Also Known
As: Cutaneous lupus erythematosus
Transmission
or Cause: Discoid lupus erythematosus (DLE) is an autoimmune disease in
which the animal’s own antibodies
attack normal components of the skin. DLE is a benign variant of systemic
lupus and has no systemic involvement. There is strong evidence that
sunlight induces and/or exacerbates the disease process.
Affected
Animals: DLE affects dogs and cats, but where
it is the second most common autoimmune disease in dogs, it is very rare
in cats. There appears to be neither a sex nor age predilection in either
species. Collies, German shepherds, Shetland sheepdogs, Siberian huskies,
Brittany spaniels, and German shorthaired pointers have demonstrated
predilection for DLE.
Clinical
Signs: Clinical signs of canine DLE include loss
of pigmentation where the brown/black color of the nose changes to a
slate blue or pink color, redness, and scaling of the nose. The disease
can ultimately progress to significant destruction of the tissue, resulting
in ulceration and crusting of the nose. Lesions may rarely involve the
ear flaps, mouth and area surrounding the eyes. The affected dogs are
otherwise healthy. In cats, DLE most commonly affects the ear and face,
resulting in redness, scaling, crusting, and hair loss. Aside from the
dermatologic lesions, affected dogs and cats are otherwise healthy.
Diagnosis: As this
disease can resemble other more serious diseases, including epitheliotropic
lymphoma (cutaneous lymphoma), pemphigus, and systemic lupus,
it is important to get a definitive diagnosis. Diagnosis is based on
a supporting clinical history and biopsy with histopathology. Biopsy
of the nose requires sedation or general anesthesia. The nose will
be numbed prior to biopsy, and sutures (stitches) will be present where
the biopsy was taken.
Treatment: Treatment
is variable and often dependent on severity of lesions. In some dogs,
sun avoidance alone may be sufficient in controlling the disease. In
more affected animals, therapy may include any individual or combination
of the following: topical and/or oral steroids, oral doxycycline, an
antibiotic with anti-inflammatory and immunomodulatory properties combined
with niacinamide, a vitamin B derivative, and tacrolimus, an immunosuppressive
topical ointment. Sun avoidance is essential in all affected animals,
with applications of sunscreen providing additional protection.
Prognosis: The prognosis of DLE is generally good, as this
does not cause systemic illness.
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