Felis ISSN 2398-2950

Skin: pemphigus foliaceus

Contributor(s): Prof Douglass Macintire, David Scarff, Richard Squires

Introduction

  • Rare auto-immune skin disease characterized by subcorneal vesicles or pustules.
  • Most common type of pemphigus diagnosed in cats; thought to be an auto-immune skin disease resulting from auto-antibodies directed against desmoglein 1 (intracellular substance), causing acantholysis of keratinocytes; drug-induced disease rarely involved.
  • Doesnotsolely involve mucocutaneous junctions.
  • Signs: exfoliative dermatitis of face, ears and paws.
  • Diagnosis: biopsy and histopathology/immunofluorescence.
  • Treatment: immunosuppressive therapy.
  • Prognosis: guarded.
    Print off the owner factsheet on Pemphigus  Pemphigus  to give to your client.

Pathogenesis

Etiology

  • Unknown.

Predisposing factors

General

Pathophysiology

  • Auto-antibodies directed against intercellular cement substance and/or keratinocyte cell membrane cause damage which   →   skin lesions.
  • See also other forms of pemphigus:
  • Lesions arise due to binding of auto-antibody to antigens associated with the epidermal cell membrane.
  • Protease release   →   intercellular cement breakdown   →   cell detachment andacantholysis(loss of cohesion between epidermal cells).
  • Auto-antibodies can be detected in circulation.
  • Disease responds to immunosuppressive therapy which reduces circulating auto-antibody.
  • In humans plasmapheresis (reducing circulating levels of auto-antibody) also reduces clinical signs.
  • Subcorneal vesicles and pustules with prominent acantholysis which may involve hair follicle rupture   →   crust formation.

Timecourse

  • Lesions start on face but may progress to be multifocal.
  • May survive for several years with treatment.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Day M J, Hanlon L & Powell L M (1993) Immune-mediated skin disease in the dog and cat. J Comp Pathol 109 (4), 395-407 PubMed.
  • Mason K V & Day M J (1987) A pemphigus foliaceus-like eruption associated with the use of ampicillin in cat. Aust Vet J 64 (7), 223-4 PubMed.
  • Scott D W, Walton D K, Slater M R et al (1987) Immune-mediated dermatoses in domestic animals: ten years after - part I. Comp Cont Ed Pract Vet (4), 424-435 VetMedResource.
  • Caciola P L, Nesbitt G H, Hurvitz A I (1984) Pemphigus foliaceous in 8 cats; and results of induction treatment using azathioprine. JAAHA 20, 571-577.
  • Manning T O, Scott D W, Smith C A et al (1982) Pemphigus diseases in the feline: seven cases reports and discussion. JAAHA 18 (3), 433-443 VetMedResource.

Other sources of information

  • Von Tscharner C (1984) Pemphigus in the cat. Proceedings 1st European Veterinary Dermatology Meeting, Hamburg.


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