Mucocutaneous lupus erythematosus in dogs (21 cases)

• Published in: Veterinary dermatology 2015-08, Vol.26 (4), p.256-e55
• Main Authors: Olivry, Thierry, Rossi, Michael A., Banovic, Frane, Linder, Keith E.
• Format: Article
• Language: English
• Subjects: Animals; Biopsy - veterinary; Dog Diseases - diagnosis; Dog Diseases - drug therapy; Dog Diseases - pathology; Dogs; Female; Glucocorticoids - therapeutic use; Lupus Erythematosus, Cutaneous - diagnosis; Lupus Erythematosus, Cutaneous - drug therapy; Lupus Erythematosus, Cutaneous - pathology; Lupus Erythematosus, Cutaneous - veterinary; Male; Sex Factors; Skin - pathology
• ISSN: 0959-4493; 1365-3164
• DOI: 10.1111/vde.12217

Background The diagnosis of dogs with chronic juxtamucosal erosive lesions and histopathology typical of cutaneous lupus erythematosus (CLE) is unclear. Hypothesis/Objectives We report herein 21 dogs with mucocutaneous erosive lesions and lupus‐specific histopathology that we propose to be affected with mucocutaneous lupus erythematosus (MCLE), another variant of chronic CLE. Methods Inclusion criteria were the presence of the following: (i) a >2 month history of chronic or recurrent skin lesions; (ii) erosions or ulcers predominating at mucosae or mucocutaneous junctions; (iii) microscopic lesions of CLE (i.e. a lymphocyte‐rich interface dermatitis with basal keratinocyte damage); and (iv) a lack of complete remission following antimicrobials. Clinical questionnaires and skin biopsies were reviewed. Direct immunofluorescence and antinuclear antibody serology were performed whenever possible. Results More than half of the 21 dogs were German shepherds or their crosses. The disease affected mostly dogs in their mid‐adulthood and there was an over‐representation of females. Erosions and ulcers predominated at genital/perigenital and anal/perianal areas, with a lower frequency of involvement of periocular, perioral and perinasal regions. In these dogs, there were no clinical signs suggestive of an associated systemic lupus erythematosus. Microscopic lesions were specific for CLE, but they were patchy and often infected with bacteria. The most common immunological finding was focal IgG deposition at the basement membrane zone. Lesions responded to varying interventions, but oral glucocorticoids led to a shorter time to complete remission. Relapses were common upon treatment tapering. Conclusions and clinical importance These observations support MCLE being another variant of canine CLE. Resumen Introducción el diagnóstico de perros con lesiones erosivas crónicas cercanas a la mucosa y con histopatología típica de cutáneos lupus eritematoso (CLE) no está muy claro. Hipótesis/Objetivos en este artículo estudiamos 21 casos de perros con lesiones erosivas mucocutáneas y patología específica de lupus que proponemos están afectados con lupus eritematoso mucocutáneo (MCLE), otra variante CLE crónico. Métodos los criterios de inclusión fueron la presencia de los siguientes elementos: i) una historia de más de dos meses de lesiones recurrentes de la piel crónicas; ii) erosiones y ulceración predominantemente en las mucosas y uniones mucocutáneas; iii) lesiones microscó