Discoid lupus erythematosus (veterinary medicine)
In veterinary medicine, discoid lupus erythematosus (DLE) is the skin form of lupus erythematosus , an autoimmune disease . It manifests itself primarily on the nasal mirror and largely corresponds to chronic discoid lupus erythematosus (CDLE) in humans.
Occurrence
The Discoid lupus erythematosus occurs in domestic cats and domestic dogs on. In dogs, an accumulation of shepherds ( German Shepherd Dog , Belgian Shepherd Dog , Collie , Shetland Sheepdog ), Siberian Husky , Epagneul Breton and German Shorthaired Pointer has been described.
The main manifestation is on the nasal mirror. The skin - mucous membrane transitions on the mouth and eye, the auricle, vulva and scrotum or the extremities are affected less often .
The disease often shows seasonal dynamics. In summer, the symptoms are more pronounced due to direct sunlight.
clinic
The primary skin changes in DLE are loss of pigmentation ( hypopigmentation ) and reddening of the skin . An edema furrows elapse of the nose leather and thus appear smooth. In the further course, erosions , ulcers , crusts and hair loss also develop . Hyperkeratosis can occur on the nasal plane and balls of the feet . In addition to hypopigmentation, excessive pigment storage ( hyperpigmentation ) can develop.
In cats, DLE manifests itself primarily on the auricle with redness, ulcers, crusts and scales.
The main differential diagnoses are pyoderma , leishmaniasis , dermatomyositis , pemphigus vulgaris and pemphigus erythematosus . The diagnosis is made using a skin biopsy .
therapy
Therapy is usually necessary for life. Since the DLE is often complicated by secondary bacterial infections, treatment with staphylococci -wirksamen antibiotics useful. Local application of anti-inflammatory ointments ( hydrocortisone , betamethasone , fluocinolone , amcinolone ) is often sufficient for DLE in the winter months .
If local therapy does not respond, systemic therapy must be carried out. In dogs, a combination of tetracycline and nicotinamide is considered the therapy of choice, which may be supplemented with local therapy. High-grade DLE can be addressed with immunosuppression with glucocorticoids . However, this is always associated with side effects (iatrogenic Cushing's syndrome in dogs , occasionally diabetes mellitus in cats ). Azathioprine can also be used in dogs . Azathioprine is contraindicated in cats (fatal bone marrow loss); chlorambucil can be tried here.
literature
- Chiara Noli and F. Scarampella: Discoid Lupus Erythematosus . In: Practical Dermatology in Dogs and Cats . 2nd Edition. Schlütersche, Hannover 2005, ISBN 3-87706-713-1 , p. 278-282 .
