving immunomodulatory treatments to maintain remission.
Conclusion and Clinical Relevance
Nasal alar arteriopathy of GSDs shares histopathological changes with DANP. It has characteristic clinical and histopathological features and appears amenable to immunomodulation.
... The current classification of cutaneous manifestations of lupus erythematosus in people has been recently adapted for dogs. 26,27 This classification recognizes 2 main groups: (1) systemic lupus erythematosus (SLE), which can present with or without skin lesions, and (2) lupus erythematosus-related skin diseases, which include lupus-specific diseases (also known as, cutaneous lupus erythematosus [CLE]), and lupus-nonspecific skin diseases (eg, vasculitis, panniculitis, bullous SLE type I). 27 Canine CLE preferentially affects haired skin and/or mucocutaneous junctions and true mucosal involvement is usually not a feature of this group of diseases. ...
... 26,27 This classification recognizes 2 main groups: (1) systemic lupus erythematosus (SLE), which can present with or without skin lesions, and (2) lupus erythematosus-related skin diseases, which include lupus-specific diseases (also known as, cutaneous lupus erythematosus [CLE]), and lupus-nonspecific skin diseases (eg, vasculitis, panniculitis, bullous SLE type I). 27 Canine CLE preferentially affects haired skin and/or mucocutaneous junctions and true mucosal involvement is usually not a feature of this group of diseases. Nonetheless, rare cases of oral cavity involvement have been reported in dogs with vesicular CLE (VCLE) and mucocutaneous lupus erythematosus (MCLE). ...
... Nonetheless, rare cases of oral cavity involvement have been reported in dogs with vesicular CLE (VCLE) and mucocutaneous lupus erythematosus (MCLE). 27 In such instances, the lesions are very minor compared to the classic annular to polycyclic erythema, erosions and ulcers on the glabrous skin of the abdomen, axillae, groin, and medial thighs in VCLE or erosions and ulcers at the mucocutaneous junctions of the anus, genitalia, oral cavity, and eyelids in MCLE. 27 Detailed information about the various CLE forms can be found in a recent comprehensive review article. ...
Immune-mediated and autoimmune diseases of the skin often present with oral cavity involvement. Autoimmune subepidermal blistering diseases and pemphigus vulgaris are classic examples. While the primary lesions (vesicles and bullae) are relatively specific, these fragile lesions evolve rapidly into erosions and ulcers, which are lesion types that overlap with many diseases. Furthermore, some immune-mediated diseases such as severe adverse drug reactions, lupus diseases, canine uveodermatological syndrome, and vasculitis, may or may not involve the oral cavity, and often nonoral clinical manifestations are more diagnostic. In these situations, disease knowledge combined with signalment, lesion distribution, and history help to narrow the differentials. Surgical biopsy is required for confirmation in most diseases, while immunosuppressive treatments most typically involve glucocorticoids with or without nonsteroidal immunosuppressants.
... The most frequently occurring pemphigus variants are PF and PE, which also are referred to as superficial pemphigus. 87 For CLE, different variants have been described in the literature 88 : discoid lupus erythematosus (DLE), exfoliative CLE (ECLE), mucocutaneous lupus erythematosus (MCLE) and vesicular CLE (VCLE). Of DLE, a localised (facial) and generalised form (GDLE) have been described. ...
... Of DLE, a localised (facial) and generalised form (GDLE) have been described. 78,[88][89][90] ...
Background
Immune‐mediated inflammatory diseases (IMIDs) are associated with an abnormal immune response, resulting in a disturbed homeostasis and chronic inflammation. Most canine dermatological IMIDs (cDIMIDs), such as allergies, autoimmune and immune‐mediated diseases, require long‐term treatment with immunosuppressive drugs with potential adverse effects. In general, nutraceuticals are thought to be safe. As a result, there is a tendency for the more frequent use of nutraceuticals in veterinary medicine.
Objectives
The aim of this review was to present evidence‐based proof for the use of various nutraceuticals in the treatment of cDIMIDs and, where possible, to provide conclusions to guide their use in veterinary dermatological practice.
Methods
A comprehensive literature search on common cDIMIDs and nutraceuticals was performed. Only peer‐reviewed articles published in English and related to the study topic were included. A total of 64 eligible publications were classified in five categories based on study design and substantively assessed on additional criteria such as standardisation of diets and number of included animals. For final appraisal, classification of major, minor or no evidence was used whereby efficacy was based on clinical outcome measurements.
Conclusions
Minor evidence for the beneficial use of several nutraceuticals, including essential fatty acids, niacinamide and probiotics, was found for treatment of specific cDIMIDs. These nutraceuticals may improve clinical signs or reduce the required dose of concurrent medication (e.g. drug‐sparing effect) in some dogs. Some nutraceuticals also may be used for long‐term maintenance therapy. Despite some promising findings, major evidence for the use of nutraceuticals in cDIMIDs is lacking, warranting further research.
... O lúpus eritematoso cutâneo vesicular (LECV) é uma doença inflamatória autoimune de rara ocorrência e constitui a única variante subaguda do lúpus eritematoso cutâneo canino, conforme nova classificação proposta por Olivry (2018). Acomete cães adultos das raças Collie, Pastor de Shetland, Border Collie e seus mestiços (Jackson, 2004;Jackson et al., 2004;Banovic et al., 2017;Olivry et al., 2018). No Brasil, essa doença foi descrita em um cão sem raça definida, sem características de cruzamento com as raças previamente elencadas (Lucina et al., 2014). ...
... Como conduta terapêutica fundamental ao controle do LECV, preconiza-se a prática de medidas fotoprotetoras, como uso de bloqueadores solares e a retirada da exposição ultravioleta. Dentre os tratamentos sistêmicos, tópicos ou combinados citados em literatura, prevalecem as terapias imunossupressoras ou imunomoduladoras, como os glicocorticoides associados ou não à azatioprina (Jackson, 2004;Banovic et al., 2017;Olivry et al., 2018), os inibidores da calcineurina (Banovic et al., 2017; Larsson & Lucas, 2020) e a combinação sinérgica tetraciclina-niacinamida (White et al., 1992;Adolph et al., 2014;Larsson & Lucas, 2020). ...
... Por se tratar de uma doença bastante rara e com resultados terapêuticos não homogêneos, até o momento não há um protocolo padrão estabelecido para o controle do LECV (Jackson, 2006). A utilização de terapia esteroidal em doses imunossupressoras resulta em benefícios imediatos e, por esse motivo, é a mais citada na literatura (Jackson, 2004;Banovic et al., 2017;Olivry et al., 2018). Porém, devido aos inúmeros efeitos colaterais ocasionados a médio/longo prazo, a manutenção deste fármaco não é bem tolerada (Jackson, 2004). ...
O lúpus eritematoso cutâneo vesicular (LECV) é uma doença inflamatória autoimune rara, única variante subaguda do lúpus eritematoso cutâneo canino. Acomete cães adultos das raças Collie, Pastor de Shetland, Border Collie e seus mestiços. Em geral, requer tratamentos imunossupressores, os quais ocasionam efeitos colaterais e têm eficácia terapêutica variada. Um cão da raça Border Collie, macho, 3 anos, foi diagnosticado com LECV. Apresentou moderada resposta à associação terapêutica de tetraciclina-niacinamida e, posteriormente, à ciclosporina-cetoconazol. O objetivo deste trabalho foi relatar o uso do oclacitinib, um inibidor da Janus quinase, no controle das lesões de LECV. O fármaco foi administrado na dose de 0,6 mg/kg/VO a cada 12 horas durante 15 dias e, na sequência, a cada 24 horas por mais 20 dias. Observou-se resolução clínica completa de forma rápida, eficaz e, aparentemente, sem efeitos adversos. Concluiu-se que o oclacitinib pode ser uma alternativa vantajosa no tratamento dessa variante do lúpus eritematoso cutâneo canino. Porém, estudos clínicos adicionais sobre o uso dos inibidores da Janus quinase no controle das doenças autoimunes dermatológicas caninas são necessários.
... Such diseases include nasal solar dermatitis and vasculitis, discoid lupus erythematosus and other forms of cutaneous lupus erythematosus, and pemphigus foliaceus and erythematosus. 7,[12][13][14][15][16] It is well-known that prolonged UV exposure can lead to the development of neoplastic skin conditions NOSE GUARDS FOR SOLAR RADIATION IN DOGS such as squamous cell carcinoma, cutaneous hemangiosarcoma and basal cell carcinoma. 7,9,17,18 Recommendations for these conditions in dogs often are to avoid the outdoors during certain hours of the day and to employ the use of sunscreen. ...
Background
Protection from solar ultraviolet (UV) radiation is paramount for some dermatological conditions, yet there are no studies assessing UV nose guards for dogs.
Objectives
Compare the ability of three nasal guards to block solar UV radiation (UVR) from the canine nose, using two commercial products and one created by the authors.
Animals
Four fabric model dogs were used in this prospective controlled trial.
Materials and Methods
Each model had a UV dosimeter applied to the dorsal nose and anterior nasal planum. Three models had nose protectors applied: (1) a mesh hood (OutFox Field Guard, OutFox For Dogs); (2) a fabric nose shield (Nose Protector, Dog Nose Protectors); or (3) a basket muzzle with ultraviolet protection factor (UPF) 50+ fabric developed by the authors. The control had no protective device applied. All the models were placed in direct sunlight and measurements taken over nine 2 h time periods. Total cumulative UVR was analysed for each location and type of guard or control.
Results
All guards provided statistically significant UV protection compared to control at all time points (p < 0.001). The basket muzzle with UPF 50+ guard was consistent in protecting the dorsal and anterior nose, blocking 94.2% and 94.3% UVR, respectively. The fabric nose protector blocked 99.2% UVR from the dorsal and 82.9% anterior. The mesh hood blocked 72.5% of UVR dorsal and 71.4% anterior.
Conclusions and Clinical Relevance
Two guards were superior in blocking UVR; however, the choice of UV guard in a clinical setting depends on an individual's disease location and tolerance of the device.
