Photosensitisation
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Description
Photosensitisation is a condition of the dermis caused by a reaction induced by photodynamic agents exposed to UV light in the skin of animals that have eaten certain plants. Photosenstisation is primarily a condition of sheep, cattle and horses but other species may also be susceptible. The condition can be divided into two categories; primary and secondary photosensitisation. Primary photosensitisation occurs due to the normal ingestion of lush green plants containing photodynamic agents. Secondary (hepatogenous) photosensitisation occurs as a result of liver or bile duct damage, leading to accumulation of phylloerythrin in the blood, body tissues and skin due to insufficient conjugation and excretion by the liver.
Clinical signs
The condition is characterised by clearly demarcated 'sunburn-like' lesions that are confined to unpigmented or hairless areas of the skin. The nose, lips, ears, muzzle and udder are commonly affected areas. In the acute stages, the affected area(s) becomes erythematous and oedematous with exudation and crust formation. Animals may be pruritic or painful. other clinical signs may include swollen lips or muzzle, tachypnoea, tachycardia, diarrhoea and salivation.
If the photosensitisation is secondary (hepatogenous), icterus may be present. Other signs may include those consistent with hepatic encephalopathy such as head-pressing, circling, and behavioural changes.
Diagnosis
The classical lesions of photosensitisation are usually sufficient for diagnosis of primary disease. There is often a history of exposure or ingestion of plants containing photodynamic agents such as St. John's Wort or clover. Additionally, phenothiazines, sulphonamides, tetracyclines and mycotoxins such as blue-green algae have been implicated in photosensitisation.
Treatment
Affected animals should only be allowed access to grazing at night. If the animal is affected by secondary photosensitisation, a low-protein, high-energy diet is recommended such as beet pulp. Anti-inflammatory drugs such as flunixin meglumine and topical steroid creams may be useful to decrease the severity of cutaneous lesions in the acute stage of the disease. If skin necrosis is severe, surgical debridement may be required.
Prognosis
In general the prognosis is favourable for primary photosensitisation and poor for secondary photosensitisation.
References
- Gupta, R. C., (2007) Veterinary Toxicology: basic and clinical principles Academic Press
- Haskell, S. R. R., (2008) Blackwell's five-minute veterinary consult: ruminant John Wiley & Sons
- Lavoie, J. P., (2009) Blackwell's five-minute veterinary consult: equine John Wiley & Sons
- Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial