VESICULOPUSTULAR DERMATOSES

(SKIN DISORDERS CHARACTERIZED BY BLISTERS AND/OR PUSTULES)

BASICS

OVERVIEW

 “Vesiculo-“ refers to vesicles; “pustular” refers to pustules; “dermatoses” is the plural of “dermatosis,” which is used to

Species

 Dogs and cats

Breed Predilections

 Lupus erythematosus—collies, shelties, and German shepherd dogs may be more susceptible than other breeds

 Pemphigus erythematosus—collies and German shepherd dogs may be more susceptible than other breeds

 Pemphigus foliaceus—Akitas, chow chows, dachshunds, bearded collies, Newfoundlands, Doberman pinschers, and

schipperkes may be more susceptible than other breeds

 Bullous pemphigoid—collies and Doberman pinschers may be more susceptible than other breeds

 Dermatomyositis—young collies and Shetland sheepdogs

 Subcorneal pustular dermatosis—schnauzers affected most frequently

 Hair loss (known as “alopecia”) and reddened skin (known as “erythema”)

 Presence of vesicles (blisters; small, circumscribed elevations of the outer layer of the skin filled with clear fluid)

 Presence of pustules (small, circumscribed elevations of the outer layer of the skin filled with pus)

 Loss of pigment of the skin and/or hair (known as “depigmentation”)

CAUSES

Vesicles

 Systemic lupus erythematosus (SLE; autoimmune disease in which body attacks its own skin and possibly other organs)

 Discoid lupus erythematosus (DLE; autoimmune disease involving the skin only, usually the face)

 Bullous pemphigoid (autoimmune disease with ulceration of the skin and/or moist tissues [known as “mucous membranes”]

of pus (known as “pyoderma”)—bacterial skin infection involving the areas of the body with sparse hair coat (known as

“impetigo”), superficial spreading pyoderma, superficial bacterial infection/inflammation of the hair follicles (known as

“bacterial folliculitis”), acne

 Pemphigus complex—pemphigus foliaceus, pemphigus erythematosus, pemphigus vegetans (autoimmune skin diseases)

 Subcorneal pustular dermatosis (skin disease of unknown cause characterized by the presence of pustules)

 Dermatophytosis (fungal skin infection)

 Sterile eosinophilic pustulosis (skin disorder characterized by the presence of eosinophils in the pustules; “eosinophils” are a

type of white-blood cell; they are involved in allergic responses by the body and are active in fighting larvae of parasites)

 Linear immunoglobulin A (IgA) dermatosis (a skin disorder seen only in dachshunds in which sterile pustules are located

just below the surface of the skin; immunoglobulin A [IgA] is present in the lowest layer of the epidermis [known as the

demodectic mange, inadequate levels of thyroid hormone [known as “hypothyroidism”], allergy, or steroid administration)

 Sunlight—pemphigus erythematosus, bullous pemphigoid, systemic lupus erythematosus (SLE), discoid lupus

erythematosus (DLE), and dermatomyositis (inflammatory disorder that affects the skin and muscles in collies and Shetland

sheepdogs)

TREATMENT

HEALTH CARE

 Periodic bathing with an antimicrobial shampoo—helps remove surface debris and control secondary bacterial infections

 Usually treated as an outpatient

MEDICATIONS

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a

particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all

inclusive.

Pemphigus Complex/Bullous Pemphigoid (Autoimmune Diseases)

 Chemotherapeutic drugs—azathioprine or chlorambucil; used to decrease the immune response

 Tetracycline and niacinamide combination

 Cyclosporine (Neoral®)—used to decrease the immune response

Subcorneal Pustular Dermatosis

Sterile Eosinophilic Pustulosis

 Prednisolone—until remission (usually 5 to 10 days); then as needed to prevent relapses (as directed by your pet’s

veterinarian); usually long-term treatment is required

FOLLOW-UP CARE

PATIENT MONITORING

 Dapsone—monitor blood work (complete blood count [CBC], platelet count, and liver enzymes) every 2 weeks initially and

if any clinical side effects develop

 Long-term sulfasalazine therapy—monitor tear production

EXPECTED COURSE AND PROGNOSIS

 Depend on underlying cause

 Systemic lupus erythematosus (SLE), pemphigus vulgaris, and bullous pemphigoid may be life-threatening