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Pemphigus Foliaceous
Pemphigus foliaceous is an uncommon autoimmune disease characterized by autoantibody production and the subsequent development of pustules in the superficial layers of the skin. Pemphigus foliaceous is most commonly seen in middle-aged dogs. The diagnosis is based on the clinical signs, skin biopsy and immunologic testing.
Signs
At the early onset the disease may be confined to the head, but later it spreads to more of the body. The lesions are bilaterally symmetrical and tend to develop in waves; animals may progress rapidly from the total absence of disease signs to the sudden appearance of dozens of pustules which quickly progress to form thick, adherent crusts with marked peeling. These peeling crusts represent the hallmark of the pemphigus foliaceous. The top of the muzzle and ears, the skin around eyes, and footpads are the most common sites of lesions. Severely affected dogs may have fever.
Treatment
Immunosuppressive drug therapy using corticosteroids or other, more potent medications, is essential to treatment. If your dog takes steroids, be vigilant about keeping his bowl full of fresh water, as the drugs often cause increased thirst. Most dogs stay on a low dose of medication throughout their lifetime.
Recent studies show that in some dogs with pemphigus foliaceous, immunosuppression can lead to long-term remission of skin lesions, and that discontinuation of treatment is not necessarily followed by a recurrence of clinical signs.
After clinical signs undergo complete remission, which occur 2 to 5 months after immunosuppression is started, the drugs may be tapered progressively and eventually withdrawn. The total duration of immunosuppressive therapy can vary between 3 and 22 months. Skin lesions of pemphigus foliaceous may not recur for up to 6 years after treatment is stopped.
Photo courtesy of PENN Veterinary Medicine
Breeds Commonly Affected by Pemphigus Foliaceous
References
- Olivry T, Bergvall KE, Atlee BA. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University. Prolonged remission after immunosuppressive therapy in six dogs with pemphigus foliaceous.
- Mordecai Siegal. UC Davis Book of Dogs: The Complete Medical Reference Guide for Dogs and Puppies.
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