Comparison of clinical history and dermatologic findings in 29 dogs with severe eosinophilic dermatitis: a retrospective analysis

Abstract

The medical records and histopathological sections of 29 dogs diagnosed with a unique eosinophilic dermatitis resembling Wells' syndrome were reviewed in an attempt to elucidate the pathogenesis of this syndrome. The medical records were reviewed for information on dermatological lesion appearance, systemic signs in other organ systems, clinical analyte abnormalities, and drug therapy. Histological sections of dogs with moderate to severe eosinophilic dermatitis without folliculitis and furunculosis were reviewed and evaluated for the presence of collagen flame figures. Three categories of patients were found. Category 1 consisted of 17 dogs treated for vomiting and/or diarrhoea (often haematochezia or haematemesis) prior (mean: 4.6 days) to the onset of skin lesions. Fourteen category 1 dogs had erythematous lesions (macules, papules or plaques) that were most pronounced on the abdomen. Sixteen of the 17 dogs received multiple classes of drugs, and 59% were hypoalbuminemic. Category 2 consisted of five dogs that had skin lesions and gastrointestinal signs at presentation and four of these dogs were hypoalbuminemic. Category 3 included seven dogs without enteric illness. A positive drug score was found in six category 1 dogs and one each from categories 2 and 3. Eighteen cases had eosinophilic dermatitis without flame figures, seven cases had early flame figures and four had well-developed flame figures. These changes did not correlate with the categories of clinical presentation. More than 50% of the dogs developed eosinophilic dermatitis following treatment for severe gastrointestinal disease. The authors propose that this represents a unique syndrome that may have causal drug association.

Eosinophilic dermatitis with edema (WellsMike syndrome) possibly triggered by cooked fish in a dog

“…The case reported here fulfilled the clinical and histopathologic criteria of EDE, as they have been established for the dog (Holm et al 1999, Mauldin et al 2006. Eosinophilic dermatitis with edema is an uncommon reaction pattern, most likely of multi factorial allergic etiology, characterized by a unique histopathologic pattern (Gross 2005 r (Gross 2005, Weedon 2009).…”

“…The human disease, apart from being idiopathic, has been associated with various infectious and parasitic diseases, heredity, malignant neoplasms, drugs, vaccines, atopic disease, arthropod bites, the hypereosinophilic syndrome and urticaria (Dijkstra et al 1986, Weedon 2009). In the dog, EDE has been associated with gastrointestinal disease, drugs, arthropod bites and allergic diseases (Holm et al 1999, Bloom 2006, Mauldin et al 2006. In a retrospective analysis of 29 canine EDE cases, severe gastrointestinal disease was the most common trigger factor that may have causal drug association (Mauldin et al 2006).…”

“…In the dog, EDE has been associated with gastrointestinal disease, drugs, arthropod bites and allergic diseases (Holm et al 1999, Bloom 2006, Mauldin et al 2006. In a retrospective analysis of 29 canine EDE cases, severe gastrointestinal disease was the most common trigger factor that may have causal drug association (Mauldin et al 2006). Approximately half of the reported canine cases had a history of atopy, suggesting a tendency to hypersensitivity reaction to various agents (Bloom 2006).…”

“…In another retrospective study on canine EDE (Holm et al 1999), only 2 out of 9 dogs had been exposed to new food, although its role could be questioned because other factors may have, also, exerted their influence simultaneously. In the study of Mauldin et al (2006), at least one dog was eventually diagnosed with food allergy, while three others were therapeutically placed on limited antigen or hydrolyzed diets. Interestingly, (b) Êtkm^à one of the authors (AFK) has reported urticarial reaction in two dogs that appeared soon after the consumption of fried fish, only to disappear a couple of hours later.…”

“…The latter disease is uncommonly occuring in the everyday practice, as only 39 cases have been reported so far in the veterinary literature (Vitale et al 1994, Holm et al 1999, Mauldin et al 2006). In the affected dogs, erythematous macules and papules that progress and coalesce into plaques of various shapes, usually appear suddenly and are mainly localized on the pinnae, ventral abdomen, thorax and the extremities and they are occasionally accompanied by facial or generalized pitting edema (Holm et al 1999).…”