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一例用奥克拉替尼治疗的疑似自身免疫性大疱性皮肤病病例。

A case of presumed autoimmune subepidermal blistering dermatosis treated with oclacitinib.

作者信息

Aymeric Estelle, Bensignor Emmanuel

机构信息

Clinique Vétérinaire, Avenue 19 mars 1962, 13390, Auriol, France.

Dermatology Referral Service, 6 rue Mare Pavee, 35510, Rennes-Cesson, France.

出版信息

Vet Dermatol. 2017 Oct;28(5):512-e123. doi: 10.1111/vde.12458. Epub 2017 Jun 20.

Abstract

BACKGROUND

Autoimmune subepidermal blistering dermatoses (ASBD) are a group of severe autoimmune dermatoses rarely described in dogs. Their treatment usually necessitates the long term use of medications potentially associated with adverse effects. In humans, Janus Kinase (JAK) inhibitors have been demonstrated to be of value in some cases of autoimmune skin disease.

HYPOTHESIS/OBJECTIVES: To evaluate oral oclacitinib, a JAK-1 predominant inhibitor, in one case of ASBD in a dog.

CASE REPORT

A 5-year-old German shepherd cross-bred dog was presented with an acute onset of ulcerative and blistering skin lesions on the face, oral cavity, lateral trunk and limbs. Associated systemic signs were not seen. A clinical diagnosis of ASBD was supported by the finding of subepidermal clefts and visualization of the epidermal basement membrane zone at the bottom of the clefts on histopathological examination. Treatment was initiated with prednisolone at 1.2 mg/kg twice daily. Because of severe adverse effects and relapse, when the prednisolone dose was reduced, oclacitinib therapy was administered at 0.5 mg/kg twice a day. A complete resolution of clinical signs was noted after one month and no relapse was observed after twelve months of treatment. No adverse effects were reported.

CONCLUSION

The use of oclacitinib may be useful for the treatment of some autoimmune skin diseases in dogs. Further controlled studies are needed to confirm our findings.

摘要

背景

自身免疫性表皮下大疱性皮肤病(ASBD)是一组严重的自身免疫性皮肤病,在犬类中鲜有描述。其治疗通常需要长期使用可能有不良反应的药物。在人类中,已证明 Janus 激酶(JAK)抑制剂在某些自身免疫性皮肤病病例中具有价值。

假设/目的:评估口服 JAK-1 为主的抑制剂奥克拉替尼对一只患有 ASBD 的犬的疗效。

病例报告

一只 5 岁的德国牧羊犬杂交犬出现急性发作的面部、口腔、侧躯干和四肢溃疡性和水疱性皮肤病变。未见相关全身症状。组织病理学检查发现表皮下裂隙以及裂隙底部表皮基底膜带的可视化,支持了 ASBD 的临床诊断。开始使用泼尼松龙治疗,剂量为 1.2 mg/kg,每日两次。由于严重不良反应和复发,当泼尼松龙剂量减少时,给予奥克拉替尼治疗,剂量为 0.5 mg/kg,每日两次。一个月后临床症状完全消退,治疗十二个月后未观察到复发。未报告不良反应。

结论

奥克拉替尼的使用可能对犬类某些自身免疫性皮肤病的治疗有用。需要进一步的对照研究来证实我们的发现。

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