Difference between revisions of "Canine Uveodermatologic Syndrome"
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Canine uveodermatologic syndrome is an autoimmune condition directed against melanin of neural crest (skin, hair, anterior uvea) and neuroectodermal (retina) origin. | Canine uveodermatologic syndrome is an autoimmune condition directed against melanin of neural crest (skin, hair, anterior uvea) and neuroectodermal (retina) origin. | ||
| − | From what is known in humans, it is thought that a cell-mediated hypersensitivity exists against melanin and melanocytes, and distinct subpopulations of cytotoxic T lymphocytes with activity against melanocytes have been identified. | + | From what is known in humans, it is thought that a cell-mediated [[:Category:Hypersensitivity|hypersensitivity]] exists against melanin and melanocytes, and distinct subpopulations of cytotoxic T lymphocytes with activity against melanocytes have been identified. |
The condition is reported most often in breeds such as: Akita, Australian Shepherd Dog, Beagle, Chow Chow, Samoyed, Siberian Husky, Alaskan Malamute and related crossbreeds. | The condition is reported most often in breeds such as: Akita, Australian Shepherd Dog, Beagle, Chow Chow, Samoyed, Siberian Husky, Alaskan Malamute and related crossbreeds. | ||
| − | ==Clinical | + | ==Clinical Signs== |
Initial onset of lesions has been noted in animals ranging from '''13 months to 6 years''' of age. | Initial onset of lesions has been noted in animals ranging from '''13 months to 6 years''' of age. | ||
| − | '''Ocular signs''' generally precede dermatological signs. Initially they consist of '''bilateral uveitis'''. | + | '''Ocular signs''' generally precede dermatological signs. Initially they consist of '''bilateral uveitis'''. Later this can progress to '''retinal detachment, posterior synechiae with secondary glaucoma and cataracts''' and a resulting '''blindness'''. |
| − | Later this can progress to '''retinal detachment, posterior synechiae with secondary glaucoma and cataracts''' and a resulting '''blindness'''. | ||
| − | '''Skin and hair abnormalities''': '''leukoderma and leukotrichia''' often involving the eyelids, nasal planum, lips, scrotum, vulva, footpads. '''Erythema, ulceration and crusting''' can also occur in the depigmented areas. | + | '''Skin and hair abnormalities''': '''[[Hypopigmentatin|leukoderma and leukotrichia]]''' often involving the eyelids, nasal planum, lips, scrotum, vulva, footpads. '''Erythema, ulceration and crusting''' can also occur in the depigmented areas. |
| − | Pain and | + | Pain and pruritus can occur and '''lymphadenopathy''' is common. |
==Diagnosis== | ==Diagnosis== | ||
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'''Histopathology''' should be performed on skin biopsies. Biopsies show lichenoid dermatitis, histiocytes, small mononuclear cells and giant cell infiltration. The level of melanin in the epidermis and hair follicles is decreased. | '''Histopathology''' should be performed on skin biopsies. Biopsies show lichenoid dermatitis, histiocytes, small mononuclear cells and giant cell infiltration. The level of melanin in the epidermis and hair follicles is decreased. | ||
| − | Differential diagnoses such as SLE, pemphigus foliaceus, pemphigus erythematosus, epitheliotropic lymphoma, vitiligo and leishmaniasis should be ruled out. | + | Differential diagnoses such as [[SLE]], [[Pemphigus|pemphigus foliaceus, pemphigus erythematosus]], epitheliotropic [[lymphoma]], vitiligo and [[Leishmania|leishmaniasis]] should be ruled out. |
==Treatment== | ==Treatment== | ||
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In all cases, '''aggressive treatment''' is required and short-term success is usually good. However '''recurrence is common''' and lesions may never fully resolve. | In all cases, '''aggressive treatment''' is required and short-term success is usually good. However '''recurrence is common''' and lesions may never fully resolve. | ||
| + | |||
| + | {{Learning | ||
| + | |flashcards = [[Small Animal Dermatology Q&A 18]] | ||
| + | }} | ||
==References== | ==References== | ||
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Maggs, D. (2008) '''Slatter's fundamentals of veterinary ophthalmology''' ''Elsevier Health Sciences'' | Maggs, D. (2008) '''Slatter's fundamentals of veterinary ophthalmology''' ''Elsevier Health Sciences'' | ||
| − | [[Category: | + | |
| − | [[Category: | + | {{review}} |
| + | [[Category:Dermatological Diseases - Dog]] | ||
| + | [[Category:Expert Review - Small Animal]] | ||
| + | [[Category:Integumantary System - Pathology]] | ||
Revision as of 13:05, 1 August 2011
Also known as: UVD — Vogt-Koyanagi-Harada-like syndrome — VKH-like syndrome
Introduction
Canine uveodermatologic syndrome is an autoimmune condition directed against melanin of neural crest (skin, hair, anterior uvea) and neuroectodermal (retina) origin.
From what is known in humans, it is thought that a cell-mediated hypersensitivity exists against melanin and melanocytes, and distinct subpopulations of cytotoxic T lymphocytes with activity against melanocytes have been identified.
The condition is reported most often in breeds such as: Akita, Australian Shepherd Dog, Beagle, Chow Chow, Samoyed, Siberian Husky, Alaskan Malamute and related crossbreeds.
Clinical Signs
Initial onset of lesions has been noted in animals ranging from 13 months to 6 years of age.
Ocular signs generally precede dermatological signs. Initially they consist of bilateral uveitis. Later this can progress to retinal detachment, posterior synechiae with secondary glaucoma and cataracts and a resulting blindness.
Skin and hair abnormalities: leukoderma and leukotrichia often involving the eyelids, nasal planum, lips, scrotum, vulva, footpads. Erythema, ulceration and crusting can also occur in the depigmented areas.
Pain and pruritus can occur and lymphadenopathy is common.
Diagnosis
There is no specific diagnosis for UVD syndrome, but the clinical signs are suggestive. A thorough history should be taken and an ophthalmic and dermatological exam performed.
Histopathology should be performed on skin biopsies. Biopsies show lichenoid dermatitis, histiocytes, small mononuclear cells and giant cell infiltration. The level of melanin in the epidermis and hair follicles is decreased.
Differential diagnoses such as SLE, pemphigus foliaceus, pemphigus erythematosus, epitheliotropic lymphoma, vitiligo and leishmaniasis should be ruled out.
Treatment
Topical treatment of the uveitis is indicated with corticosteroids and cycloplegics.
Systemic corticosteroids are also required to resolve the uveitis and dermatological lesions. Long-term therapy is usually required to obtain remission and the dose can then be tapered down.
Azathioprine can be used to lower the dose of corticosteroids, and might be used alone in some cases.
Systemic cyclosporin is used in humans and has been suggested as another possible treatment option.
In all cases, aggressive treatment is required and short-term success is usually good. However recurrence is common and lesions may never fully resolve.
| Canine Uveodermatologic Syndrome Learning Resources | |
|---|---|
 Test your knowledge using flashcard type questions |
Small Animal Dermatology Q&A 18 |
References
Schaer, M. (2010) Clinical Medicine of the Dog and Cat Manson Publishing
Harvey, R. (2009) A Colour Handbook of Skin Diseases of the Dog and Cat Manson Publishing
Maggs, D. (2008) Slatter's fundamentals of veterinary ophthalmology Elsevier Health Sciences
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