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#REDIRECT[[:Category:Integumentary System - Immunologic Pathology]]
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|linkpage =Integumentary System - Pathology
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|linktext =Integumentary System
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|maplink = Integumentary System (Content Map) - Pathology
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|pagetype =Pathology
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}}
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<br>
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==General==
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*Classification:
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**Hypersensitivity - response to normally harmless substances
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**Auto-immune - antobodies or T-cells reactive against self-antigens
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*Mostly involves mixture of types described below
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===Type I reactions===
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*Mediated by pharmacologically active substances from [[Mast Cells - WikiBlood|mast cells]] and [[Basophils - WikiBlood|basophils]]
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**Due to antigen-antibody (usually IgE) binding to receptors on those cells
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*Substances include histamine, serotonin, leukotriens, prostaglandins
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*Can be systemic or local
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*Skin becomes pruritic, raised erythematous borders of wheals
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*Immediate reaction
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*Includes:
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**[[Skin Immunologic - Pathology#Atopy|Atopic dermatitis]]
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**[[Skin Glossary - Pathology|Urticaria]]
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**Angioedema
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**Fly bite hypersensitivity
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**Gastrointestinal parasites
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**Food
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*Microscopically:
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**Capillary dilation, oedema, mast cell degranulation, eosinophil infiltration
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===Type II reactions===
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*Cytotoxic reaction
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*IgG and IgM interaction with antigens bound to cellular membranes
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*Often involves [[Complement - WikiBlood#Complement Fixation Pathways|complement fixation]] -> cellular damage
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*In skin - circulating antibody to proteins of desmosomes in intercellular areas along basement membranes at epidermal-dermal junction
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*Includes:
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**[[Skin Immunologic - Pathology#Pemphigus|Pemphigus]]
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**[[Skin Immunologic - Pathology#Bullous pemphigoid|Bullous pemphigoid]]
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===Type III reactions===
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*[[Complement - WikiBlood#Complement Fixation Pathways|Complement fixing]] immune complexes
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*IgG or IgM
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*Complexes deposit in tissue -> fix complement -> cytokines and othe factors attrack neutrophils -> release lysosomal enzymes, activation of complement and coagulation, platelet aggregation -> tissue damage
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*Immune complex vasculitis -> [[General Pathology - Haemorrhage#Purpura haemorrhagica|purpura haemorrhagica]]
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*Includes:
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**[[Skin Immunologic - Pathology#Lupus erythematosus|Systemic lupus erythematosus]]
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**[[Skin Immunologic - Pathology#Dermatomyositis|Canine dermatomyositis]]
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===Type IV reactions===
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*Delayed hypersensitivity
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*Haptens bind to carrier proteins (mainly epidermal)
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*Mediated by sensitised [[General Pathology - T-cell Activation and Function|T-cells]] -> release cytokines +/- recruit lymphocytes
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*Used in diagnosis of tuberculosis, histoplasmosis and coccidiomycosis
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*Perivascular mononuclear cell accumulation
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==Hypersensitivity reactions==
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===Atopy===
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*Involves [[Skin Immunologic - Pathology#Type I reactions|Type I reaction]]
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*Mainly causes pruritus
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*Dogs - face rubbing and foot licking; secondary [[Bacterial skin infections - Pathology#Pyoderma|pyoderma]] or seborrhea
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*Cats - facial, ear or generalised pruritus, miliary dermatitis, [[Skin Other - Pathology#Eosinophilic granuloma|eosinophilic granuloma complex]], symmetric alopecia
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*Horses - pruritic hea, pinnae, ventrum, legs, tailhead or recurrent [[Skin Glossary - Pathology|urticaria]]
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*Lesions generally due to self-trauma
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*Microscopically:
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**Hyperplastic superficial perivascular dermatitis
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**Mast cells, eosinophils, nonmetachromatic mononuclear cells
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**Perivascular inflammation may be involved especially in horses
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===Flea bite hypersensitivity===
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*Usually involves [[Skin Immunologic - Pathology#Type I reactions|Type I reaction]] and [[Skin Immunologic - Pathology#Type IV reactions|Type IV reaction]] and cutaneous basophil hypersensitivity
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*Mainly dorsolumbosacral area involved, abdomen, caudomedial thighs, flanks, neck of cats
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*Secondary trauma is self-inflicted
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*Grossly:
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**Papular dermatitis
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**Secondary excoriations
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**Alopecic nodule if chronic
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*Microscopically:
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**Hyperplastic superficial perivascular dermatitis
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**Oedema, [[Mast Cells - WikiBlood|mast cells]], [[Basophils - WikiBlood|basophils]], [[Eosinophils - WikiBlood|eosinophils]], [[Lymphocytes - WikiBlood|lymphocytes]], histiocytes
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**Fibropruritic nodules covered by hyperplastic epidermis
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===Culicoides hypersensitivity===
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*Usually involves [[Skin Immunologic - Pathology#Type I reactions|Type I reaction]] and [[Skin Immunologic - Pathology#Type IV reactions|Type IV reaction]]  due to salivary antigens of ''Culicoides'' sp.
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*May be seasonally recurring or continuous depending on climate
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*Grossly:
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**Papules, crusts, alopecia, excoriations, lichenification
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*Microscopically:
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**Superficial and dep perivascular dermatitis
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**Many eosinophils
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**Epidermal hyperplasia
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**Hyperkeratosis
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**Dermal fibrosis
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**Possibly eosinophilic folliculitis, intraepidermal pustules and [[Skin Other - Pathology#Eosinophilic granuloma|eosinophilic granulomas]]
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===Allergic contact dermatitis===
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*Usually involves [[Skin Immunologic - Pathology#Type IV reactions|Type IV reaction]]
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*Pruritic lesions with self-inflicted trauma
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*At areas in contact with allergen
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*Grossly:
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**Erythema, papules, +/- vesicles, exudation -> crusts
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**If chronic, lichenification, hyperpigmentation, alopecia
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*Microscopically:
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**Spongiotic superficial perivascular dermatitis
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**Mononuclear cells
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**If chronic, epidermal hyperplasia
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**May involve [[Eosinophils - WikiBlood|eosinophils]]
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==Autoimmune reactions==
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BS-to-finish
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===Dermatomyositis===
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*See also [[Muscles Developmental - Pathology#Canine dermatomyositis|Canine dermatomyositis]]
 
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