Pemphigus Foliaceous Signs and Treatment

Pemphigus Foliaceous is an uncommon autoimmune disease characterized by autoantibody production and the subsequent development of pustules in the superficial layers of the skin. Pemphigus Foliaceous is most commonly seen in middle-aged dogs. The diagnosis is based on the clinical signs, skin biopsy and immunologic testing.

Signs of Pemphigus Foliaceous

At the early onset the disease may be confined to the head, but later it spreads to more of the body. The lesions are bilaterally symmetrical and tend to develop in waves; animals may progress rapidly from the total absence of disease signs to the sudden appearance of dozens of pustules which quickly progress to form thick, adherent crusts with marked peeling. These peeling crusts represent the hallmark of the pemphigus Foliaceous. The top of the muzzle and ears, the skin around eyes, and footpads are the most common sites of lesions.

Severely affected dogs may have fever.

Treatment of Pemphigus Foliaceous

Immunosuppressive drugs drug therapy (corticosteroids or other, more potent medications) is essential to treatment. Dogs must be monitored very carefully for drug side effects. If your dog takes steroids, be vigilant about keeping his bowl full of fresh water, as the drugs often cause increased thirst.

Although the medication is tapered gradually, most dogs stay on a low dose of medication throughout their lifetime.

Recent studies show that in some dogs with pemphigus Foliaceous, immunosuppression can lead to long-term remission of skin lesions, and that discontinuation of treatment is not necessarily followed by a recurrence of clinical signs. Dogs are treated either with immunosuppressive doses of oral glucocorticoids or with a combination of oral glucocorticoids and azathioprine.

After clinical signs underwent complete remission, which occurred 1.5-5 months after immunosuppression was started, the drugs were tapered progressively and eventually withdrawn. The total duration of immunosuppressive therapy varied between 3 and 22 months. Skin lesions of pemphigus Foliaceous may not recur for 1.5-6 years after treatment is stopped.

Breeds Commonly Affected by Pemphigus Foliaceous

References:
1. Prolonged remission after immunosuppressive therapy in six dogs with pemphigus 'Foliaceous. Olivry T, Bergvall KE, Atlee BA. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State 'University
2. UC Davis Book of Dogs: The Complete Medical Reference Guide for Dogs and Puppies By 'Mordecai Siegal

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