Wiemelt S P, Goldschmidt M H, Greek J S, Jeffers J G, Wiemelt A P, Mauldin E A
Department of Clinical Studies, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA 19104, USA.
Vet Dermatol. 2004 Dec;15(6):341-8. doi: 10.1111/j.1365-3164.2004.00396.x.
Canine discoid lupus erythematosus (DLE) and mucocutaneous pyoderma (MCP) have overlapping clinical and histopathological changes, often making diagnosis difficult. Histopathological features of 27 nasal planum biopsies were scored to determine whether DLE and MCP were histopathologically distinguishable. Long-term follow-up, enabling assessment of clinical diagnoses, was available on 15 cases; 11/15 cases were immunomodulatory responsive (ImR) and 4/15 were antibiotic responsive (AbR). Clinical diagnosis, determined by response to treatment for 15/27 cases, was not predictable based on scoring of histopathological features. Distinct histopathological patterns were observed: 2/11 ImR cases had a lymphocyte-rich interface dermatitis. All other cases had the same histopathological changes: a band-like diffuse superficial plasmacytic to lymphoplasmacytic dermatitis +/- focal basal cell damage, but different clinical diagnoses (4/4 AbR, 9/11 ImR). German shepherd dogs/crosses were over-represented (44.4% of the cases) and tended to have more multifocal lesions (41.7% vs. 26.7% of all other breeds). Longer duration of disease was associated with a preponderance of plasmacytic infiltrate (P = 0.026).
犬盘状红斑狼疮(DLE)和黏膜皮肤脓皮病(MCP)具有重叠的临床和组织病理学变化,常常使诊断变得困难。对27例鼻平面活检的组织病理学特征进行评分,以确定DLE和MCP在组织病理学上是否可区分。15例病例有长期随访资料,可用于评估临床诊断;15例中有11例对免疫调节有反应(ImR),4例对抗生素有反应(AbR)。对于27例中的15例,根据对治疗的反应确定的临床诊断,无法根据组织病理学特征评分来预测。观察到不同的组织病理学模式:11例ImR病例中有2例具有富含淋巴细胞的界面性皮炎。所有其他病例具有相同的组织病理学变化:带状弥漫性浅表浆细胞性至淋巴浆细胞性皮炎+/-局灶性基底细胞损伤,但临床诊断不同(4例AbR,11例ImR中的9例)。德国牧羊犬/杂交犬的比例过高(占病例的44.4%),并且往往有更多的多灶性病变(占所有其他品种的41.7%对26.7%)。病程较长与浆细胞浸润占优势相关(P = 0.026)。