Pemphigus foliaceus in dogs is a rare autoimmune skin disease that causes blistering and pustules on the face, nose, and skin. Pemphigus foliaceus can appear at any time; however, it is most common in middle-aged dogs. Symptoms include large pustules on the face, muzzle, ears, and feet; and ulcers on the nose and lips. Treatment includes medication to treat all symptoms and reduce inflammation, antibiotics if secondary bacterial infections are present, and corticosteroids to suppress the immune system.
What is pemphigus foliaceus in dogs?
Pemphigus foliaceus is an autoimmune condition that causes pustules, erosions, and crusts on the skin. Other systemic symptoms are possible. Despite being rare in dogs, pemphigus foliaceus is one of the most common autoimmune skin diseases. The average age of pemphigus foliaceus in dogs is around 5 years.
Pemphigus foliaceus is an immunoglobulin G (IgG) immune response that targets antigens in the epidermis's superficial layers. This immune reaction causes disruption and separation of the layers of the epidermis. Pustules, crusts, and erosions result from this separation.
What causes pemphigus foliaceus in dogs?
Most cases of pemphigus foliaceus are idiopathic, meaning the cause is unknown. However, in the dog's history, potential causes or triggering factors may sometimes be identified. Sunlight is a possible environmental trigger and skin lesions can worsen in the summer and improve in the winter.
Although very rare, some drugs can cause pemphigus foliaceus in dogs. These include:
- Sulfonamides
- Penicillins
- Tetracyclines
- Itraconazole
What are the symptoms of pemphigus foliaceus in dogs?
The primary lesions for pemphigus foliaceus are large, transient pustules. Intact pustules are fragile and quickly turn into sharply defined, pinpoint erosions and yellowish crusts. In most cases, the initial lesions are located on the face, particularly the nasal planum, muzzle, eyelids, and/or ears. In the majority of cases, lesions become more generalized and can involve the footpads. Lesions that are isolated to the face occur in a small percentage of cases.
Footpads that have been affected show thickening, crusting, hyperkeratotic, fissures, and painful symptoms. There may be lameness or difficulty walking. The presence of itching and pain varies and fever, anorexia, and/or lethargy can also occur.
How is pemphigus foliaceus in dogs diagnosed?
Pemphigus foliaceus can be difficult to diagnose, depending on where the lesions are located and whether other concurrent conditions are present (e.g. a bacterial infection). Your veterinarian will obtain a detailed history from you regarding your dog's health, the onset of symptoms, and any potential triggers. A thorough physical examination will be performed.
Skin biopsies are the best way to confirm a diagnosis of pemphigus foliaceus. The biopsy will be submitted to a veterinary dermatopathologist for evaluation. In-clinic cytology is sometimes used to help with the diagnosis. A small amount of pustular material is obtained and examined under a microscope. If specific cells called acanthocytes are found during cytological evaluation, pemphigus foliaceus is likely to be present.
Your veterinarian may also order blood tests, including a Complete Blood Count (CBC), serum biochemistry profile, and urinalysis. These tests help to rule out other conditions that may present with similar symptoms.
How is pemphigus foliaceus in dogs treated?
There is no one-size-fits-all approach to the treatment of pemphigus foliaceus in dogs. The goal of treatment is to control the signs and symptoms and improve the quality of life for your dog. The type of treatment will be based on the severity of the disease and how your dog is responding to therapy.
Possible treatments for pemphigus foliaceus in dogs include:
Antibiotics: If a secondary bacterial infection is present, antibiotics may be prescribed.
Corticosteroids: Corticosteroids will be used to suppress the immune system and help to control the signs and symptoms of pemphigus foliaceus. The use of corticosteroids should balance efficacy with potential side effects.
Immunosuppressants (non-corticosteroids): Cyclosporine and azathioprine are two of the most common nonsteroidal medications used to treat pemphigus foliaceus. They may be used in conjunction with corticosteroids.
Usually, therapy is needed for an extended period and may be lifelong. Therapy aims to achieve remission with the lowest effective dose. To reduce the dose of individual drugs, combination therapies may be used.
What is the prognosis for dogs with pemphigus foliaceus?
The prognosis for pemphigus foliaceus in dogs is variable. Some dogs respond well to treatment and achieve remission, while others have a more chronic course with relapses. With appropriate and timely treatment, the majority of dogs will have a good quality of life.
What breeds are commonly affected by pemphigus foliaceus?
Predisposed breeds include the Akita and chow-chow.
Pemphigus foliaceus in dogs is a rare autoimmune skin disease that causes blistering in the mouth, nose, and skin. It most commonly affects middle-aged dogs and can appear at any time. Symptoms include pustules on the face, muzzle, ears, and feet; and ulcers on the nose and lips. Treatment includes medication to treat all symptoms and reduce inflammation, antibiotics if secondary bacterial infections are present, and corticosteroids to suppress the immune system. The prognosis for pemphigus foliaceus in dogs is variable, but with appropriate treatment, most dogs will have a good quality of life. If you are concerned that your dog may be affected by pemphigus foliaceus, please contact your veterinarian.