Resolution of iatrogenic calcinosis cutis in a dog through topical application of DMSO

Tolon, Jose Maria Cifuentes; Jimenez, Juan Jose Esteban; Irizar, Iñigo Gilabert; Trasobares, Paula Casas

doi:10.1136/vetreccr-2018-000619

Cited by 3 publications

(7 citation statements)

References 5 publications

(6 reference statements)

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“…A forma distrófica ou idiopática ocorre quando a calcificação acontece em um local em que houve um dano tecidual, podendo ser devido a trauma, manipulação cirúrgica, necrose, inflamação, hipercortisolismo ou neoplasia, porém, os níveis séricos de cálcio e fósforo encontram-se normais (Lee et al, 2016;Tafti et al, 2005). Segundo Tolon et al (2018), este subtipo está associado a doenças endócrinas como o HAC, pois pacientes que são tratados com corticoides durante um longo período, comprovando o achado descrito no relato.…”

Section: Resultsunclassified

“…De acordo com a anamnese e exame físico, não houve danos no local antes da formação da calcificação e nenhum procedimento cirúrgico foi realizado, porém, tutores relatam uso contínuo de medicação glicocorticoide para controle de quadro alérgico, o que comprova a literatura descrita por Tolon et al (2018) que definem o uso contínuo de corticoides como uma das causas de hipercortisolismo em cães e por sua vez, quando descontrolado pode levar à calcinose cutânea distrófica.…”

Section: Resultsunclassified

“…Medidas terapêuticas podem incluir o uso de corticosteroides, modificação da dieta, administração de suplementos vitamínicos e minerais com o objetivo de corrigir as deficiências nutricionais, analgésicos, além do manejo adequado das lesões cutâneas. Em casos mais graves pode ser necessária a remoção cirúrgica das lesões (Boag, 2012;Kim et al, 2021;Tolon et al, 2018).…”

Section: Introductionunclassified

See 2 more Smart Citations

Calcinosis cutánea en un perro con hipercortisolismo: Reporte de caso

Bessa,

Rafael,

Teixeira

et al. 2023

Pubvet

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A calcinose cutânea em cães é uma condição dermatológica que envolve o depósito de sais de cálcio na pele dos animais. Sua etiologia ainda não foi totalmente estabelecida, mas acredita-se que fatores genéticos, nutricionais e metabólicos possam desempenhar um papel importante no desenvolvimento da doença. Esta patologia é dividida de acordo com sua patogênese em quatro subtipos: distrófica, metastática, idiopática e iatrogênica, sendo a distrófica a causa mais comum. O hipercortisolismo, também conhecido como síndrome de Cushing, é uma das principais causas de calcinose cutânea em cães. Nesta condição, há um excesso de produção de cortisol pelas glândulas adrenais, levando a uma série de alterações metabólicas, imunológicas e inflamatórias, que contribuem para a formação de depósitos de cálcio na pele. Os sintomas são variáveis, mas geralmente se manifestam por meio da formação de nódulos subcutâneos duros e brancos, que podem ulcerar ou drenar material cremoso. Seu diagnóstico é realizado por meio de exames clínicos e laboratoriais, como citologia dos nódulos, biópsia e exames laboratoriais. O tratamento visa o controle da doença subjacente e cuidados locais, porém é bastante desafiador, uma vez que não há uma terapia específica estabelecida. Esse trabalho objetivou relatar um caso de um cão diagnosticado com hipercortisolismo e apresentando calcinose cutânea secundária.

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Section: Resultsunclassified

Section: Introductionunclassified

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Calcinosis cutánea en un perro con hipercortisolismo: Reporte de caso

Bessa,

Rafael,

Teixeira

et al. 2023

Pubvet

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“…The management of the underlying disease and possible secondary bacterial infections are the basis of treatment [12]. Thus, the patient was treated with trilostane, antibiotic therapy and intensive hydration of the mineralized plaques resulting in a satisfactory involution of the clinical signs.…”

Section: Discussionmentioning

confidence: 99%

Calcinosis Cutis with Large Extension and Uncommon Location in a Dog

Moraes

Romani

Amaral

et al. 2021

Acta Scientiae. Vet.

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Background: Calcinosis cutis is an uncommon dermatopathy characterized by the deposition of minerals in the skin, usually involving collagen and elastic fibers in the dermis. Usually, it results from dystrophic calcification and can be generalized or focal. The dermatopathy may be primary or secondary to certain disorders, especially chronic proliferative otitis, foreign body reactions, hyperadrenocorticism (HAC) and less frequently percutaneous penetration of calcium-rich products. The aim of this report is to describe a presentation of calcinosis cutis affecting the skin of the back, internal face of hind limbs and anal region of a 9-year-old bitch.Case: A 9-year-old, non-defined breed, bitch, ovariohysterectomized, weighing 9.45 kg, was attended at the Dermatological Service of companion animals at the Veterinary Hospital of the Federal University of Jataí (UFJ). The animal came in with the complaint of extensive dorsal alopecia, covered by firm lesions, with a 3-month evolution, additionally to polyuria and polydipsia. After physical examination, alopecic areas of great extension were confirmed on the dorsum, on the internal surface of the hind limbs and in the anal region. Also, an exudative and painful lesion located on the back was detected, plus loss of elasticity of the ventral abdomen skin and visible abdominal vessels. The screening tests showed a marked increase in the alanine aminotransferase enzyme (ALT), alkaline phosphatase (ALP) and total cholesterol. The specific urinary density was decreased. On the ultrasound examination, hepatomegaly and an increase in the caudal pole of the left adrenal were detected. Based on these findings, calcinosis cutis secondary to spontaneous hyperadrenocorticism (HAC) was suspected. For confirmation, skin biopsy and low dose dexamethasone suppression test (LDDS) were performed. LDDS test showed no reduction of serum cortisol after 8 h of dexamethasone dose administration and histopathological evaluation revealed multiple foci of calcinosis characterized by the deposition of basophilic material on the pre-existing collagen fibers, plus areas with pyogranulomatous inflammatory reaction and peripheral fibrosis with transepidermal elimination of minerals. Thus, trilostane and intense hydration of skin plaques were applied as treatment.Discussion: The dermatological alterations were compatible with those described in the consulted literature, with remarkable yellow-brown, firm, sandy-looking plaques, located on the back, internal face of hind limbs and anal region, possibly related to HAC later confirmed by LDDS test and biopsy. The management of the underlying disease and possible secondary bacterial infections are the basis of treatment. Therefore, the patient was treated with trilostane, antibiotic therapy and intensive hydration of the mineralized plaques resulting in a satisfactory involution of the clinical signs. Even though there are reports of calcinosis cutis on the dorsum, in the consulted literature there was no evidence of dorsum large extension lesion due to HAC as in this case report, but secondary to exogenous corticosteroid treatment, systemic blastomycosis and leptospirosis. In this case report, the affected thorax portion was the dorsum, differently from a study that pointed the ventral thorax as the affected portion. Similarly, anus and ventral part of the tail were hardly affected together with secondary inflammation and ulceration. Thus, the existent literature shows areas of calcinosis cutis in dogs in different parts of the body, but neither extensive as in the back of this reported female dog, nor widely affected as in the anal area, additionally to the internal face of hind limbs as already reported in the literature.

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“…Topical treatment of the calcinosis cutis lesions with dimethyl sulfoxide (DMSO) 99.7 per cent (Pro Vitas; Supplements ProVitas International S.L.) once daily was prescribed to hasten resolution due to its anti‐inflammatory effects and ability to capture free radicals, as well as the promotion of translocation of substances via biological membranes 3 9. Since the bacterial skin infection was generalised and because of the nature of the lesions, a deeper skin infection could not be excluded and the dog was treated systemically with empirical cephalexin (25 mg/kg twice daily, Cefalexin; CP‐Pharma Handelgesellschaft mbH) 5.…”

Section: Treatmentmentioning

confidence: 99%

Use of fluorescent light energy for the management of bacterial skin infection associated with canine calcinosis cutis lesions

Apostolopoulos

Mayer

2020

Vet Record Case Reports

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A 15-year-old male golden retriever who had been receiving prednisolone for orthopaedic problems for the past 2 years was presented for multifocal symmetrical alopecia, skin nodules and plaques on the dorsal aspect of the body. Cytology was compatible with calcinosis cutis due to suspected iatrogenic hypercortisolism, with secondary pyoderma. The Phovia system, a device that emits fluorescent light energy (FLE), was used as an adjunct to systemic antimicrobial and topical (spray and shampoo) therapies. Part of the lesions were covered with a towel and not exposed to Phovia, to evaluate efficacy. Cytology confirmed accelerated improvement of the Phovia-illuminated lesions compared with unexposed lesions. To the authors’ knowledge, this is the first report of FLE being used to manage bacterial skin infection associated with canine calcinosis cutis. It highlights the importance of this type of topical management against bacterial skin infections.

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Resolution of iatrogenic calcinosis cutis in a dog through topical application of DMSO

Cited by 3 publications

References 5 publications

Calcinosis cutánea en un perro con hipercortisolismo: Reporte de caso

Calcinosis cutánea en un perro con hipercortisolismo: Reporte de caso

Calcinosis Cutis with Large Extension and Uncommon Location in a Dog

Use of fluorescent light energy for the management of bacterial skin infection associated with canine calcinosis cutis lesions

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