|
Epidermal Dysplasia
Epidermal Dysplasia is a hereditary, very severe skin disorder reported most often in West Highland White Terriers.
Signs of Epidermal Dysplasia
The early signs of epidermal dysplasia usually occurs between 6 and 12 months of age. Intense itching and skin inflammation are the primary symptoms. The initial distribution of lesions is on the abdomen, extremities, and face. The lesions become more spread with alopecia, thickening and hardening of the skin, greasy skin, and foul odor. Inflammation of the ear with excessive earwax buildup, secondary bacterial skin and lymph node infections are common.
Malassezia is frequently identified although it is not found in all dogs with epidermal dysplasia.
It is often, but not always, associated with secondary Malassezia infection.
Diagnosis of Epidermal Dysplasia
The early age of onset of severe inflammation and itchiness rapidly progressing to chronic lesions in a West Highland White Terrier is one of the reasons for suspecting the disorder. A tentative diagnosis is made from skin biopsy findings. A definitive diagnosis of epidermal dysplasia can be made only with characteristic clinical and histologic findings and can be assessed only by evaluating response after appropriate topical and systemic antimicrobial therapy.
Treatment and Prognosis for Epidermal Dysplasia
Epidermal dysplasia is usually non-responsive to medical therapy with drugs including antibiotics, anti-inflammatory doses of glucocorticoids, antiseborrheic shampoos, vitamin A alcohol, systemic retinoids, vitamin E, and essential fatty acids. The prognosis is poor, especially if the condition is chronic and severe secondary changes have occurred. In dogs with secondary Malassezia invasion, there may be significant improvement in itchiness and skin condition with ketoconazole (Nizoral) and twice-weekly application of topical ketoconazole (Nizoral shampoo) for 3 to 4 weeks.
Recurrence of the Malassezia infection is common. Periodic ketoconazole shampoos help to prevent relapses. A sulfur and benzoyl peroxide shampoo has also been helpful in long-term management of some cases. For cases in which the chronic cutaneous changes have not occurred, there may be a dramatic response to oral prednisone or prednisolone until the condition is controlled followed by a gradual decrease in the dose to alternate-day for long-term maintenance. Before such therapy is used, allergies are to be ruled out and the side effects associated with chronic steroid therapy should be considered.
References:
1. Scott, Miller, Griffin. Small Animal Dermatology, 5th ed., Philadelphia, WB Saunders
2. Nesbitt & Ackerman. Canine & Feline Dermatology, 1st ed., New Jersey, Veterinary Learning Systems
|
Related Diseases and Disorders
|