Rossi Michael A, Messenger Linda M, Linder Keith E, Olivry Thierry
From the Veterinary Skin and Allergy Specialists, Veterinary Referral Center of Colorado, Englewood, CO (M.R., L.M.); and Department of Population Health and Pathobiology (K.L.) and Department of Clinical Sciences (T.O.), North Carolina State University, Raleigh, NC.
J Am Anim Hosp Assoc. 2015 May-Jun;51(3):171-5. doi: 10.5326/JAAHA-MS-6116.
Discoid lupus erythematosus (DLE) is a commonly reported canine autoimmune disease that normally presents with a phenotype consisting of erythema, depigmentation, scaling, erosions/ulcers, and scarring over the nasal planum and the proximal dorsal muzzle. Recently, two cases of a generalized variant of this disease have been reported, whose lesions responded to either systemic glucocorticoids or a combination of topical corticosteroids, topical tacrolimus, and the oral antimalarial hydroxychloroquine. The purpose of this report is to describe an 11 yr old shih tzu that presented with skin lesions consisting of multiple annular, erythematous papules and plaques, hyperpigmentation, adherent scaling, and atrophic scars over the caudal dorsum, flanks, craniodorsal thorax, and lateroproximal extremities. A diagnosis of generalized DLE was made based on the clinical presentation, histopathology, laboratory values, and direct immunofluorescence findings. Treatment consisted of oral tetracycline and oral niacinamide, which resulted in complete remission of clinical signs. This is the first documented report of generalized canine DLE responding to the described immunomodulating regimen. Such a combination might therefore be considered as a glucocorticoid and/or antimalarial alternative for the management of generalized DLE.
盘状红斑狼疮（DLE）是一种常见的犬类自身免疫性疾病，通常表现为鼻平面和口鼻近端背部出现红斑、色素脱失、鳞屑、糜烂/溃疡及瘢痕等症状。最近，有两例该疾病的全身性变异病例被报道，其病变对全身用糖皮质激素或局部用皮质类固醇、局部用他克莫司及口服抗疟药羟氯喹联合治疗有反应。本报告旨在描述一只11岁的西施犬，其皮肤病变包括尾背部、胁腹、颅背胸部及四肢近端外侧出现多个环形红斑丘疹和斑块、色素沉着、黏附性鳞屑及萎缩性瘢痕。根据临床表现、组织病理学、实验室检查结果及直接免疫荧光检查结果，诊断为全身性DLE。治疗采用口服四环素和口服烟酰胺，临床症状完全缓解。这是首次有文献报道全身性犬DLE对所述免疫调节方案有反应。因此，这种联合用药可被视为治疗全身性DLE的糖皮质激素和/或抗疟药替代方案。
