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Cutaneous polyautoimmunity in two unrelated dogs: pemphigus foliaceus and generalized discoid lupus erythematosus
Author(s) -
Levy Britt J.,
Linder Keith E.,
Mamo Lisa B.,
Herrmann Ina,
Bizikova Petra
Publication year - 2020
Publication title -
veterinary dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.744
H-Index - 60
eISSN - 1365-3164
pISSN - 0959-4493
DOI - 10.1111/vde.12851
Subject(s) - pemphigus foliaceus , medicine , discoid lupus erythematosus , dermatology , pathology , lupus erythematosus , direct fluorescent antibody , prednisolone , lesion , systemic lupus erythematosus , antibody , disease , immunology , autoantibody
Background Polyautoimmunity, the concurrent expression of two or more distinct autoimmune diseases (ADs) in a single individual, is a known phenomenon in humans and has been rarely reported in dogs. To the best of the authors’ knowledge, comorbid pemphigus foliaceus (PF) and generalized discoid lupus erythematosus (GDLE) has not been reported in dogs. Hypothesis/Objectives To describe the clinical, histological and immunological features and treatment outcome of two unrelated dogs with comorbid PF and GDLE. Animals One 10‐year‐old, spayed German shepherd dog and one 8‐year‐old, castrated American Staffordshire terrier presented for evaluation of a symmetrical, facial‐ and/or pedal‐dominant pustular dermatitis with concurrent, truncal scaly plaques. Methods For each dog, clinicopathological characterization included physical examination, lesion cytological evaluation, bacterial culture and sensitivity testing, skin histopathological investigation and direct and indirect immunofluorescence testing. Additional diagnostic imaging and haematological testing was performed to exclude extracutaneous disease. Results Both dogs exhibited lesions clinically and histologically compatible with PF and GDLE. Moreover, one dog exhibited generalized leucotrichia and chronic superficial keratitis. Remission was achieved with immunosuppressive dosages of prednisolone [high‐dose pulse (Case 1) or standard immunosuppressive dosage (Case 2)] and ciclosporin (5–6 mg/kg/day). Tissue‐bound antikeratinocyte immunoglobulin (Ig)G and IgM were detected in both dogs. A weak basement membrane zone deposit of C3 was seen in one dog. Circulating antikeratinocyte and anti‐desmocollin‐1 IgG were detected in one dog. Conclusions and clinical importance Cutaneous polyautoimmunity can occur in the dog. Depending on the specific disease combinations, overlapping clinical features may present diagnostic and/or therapeutic challenges. Moreover, these cases should be monitored for development of additional cutaneous or extra‐cutaneous AD(s).