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Canine cutaneous autoimmune disease
Immune-mediated dermatoses are uncommon diseases in the dog and cat and may be subdivided into autoimmune and immune-mediated categories (1). Autoimmunity is considered to result from failure of the immune system to recognize “self”, mounting an immune response composed of antibodies or activated lymphocytes against normal body structures and tissues, whereas immune-mediated conditions are triggered by a foreign antigen such as drugs (including vaccines) or infectious agents. KEY POINTS • Autoimmune diseases result from failure of the immune system to recognize “self”. • There are numerous autoimmune and immune-mediated cutaneous diseases that have variable clinical presentations; they can often mimic other, more common, cutaneous disorders. • Histopathologic evaluation is the gold standard in diagnosing a cutaneous autoimmune disease, but location and stage of the lesion can influence the diagnostic outcome. • Use of immunomodulatory medications versus immunosuppressive medications is dependent on the type and severity of disease. There are numerous autoimmune and immune-mediated dermatoses, with the prognosis dependent on the type of disease. Some disorders affect only the skin and have minimal or mild systemic involvement; other diseases, such as lupus erythematosus and various forms of vasculitis, can affect other organ systems and have a serious systemic impact. This article will focus on recognition of clinical signs, diagnostic options, therapeutic modalities, and avoidance of potential triggers for autoimmune dermatoses. With the proper approach, many of these diseases can be rewarding to treat. ■ Clinical signs and diagnosis As with any skin disease, diagnosis is made utilizing a combination of history, clinical signs and routine dermatologic diagnostics, such as skin scraping, cytologic analysis, and biopsy with histopathology. It is not uncommon for some disorders, such as pemphigus, to have a waxing and waning history. Most autoimmune disorders occur in young to middle-aged animals, and many autoimmune dermatoses show a breed predisposition which can aid in formulating a differential diagnosis. Clinical presentation may be variable and can mimic many other dermatoses due to the limited number of reaction patterns of the skin.
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