Clinical and histopathological features of pemphigus foliaceus with and without eosinophilic infiltrates: a retrospective evaluation of 40 dogs

Abstract

The importance of cellular infiltrates in tissues has been investigated as a diagnostic tool, mechanism of pathogenesis, and prognostic indicator in certain human diseases. Eosinophils, in particular, have a distinct role in the development of cutaneous lesions in human autoimmune diseases. Identification of an eosinophilic infiltrate can aid the diagnosis of immunobullous disease in the early stages of the disease process. In canine pemphigus foliaceus, eosinophils are present to a variable degree within lesional tissue. This study retrospectively evaluated 40 dogs with pemphigus foliaceus, and examined clinical and histologic features and final outcomes in cases with and without eosinophilic infiltrates. Twenty-five of 40 dogs (63%) had an eosinophilic infiltrate in either the pustules/crust, follicular infundibulum or dermis. There was no statistically significant difference in clinical distribution or appearance of dermatological lesions, response to treatment, or disease outcome in dogs with or without an eosinophilic infiltrate. However, dogs with concurrent disease were significantly more likely to have an eosinophilic infiltrate (P = 0.01). Dogs with adverse effects associated with immunosuppressive therapy were significantly more likely to have an eosinophilic infiltrate (P = 0.05). Fifteen of 40 dogs (38%) had a history of allergic disease and a significantly higher proportion of these dogs had an eosinophilic infiltrate (P = 0.04). An eosinophilic infiltrate was found in more than half of the dogs in this study. These findings justify further studies to investigate the role of eosinophils in the pathogenesis, therapy and prognosis in dogs with pemphigus foliaceus.

Clinical presentation, treatment and outcome in dogs with pemphigus foliaceus with and without vasculopathic lesions: an evaluation of 41 cases

“…One study evaluated whether eosinophilic infiltrates are associated with outcome, and there was no difference in survival between those with an eosinophilic infiltrate and those without. 7 However, the study did indicate that dogs with adverse effects associated with treatment and those with concurrent diseases were more likely to have an eosinophilic infiltrate. 7 Based on the authors' experience, there is a subset of dogs with PF and histopathological evidence of vasculopathic lesions.…”

“…In fact, in that same study, among the dogs that died, 41.9% (18 of 43) were euthanised as a consequence of the direct complications of skin disease, including adverse effects associated with treatment 5 . Based on the most recent report, 46% (17 of 37) of dogs had some adverse effects associated with treatment 7 . Iatrogenic Cushing’s syndrome is especially common because glucocorticoids are a mainstay of treatment.…”

“…There are rare reports on the variation in histopathological findings in dogs with PF and association with outcome. One study evaluated whether eosinophilic infiltrates are associated with outcome, and there was no difference in survival between those with an eosinophilic infiltrate and those without 7 . However, the study did indicate that dogs with adverse effects associated with treatment and those with concurrent diseases were more likely to have an eosinophilic infiltrate 7 …”

“…5 Based on the most recent report, 46% (17 of 37) of dogs had some adverse effects associated with treatment. 7 Iatrogenic Cushing's syndrome is especially common because glucocorticoids are a mainstay of treatment. Identification of more prognostic indicators may help to better predict which dogs with PF are likely to respond favourably to treatment and to help guide treatment.…”

Avaliação de exeqüibilidade e da efetividade da determinação de anticorpos séricos pela IFI, em cães acometidos por pênfigo foliáceo na pré e trans-terapia

“…Este infiltrado eosinofílico pode ter relação com uma dermatite alérgica prévia, segundo Vaughan et al (2010). Como as pústulas se rompem facilmente muitas vezes o diagnóstico advêm da presença de queratinócitos livres e degenerados aderidos às crostas (IHRKE et al, 1985a).…”