Banovic Frane, Robson David, Linek Monika, Olivry Thierry
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Athens, GA, 30602, USA.
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr, Raleigh, NC, 27607, USA.
Vet Dermatol. 2017 Oct;28(5):493-e115. doi: 10.1111/vde.12448. Epub 2017 Apr 24.
Oral and topical calcineurin inhibitors (CIs) have been reported to lead to complete lesion remission in several dogs with vesicular cutaneous lupus erythematosus (VCLE).
To report retrospectively on the effectiveness and adverse effects of systemic (ciclosporin) and/or topical (tacrolimus/pimecrolimus) CIs in 11 dogs with VCLE.
Inclusion criteria were: (i) presence of characteristic annular, polycyclic or serpiginous ulcerations distributed over the groin, axillae and/or ventral abdomen; (ii) a histopathological diagnosis of VCLE (i.e. a lymphocyte-rich interface dermatitis with vesiculation); (iii) treatment that included CIs for at least eight weeks; and (iv) follow-up until death/euthanasia or for a minimum of 12 months post-diagnosis.
Initial therapy included the avoidance of excessive sun exposure, oral glucocorticoids [six of 11 dogs (55%); progressively tapered over a month] and once daily ciclosporin [11 dogs (100%); median 5.8 mg/kg]. A complete remission (CR) of signs occurred between days 35 and 70 after starting CIs in eight dogs (73%); increasing ciclosporin dosage and adding topical tacrolimus induced a CR in two additional dogs (18%). Relapses were common when doses were tapered or discontinued. With the exception of three dogs that were euthanized, clinical signs were maintained in CR with oral ciclosporin (eight of eight dogs treated, 100%) or topical tacrolimus/pimecrolimus (four of eight dogs; 50%) with a median follow-up of 2.9 years.
These observations support CIs as the preferable therapeutic alternatives to long-term immunosuppression with oral glucocorticoids in dogs with VCLE.
据报道，口服和局部应用钙调神经磷酸酶抑制剂（CIs）可使数只患有水疱性皮肤红斑狼疮（VCLE）的犬只皮损完全缓解。
回顾性报告11只患有VCLE的犬只使用全身性（环孢素）和/或局部性（他克莫司/吡美莫司）CIs的有效性和不良反应。
纳入标准为：（i）腹股沟、腋窝和/或腹侧腹部出现特征性环状、多环状或匐行性溃疡；（ii）VCLE的组织病理学诊断（即富含淋巴细胞的界面性皮炎伴水疱形成）；（iii）接受CIs治疗至少8周；（iv）随访至死亡/安乐死或诊断后至少12个月。
初始治疗包括避免过度日晒口服糖皮质激素[11只犬中有6只（55%）；在1个月内逐渐减量]和每日一次环孢素[11只犬（100%）；中位剂量5.8mg/kg]。8只犬（73%）在开始使用CIs后35至70天出现症状完全缓解（CR）；增加环孢素剂量并加用局部他克莫司使另外2只犬（18%）达到CR。剂量减量或停药时复发很常见。除3只犬实施安乐死外，8只接受口服环孢素治疗的犬（100%）和8只接受局部他克莫司/吡美莫司治疗的犬中的4只（50%）临床症状维持在CR状态，中位随访时间为2.9年。
这些观察结果支持CIs作为VCLE犬长期口服糖皮质激素免疫抑制治疗的首选替代疗法。
