Pemphigus Complex

Condition Overview

This is an autoimmune skin disease. In pemphigus, the autoantibody is directed against the walls of the skin cells. These cells lose their ability to remain attached, separating and forming blebs (an irregular bulge in the plasma membrane of a cell), pustules (puss filled pimples), and vesicles.

Symptoms

Pemphigus foliaceus is the most common autoimmune skin disease of dogs. It generally occurs in dogs 2 - 7 years of age. Predisposed breeds include the Akita, Bearded Collie, Newfoundland, Chow Chow, Dachshunds, Doberman Pinscher, Finnish Spitz, and Schipperkes.

Pemphigus foliaceus is a pustular dermatitis that begins with red skin patches that involve the face and ears, but often become generalized. The patches rapidly progress to blisters and pustules, which become dry yellow crusts. The crusts adhere to the underlying skin and hair. Areas of depigmentation occur as the disease progresses.

Pemphigus foliaceus can involve the feet, causing thickening and cracking of the foot pads, and pain when the dogs puts weight on her feet. In some cases, the disease involves only the foot pads.

Phemphigus erythematosus is a localized variant of pemphigus foliaceus with involvement limited to the face, head, and foot pads. Collies and German Shepherds appear to at greatest risk, The disease is easily confused with discoid lupus erythematosus.

Pemphigus velgaris is an uncommon disease in which blisters and ulcers form at the junction of the skin and the mucus membranes. It involves the lips, nostrils, and eyelids. It can also attack the nailbeds, with nails eventually falling out.

Pemphigus vegetans is an extremely rare form of pemphigus vulgaris. It is characterized by flat-topped pustules in the skin folds of the armpits and groin. Characteristically, the lesions heal with wart-like growths.

All symptoms +

Causes

The exact stimulus for the pemphigus antibody is unknown.

Diagnosis

Four types of pemphigus are seen in dogs, and all are best diagnosed by skin biopsy. Serologic blood tests are helpful, but false positives and false negatives are common.

Pemphigus foliaceus should be considered whenever a dog with a painful limp has thickened or cracked foot pads.

Treatment

There is no cure for any form of pemphigus, but more than 50% of dogs with pemphigus foliaceus and pemphigus erythematosus can be kept relatively free of symptoms using corticosteroids alone, or corticosteroids in combination with immunosuppressive drugs such as cyclophosphamide, azathioprine, or chlorambucil. Treatment is life long. Sunscreen applied to the depigmented skin of the nose helps to prevent ultraviolet damage.

Pemphigus vulgarius and pemphigus vegetans respond less well to treatment.

Prevention

There is currently no known prevention for this condition.

Support

Please contact your veterinarian with questions regarding this condition.