Banovic Frane, Olivry Thierry, Linder Keith E
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA; Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA.
Vet Dermatol. 2014 Oct;25(5):483-e79. doi: 10.1111/vde.12139. Epub 2014 Jun 11.
Generalized discoid lupus erythematosus (DLE) is an autoimmune skin disease variant rarely reported in dogs. The antimalarial immunomodulator hydroxychloroquine has been suggested as maintenance therapy for generalized DLE in one dog, but several recurrences were noted in the 1 year follow-up of that patient.
HYPOTHESIS/OBJECTIVE: To describe the effective treatment of generalized DLE with ciclosporin in one dog.
A 6-year-old, castrated male crossbred dog was presented with pruritic, well-demarcated annular to polycyclic, hyperpigmented plaques with marginal erythema on the dorsal head, neck, trunk and medial extremities; these had been nonresponsive to treatment with doxycycline and niacinamide.
Investigation included complete blood count, serum chemistry profile, urinalysis, serum antinuclear antibody test, histopathological examination and direct immunofluorescence testing of skin biopsies.
The presence of lymphocyte-rich interface dermatitis on histology, together with generalized chronic recurrent hyperpigmented plaques, was consistent with the diagnosis of a generalized variant of DLE. The absence of systemic signs and unremarkable laboratory tests excluded concurrent systemic lupus erythematosus. Treatment was initiated with oral dexamethasone and ciclosporin. After 1 month, dexamethasone was discontinued and oral ketoconazole was added to the therapeutic regimen. Four months later, pruritus and erythema resolved, with most skin lesions becoming impalpable. Over the last 6 months, the patient's DLE was maintained in remission with oral ciclosporin and ketoconazole in combination every 3 days.
The combination of ciclosporin and ketoconazole appeared effective to induce and maintain lesion remission in this dog with generalized DLE.
全身性盘状红斑狼疮（DLE）是一种在犬类中鲜有报道的自身免疫性皮肤病变体。抗疟免疫调节剂羟氯喹已被建议作为一只犬全身性DLE的维持治疗药物，但在该患者1年的随访中出现了几次复发情况。
假设/目的：描述环孢素对一只犬全身性DLE的有效治疗。
一只6岁去势雄性杂种犬，其头部、颈部、躯干和四肢内侧出现瘙痒性、边界清晰的环状至多环状色素沉着斑，伴有边缘红斑；这些症状对强力霉素和烟酰胺治疗无反应。
检查包括全血细胞计数、血清化学分析、尿液分析、血清抗核抗体检测、组织病理学检查以及皮肤活检的直接免疫荧光检测。
组织学检查发现富含淋巴细胞的界面性皮炎，以及全身性慢性复发性色素沉着斑，这与全身性DLE变体的诊断相符。无全身症状且实验室检查无异常排除了并发系统性红斑狼疮。治疗开始时给予口服地塞米松和环孢素。1个月后，停用了地塞米松，并在治疗方案中添加了口服酮康唑。4个月后，瘙痒和红斑消退，大多数皮肤病变已无法触及。在过去6个月中，该犬的DLE通过每3天口服一次环孢素和酮康唑联合用药维持缓解状态。
环孢素和酮康唑联合用药似乎对这只患有全身性DLE的犬诱导和维持病变缓解有效。
