Department of Clinical Sciences, College of Veterinary Medicine, NC State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
Department of Population Health and Pathobiology, College of Veterinary Medicine, NC State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
Vet Dermatol. 2020 Aug;31(4):330-e86. doi: 10.1111/vde.12852. Epub 2020 Apr 19.
Hyperkeratotic erythema multiforme (HKEM) is a clinically distinct dermatosis and poorly characterized syndrome, comprised of hyperkeratotic plaques with variable symmetry and apoptosis similar to "classic" erosive canine EM. Hyperkeratotic EM has a protracted clinical course and, although treatments with glucocorticoids, azathioprine and/or ciclosporin have been tried, rates of remission are low.
To describe successful treatment of HKEM in two dogs using oclacitinib.
A 7-year-old, spayed Havanese dog (Case 1) and a 1-year-old, intact cryptorchid Dachshund dog (Case 2).
Case characterization and clinical diagnoses were based on lesion character, surgical biopsy, cytological evaluation, culture, direct immunofluorescence (DIF) and expected responses to treatments.
Both cases exhibited multifocal, often symmetrical hyperkeratotic plaques with adherent scale. Histological findings revealed prominent epidermal hyperplasia, parakeratotic hyperkeratosis, lymphocytic dermatitis and transepidermal apoptosis with lymphocytic satellitosis. DIF revealed fine, patchy IgG, IgM and IgA basement membrane deposits (Case 2). Both dogs exhibited rapid improvement with oral oclacitinib (0.6-0.9 mg/kg twice daily) with a complete remission of clinical signs observed in 12 and seven weeks in cases 1 and 2, respectively.
Oclacitinib could be considered as a fast-acting and effective treatment option for HKEM in dogs.
角化过度性多形红斑（HKEM）是一种具有独特临床特征的皮肤病，也是一种特征不明显的综合征，其特征为角化过度斑块，具有不同的对称性和类似“经典”糜烂性犬多形红斑的凋亡。角化过度性 EM 具有较长的临床病程，尽管尝试了糖皮质激素、硫唑嘌呤和/或环孢素治疗，但缓解率较低。
描述使用oclacitinib 成功治疗两只犬的 HKEM。
一只 7 岁、绝育的哈瓦那犬（病例 1）和一只 1 岁、未去势的短毛腊肠犬（病例 2）。
基于病变特征、手术活检、细胞学评估、培养、直接免疫荧光（DIF）和预期的治疗反应对病例进行特征描述和临床诊断。
两例均表现为多灶性、常对称的角化过度斑块，伴有黏附性鳞屑。组织学发现显示明显的表皮增生、角化不全性角化过度、淋巴细胞性皮炎和伴有淋巴细胞卫星现象的表皮凋亡。DIF 显示细斑状 IgG、IgM 和 IgA 基底膜沉积（病例 2）。两例犬均口服 oclacitinib（0.6-0.9mg/kg，每日两次）后迅速改善，病例 1 和 2 的临床症状分别在 12 周和 7 周完全缓解。
oclacitinib 可被视为犬 HKEM 的一种快速起效且有效的治疗选择。
