3살령의 중성화 하지 않은 암컷 풍산개가 4개월 동안의 전신 항생제와 글루코 코르티코이드 치료에 반응하지 않는 미란성의 발적을 동반한 피부염을 주증상으로 내원하였다. 신체검사상 귀끝, 콧잔등과 앞다리에서 가피, 미란, 탈모가 관찰되었으며, 농포의 세포학적 검사에서 원형의 극세포해리성 각질세포들이 비퇴행성의 호중구, 호산구와 함께 관찰되었다. 조직병리학적 검사 결과, 표피내 농포에는 다수의 호중구, 소수의 호산구와 고립되거나 군집되어있는 해리성 극세포가 포함되어 있었다. 본 환자는 병력, 임상증상, 세포학적, 조직병리학적 검사를 통해 낙엽성천포창으로 진단되었으며, 피부병변은 사이클로스포린의 경구 투약으로 개선되었다. 이 증례는 면역 억제제인 사이클로스포린의 단독 사용으로 개에서의 낙엽성 천포창을 치료 관리 할 수 있다는 것을 입증하였다.
3살령의 중성화 하지 않은 암컷 풍산개가 4개월 동안의 전신 항생제와 글루코 코르티코이드 치료에 반응하지 않는 미란성의 발적을 동반한 피부염을 주증상으로 내원하였다. 신체검사상 귀끝, 콧잔등과 앞다리에서 가피, 미란, 탈모가 관찰되었으며, 농포의 세포학적 검사에서 원형의 극세포해리성 각질세포들이 비퇴행성의 호중구, 호산구와 함께 관찰되었다. 조직병리학적 검사 결과, 표피내 농포에는 다수의 호중구, 소수의 호산구와 고립되거나 군집되어있는 해리성 극세포가 포함되어 있었다. 본 환자는 병력, 임상증상, 세포학적, 조직병리학적 검사를 통해 낙엽성 천포창으로 진단되었으며, 피부병변은 사이클로스포린의 경구 투약으로 개선되었다. 이 증례는 면역 억제제인 사이클로스포린의 단독 사용으로 개에서의 낙엽성 천포창을 치료 관리 할 수 있다는 것을 입증하였다.
A 3-year-old, intact female Poong-san dog was presented with a 4-month history of erosive, erythematous dermatitis unresponsive to systemic antibiotics and glucocorticoids. Crust, erosion, and alopecia were noted on the ear pinnae, bridge of nose, and forelimb. Cytological evaluation of intact pustu...
A 3-year-old, intact female Poong-san dog was presented with a 4-month history of erosive, erythematous dermatitis unresponsive to systemic antibiotics and glucocorticoids. Crust, erosion, and alopecia were noted on the ear pinnae, bridge of nose, and forelimb. Cytological evaluation of intact pustules showed isolated free-floating rounded acantholytic keratinocytes admixed with non-degenerated neutrophils and eosinophils. Results of histopathologic examination revealed the intra-epidermal pustules with predominant neutrophils, less eosinophils, and isolated and clustered acantholytic cells. A diagnosis of pemphigus foliaceus (PF) was made based on the history, clinical, cytological and histopathological results. The skin lesions had improved after systemic cyclosporine therapy. This case report demonstrates that cyclosporine, an immunosuppressive agent, can be used in the management of PF in dogs.
A 3-year-old, intact female Poong-san dog was presented with a 4-month history of erosive, erythematous dermatitis unresponsive to systemic antibiotics and glucocorticoids. Crust, erosion, and alopecia were noted on the ear pinnae, bridge of nose, and forelimb. Cytological evaluation of intact pustules showed isolated free-floating rounded acantholytic keratinocytes admixed with non-degenerated neutrophils and eosinophils. Results of histopathologic examination revealed the intra-epidermal pustules with predominant neutrophils, less eosinophils, and isolated and clustered acantholytic cells. A diagnosis of pemphigus foliaceus (PF) was made based on the history, clinical, cytological and histopathological results. The skin lesions had improved after systemic cyclosporine therapy. This case report demonstrates that cyclosporine, an immunosuppressive agent, can be used in the management of PF in dogs.
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제안 방법
The definitive diagnosis of PF is based on the history, physical examination, cytology, skin biopsy, immunofluores-ence or immunohistochemical testing, demonstration of the antigen being targeted (desmoglein I), and histopathologic examination. PF is characterized histological findings includ-ing intragranular or subcorneal acantholysis with resultant cleft and vesicle or pustule formation (1,11,15).
대상 데이터
A 3-year-old, intact female Poong-san dog was admitted for the complaint of a severely erosive, erythematous dermatitis with 4 months duration. Initially, the dog had been taken empirical treatment with prednisolone (2.
Gross findings during dermatologic examination. The patient exhibits vesicles, pustules, and crusting erosions distrib-uted on the dorsal muzzle, dorsal nasal planum (A), ear pinnae (B), and forelimb (C).
성능/효과
In conclusion, this report demonstrates that complete remission in the dog with PF, can be achieved with cyclospo-rine as the sole regimen in immune suppressive treatment. Although the case is single, this clinical finding shows a pos-sibility that cyclosporine can be used as a sole agent in the management of PF in dogs.
Cytology from the pustular lesion revealed multiple acantholytic keratinocytes, neutrophils and a few eosinophils (Fig 3). Results of bacterial and fungal cultures were negative.
The definitive diagnosis was made based on the histopa-thology of nasal planum lesion which showed thick-layered serocellular crusts and pustules filled with intact neutrophils, occasional eosinophils and small numbers of rounded acan-tholytic kerationocytes (Fig 4). No fungal hyphae were found in Periodic Acid-Schiff (PAS) stained sections.
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