Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지
DOI QR코드

DOI QR Code

Pemphigus-like Drug Reaction after Surgical Removal of a Splenic Hemangiosarcoma in a Dog

  • An, Sung-Ah (College of Veterinary Medicine, Chungnam National University) ;
  • Wang, Hye-Bin (College of Veterinary Medicine, Chungnam National University) ;
  • Han, Man-Gil (Royal Animal Medical Center) ;
  • Jung, In-Sung (Royal Animal Medical Center) ;
  • Song, Kun-Ho (College of Veterinary Medicine, Chungnam National University) ;
  • Seo, Kyoung-Won (College of Veterinary Medicine, Chungnam National University)
  • Received : 2016.10.06
  • Accepted : 2017.03.28
  • Published : 2017.04.28
Download PDF
⟨ Previous Next ⟩

Abstract

A 7-year-old spayed female Shih-tzu dog with 4-month history of anorexia and weight loss was diagnosed with splenic hemangiosarcoma. One week after splenectomy, the dog developed severe, multifocal, coalescing erosive and ulcerative dermatosis with epidermal collarettes and crusts on the dorsal trunk. The dog was prescribed systemic antibiotics comprising cephradine and enrofloxacin postoperatively. Histopathological examination of skin biopsies from haired skin lesions revealed changes consistent with pemphigus foliaceus (PF). Tentative diagnosis for this patient was pemphigus-like drug reaction resulting from cephradine treatment. However, given the dog's history of hemangiosarcoma, paraneoplastic pemphigus (PNP), a rarely reported cancer-related pemphigus in dogs, was also considered for tentative diagnosis. Significant clinical remission of dermal lesions was achieved with four weeks of prednisolone and mycophenolate mofetil (MMF) treatment. Drugs were gradually tapered and eventually discontinued with concurrent reduction of dermal lesions, and no further recurrence was noted.

Keywords

References

  1. Anhalt GJ, Kim SC, Stanley JR, Korman NJ, Jabs DA, Kory M, Izumi H, Ratrie H, Mutasim D, Ariss-Abdo L. Paraneoplastic pemphigus. An autoimmune mucocutaneous disease associated with neoplasia. N Engl J Med 1990; 323: 1729-1735. https://doi.org/10.1056/NEJM199012203232503
  2. Bizikova P, Dean GA, Hashimoto T, Olivry T. Cloning and establishment of canine desmocollin-1 as a major autoantigen in canine pemphigus foliaceus. Vet Immunol Immunopathol 2012; 149: 197-207. https://doi.org/10.1016/j.vetimm.2012.06.025
  3. Bizikova P, Linder KE, Olivry T. Fipronil-amitraz-S-methoprene-triggered pemphigus foliaceus in 21 dogs: clinical, histological and immunological characteristics. Vet Dermatol 2014; 25: 103-111. https://doi.org/10.1111/vde.12117
  4. Bizikova P, Moriello KA, Linder KE, Sauber L. Dinotefuran/pyriproxyfen/permethrin pemphigus-like drug reaction in three dogs. Vet Dermatol 2015; 26: 206-208. https://doi.org/10.1111/vde.12202
  5. Brenner S, Bialy-Golan A, Ruocco V. Drug-induced pemphigus. Clin Dermatol 1998; 16: 393-397. https://doi.org/10.1016/S0738-081X(98)00010-8
  6. Bruin D, Meulemeester D. Paraneoplastic pemphigus in a dog. Vet Dermatol 1998; 9: 127-134. https://doi.org/10.1046/j.1365-3164.1998.00095.x
  7. Camisa C, Helm TN, Liu YC, Valenzuela R, Allen C, Bona S, Larrimer N, Korman NJ. Paraneoplastic pemphigus: a report of three cases including one long-term survivor. J Am Acad Dermatol 1992; 27: 547-553. https://doi.org/10.1016/0190-9622(92)70220-A
  8. Elmore SA, Basseches J, Anhalt GJ, Cullen JM, Olivry T. Paraneoplastic pemphigus in a dog with splenic sarcoma. Vet Pathol 2005; 42: 88-91. https://doi.org/10.1354/vp.42-1-88
  9. Frew JW, Murrell DF. Paraneoplastic pemphigus (paraneoplastic autoimmune multiorgan syndrome): clinical presentations and pathogenesis. Dermatol Clin 2011; 29: 419-425. https://doi.org/10.1016/j.det.2011.03.018
  10. Hill PB, Brain P, Collins D, Fearnside S, Olivry T. Putative paraneoplastic pemphigus and myasthenia gravis in a cat with a lymphocytic thymoma. Vet Dermatol 2013; 24: 646-649. https://doi.org/10.1111/vde.12086
  11. Horn TD, Anhalt GJ. Histologic features of paraneoplastic pemphigus. Arch Dermatol 1992; 128: 1091-1095. https://doi.org/10.1001/archderm.1992.01680180085011
  12. Horvath C, Neuber A, Litschauer B. Pemphigus foliaceuslike drug reaction in a 3-month old cross breed dog treated for juvenile cellulitis. Vet Dermatol 2007; 18: 353-359. https://doi.org/10.1111/j.1365-3164.2007.00620.x
  13. Iwasaki T, Shimizu M, Obata H, Isaji M, Yanai T, Kitagawa H, Sasaki Y. Detection of canine pemphigus foliaceus autoantigen by immunoblotting. Vet Immunol Immunopathol 1997; 59: 1-10. https://doi.org/10.1016/S0165-2427(97)00054-8
  14. Joly P, Richard C, Gilbert D, Courville P, Chosidow O, Roujeau JC, Beylot-Barry M, D'incan M, Martel P, Lauret P, Tron F. Sensitivity and specificity of clinical, histologic, and immunologic features in the diagnosis of paraneoplastic pemphigus. J Am Acad Dermatol 2000; 43: 619-626. https://doi.org/10.1067/mjd.2000.107488
  15. Miller WH, Griffin CE, Campbell KL. Autoimmune and immune-mediated dermatoses. In: Muller and Kirk's small animal dermatology, 7th ed. St Louis: Elsevier. 2013; 483-445.
  16. Nguyen VT, Ndoye A, Bassler KD, Shultz LD, Shields MC, Ruben BS, Webber RJ, Pittelkow MR, Lynch PJ, Grando SA. Classification, clinical manifestations, and immunopathological mechanisms of the epithelial variant of paraneoplastic autoimmune multiorgan syndrome: a reappraisal of paraneoplastic pemphigus. Arch Dermatol 2001; 137: 193-206.
  17. Oberkirchner U, Linder KE, Dunston S, Bizikova P, Olivry T. Metaflumizone-amitraz (Promeris)-associated pustular acantholytic dermatitis in 22 dogs: evidence suggests contact drug-triggered pemphigus foliaceus. Vet Dermatol 2011; 22: 436-448. https://doi.org/10.1111/j.1365-3164.2011.00974.x
  18. Olivry T. A review of autoimmune skin diseases in domestic animals: I-superficial pemphigus. Vet Immunol Immunopathol 2006; 17: 291-305.
  19. Olivry T, LaVoy A, Dunston SM, Brown RS, Lennon EM, Warren SJ, Prisayanh P, Muller EJ, Suter MM, Dean GA. Desmoglein-1 is a minor autoantigen in dogs with pemphigus foliaceus. Vet Immunol Immunopathol 2006; 110: 245-255. https://doi.org/10.1016/j.vetimm.2005.10.002
  20. Preziosi DE, Goldschmidt MH, Greek JS, Jeffers JG, Shanley KS, Drobatz K, Mauldin EA. Feline pemphigus foliaceus: a retrospective analysis of 57 cases. Vet Dermatol 2003; 13: 313-321.
  21. Rosenkrantz WS. Pemphigus: current therapy. Vet Dermatol 2004; 15: 90-98. https://doi.org/10.1111/j.1365-3164.2004.00360.x
  22. White SD, Carlotti DN, Pin D, Bonenberger T, Ihrke PJ, Monet E, Nishifuji K, Iwasaki T, Papich MG. Putative drugrelated pemphigus foliaceus in four dogs. Vet Dermatol 2002; 13: 195-202. https://doi.org/10.1046/j.1365-3164.2002.00297.x
  23. Williams JV, Marks JG, Jr., Billingsley EM. Use of mycophenolate mofetil in the treatment of paraneoplastic pemphigus. Br J Dermatol 2000; 142: 506-508. https://doi.org/10.1046/j.1365-2133.2000.03365.x
  24. Wilson JP, Koren JF, Daniel RC, 3rd Chapman SW. Cefadroxil-induced ampicillin-exacerbated pemphigus vulgaris: case report and review of the literature. Drug Intell Clin Pharm 1986; 20: 219-223. https://doi.org/10.1177/106002808602000309
  25. Wolf R, Tamir A, Brenner S. Drug-induced versus drugtriggered pemphigus. Dermatologica 1991; 182: 207-210. https://doi.org/10.1159/000247795

Cited by

  1. Are low doses of oral glucocorticoids as effective as high doses as the sole treatment for canine pemphigus foliaceus? vol.185, pp.21, 2017, https://doi.org/10.1136/vr.l6563