The comparative pathology of non-viral bullous skin diseases in domestic animals

Deep pemphigus (pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus) in dogs, cats and horses: a comprehensive review

Pemphigus is the term used to describe a group of rare mucocutaneous autoimmune bullous diseases characterized by flaccid blisters and erosions of the mucous membranes and/or skin. When the autoantibodies target desmosomes in the deep layers of the epidermis, deep pemphigus variants such as pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus develop. In this article, we will review the signalment, clinical signs, histopathology and treatment outcome of pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus in dogs, cats and horses; where pertinent, we compare the animal diseases to their human homologue. Canine, feline and equine pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus have many features similar to the human counterpart. These chronic and often relapsing autoimmune dermatoses require aggressive immunosuppressive therapy. In animals, the partial-to-complete remission of pemphigus vulgaris and pemphigus vegetans has been achieved with high dose glucocorticoid therapy, with or without adjunct immunosuppressants; the prognosis is grave for paraneoplastic pemphigus.

Auto-immune skin diseases in animals: time to reclassify and review after 40 years

It has been more than 40 years since the dual descriptions of canine pemphigus vulgaris. Over the ensuing four decades, the reports of—mostly canine—novel autoimmune skin diseases (AISDs) have progressed in successive waves separated by long periods of quiescence. This Editorial introduces a series of comprehensive review papers on the various canine and feline AISDs. This collection of articles aims at remediating the current veterinary literature deficiency on this topic by summarizing the key historical, clinical, histological, immunological and treatment characteristics of animal AISDs.

A high yield method for growing primary canine keratinocytes

From a small amount of starting material, a large quantity of canine keratinocytes can be generated for experimental purposes using a refined method of explant culture to initiate the growth of basal cells with a high proliferative potential. The dividing capacity of cultures was promoted by a system selecting clonogenic cells onto an i3T3 feeder layer in combination with carefully monitoring cell morphology and passaging to select out excessive numbers of differentiated keratinocytes. Levels of contaminating dermal fibroblasts, which if left unchecked will overgrow keratinocytes, were kept to a minimum by a combination of careful explant micro-dissection to remove dermis, eliminating explants with signs of fibroblast growth as well as using cholera toxin, EGF and i3T3 feeder layers. The advantage of the method described is that it does not rely on the provision of large quantities of starting material thereby reducing the need for repeated tissue sampling, and passage numbers of five or six can be routinely achieved. This technique can therefore be useful to experimenters who require a regular and reliable source of cells for their studies.

Production of recombinant extracellular domains of canine desmoglein 1 (Dsg1) by baculovirus expression

The aim of this study was to generate a recombinant protein to represent the entire extracellular domain of canine desmoglein 1 (Dsg1), a desmosomal cell-cell adhesion molecule, by the baculovirus expression system. Cotransfection of a baculovirus transfer vector containing the cDNA for the entire extracellular domain of canine Dsg1 with baculovirus DNA into insect cells resulted in the secretion of soluble canine Dsg1 into insect culture supernatants. Immunoreactivity of 11 human pemphigus foliaceus (PF) sera against the cell surface of canine keratinocytes was completely removed when the sera were preincubated with the canine Dsg1 baculoprotein. This recombinant canine Dsg1 produced by baculovirus shares the major epitopes of the authentic canine Dsg1 recognized by human PF sera, and will be useful in studying the molecular pathophysiological mechanisms in PF and impetigo in canine patients.

Review cutaneous lesions of the canine scrotum

Scrotal lesions are uncommon and often present a diagnostic challenge. In the veterinary literature there are no texts devoted to this subject. This study reviews and illustrates canine scrotal lesions following an aetiological layout with the aim of facilitating clinical identification and diagnosis. Infectious, immune-mediated, endocrinological and neoplastic conditions are the most commonly reported causes of scrotal lesions in the dog. They may affect the scrotum only or other parts of the body as well. The clinical presentation of the lesions, the presence of primary or secondary lesions and the presence of clinical signs of systemic disease may help in obtaining a diagnosis. In some cases further investigations are necessary to reach a definitive diagnosis. Histopathology aids in understanding pathological reactions of the scrotal skin but unfortunately this is not commonly carried out and few reports in the literature include histopathology. The list of conditions given in this review is not exhaustive and other, more rare, diseases may be encountered.

Vesicle formation and follicular root sheath separation in mice homozygous for deleterious alleles at the balding (bal) locus

The balding (bal) mutation of the mouse is an autosomal recessive mutation that causes alopecia and immunologic anomalies. A new allele was identified by allelism testing after using an interspecific backcross to localize the mutation to the centromeric end of mouse chromosome 18. We investigated the skin and hair histologic lesions of two alleles (bal(J) and bal(Pas)) at this locus and analyzed the expression of several keratinocyte markers and the production of autoantibodies by immunofluorescence on frozen skin sections. The lesions observed included separation of the inner and outer root sheath in anagen follicles resulting in the hair fiber being very easily plucked from the follicle. Vesicles on the ventral tongue, mucocutaneous junction of the eyelid, foot pads, and rarely in skin were also evident. Separation occurred between the basal and suprabasilar cells forming an empty cleft, resembling that observed in human pemphigus vulgaris. Immunofluorescence studies did not reveal the presence of tissue-bound or circulating autoantibodies. Expression of keratinocyte markers in hair follicles was normal. Keratin 6-positive cells were found on either side of the follicular separation suggesting a molecular defect in adhesion molecules between the inner layer of the outer root sheath cells to layers on either sides. This hypothesis has been confirmed by another group who demonstrated that the bal(J) mutation is due to the insertion of a thymidine in the desmoglein 3 gene, resulting in a premature stop codon.

Canine bullous pemphigoid (BP): identification of the 180-kd canine BP antigen by circulating autoantibodies

Human bullous pemphigoid (BP) is an immune-mediated blistering disease characterized by autoantibodies against BP antigens (230/180 kd), which are constitutive glycoproteins of hemidesmosomes found in basal keratinocytes. Blistering diseases similar to human BP have been reported in dogs. IgG deposits at the basement membrane zone (BMZ) are a common feature of canine BP. Although circulating anti-BMZ IgG autoantibodies have been demonstrated in some cases of canine BP, the specific skin protein targeted by these autoantibodies has not been identified. In this study, we characterized the antigenic target of the autoantibodies in the serum from a 3-year-old castrated male Pit Bull Terrier with BP. Direct immunofluorescence of the patient's skin demonstrated IgG deposits at the dermal-epidermal junction. Indirect immunofluorescence demonstrated autoantibodies in the patient's serum that stained the epidermal roof of salt-split canine skin and left the dermal floor unstained. These serum autoantibodies did not stain normal intact dog skin but labeled intact bovine tongue. Direct immunoelectron microscopy of the dog's skin revealed IgG deposits within the hemidesmosomes of the basal keratinocytes. Western immunoblotting experiments showed that canine keratinocytes express both the 230-kd and 180-kd bullous pemphigoid antigens, and the autoantibodies from the patient's serum recognized the 180-kd bullous pemphigoid antigen in proteins extracted from canine and human keratinocytes. Canine BP has many parallel features with human BP including similar immune deposition of IgG within hemidesmosomes and a hemidesmosome-associated 180-kd glycoprotein target for circulating autoantibodies.

Hereditary suprabasilar acantholytic mechanobullous dermatosis in buffaloes (Bubalus bubalis)

A skin disease characterized by trauma-induced sloughing of haired skin, hooves, and horns is described in four calves from a herd of Murrah buffaloes (Bubalus bubalis) in Brazil. Affected calves were detected shortly after birth by the presence of lesions affecting the distal extremities, the scapular and gluteal regions, and the tip of the tail. On histologic evaluation of affected skin, the lesions were characterized by suprabasilar vesicles and acantholysis affecting the epidermis and outer root sheath of the hair follicle infundibulum. The basal cell layer was intact and appeared as a single layer of cuboidal cells attached to the dermis. Ultrastructurally, the region between the stratum basale and the lower stratum spinosum had widened intercellular spaces with loss of desmosomal attachments, which led to the suprabasilar separation. The disease appears to be inherited as an autosomal recessive trait.

Comparative histopathology of pemphigus foliaceus and superficial folliculitis in the dog

A comparative histopathologic study of 50 cases of pemphigus foliaceus and 47 cases of superficial folliculitis in the dog was undertaken to identify those histopathologic features important in differentiating these diseases. All cases were diagnosed by the Surgical Pathology Service of the Laboratory of Pathology of the University of Pennsylvania, School of Veterinary Medicine, between January 1986 and March 1991. These cases were followed clinically to determine the accuracy of the initial histopathologic diagnosis. Data were analyzed by Fisher's exact test for discrete data and the Mann-Whitney U-test for continuous data. A probability of < 0.05 was considered statistically significant. The following breeds were affected with pemphigus foliaceus: Akita, Brittany Spaniel, Chow Chow, Collie, Dachshund, Doberman Pinscher, English Cocker Spaniel, English Setter, Golden Retriever, Siberian Husky, Laborador Retriever, Miniature Schnauzer, Old English Sheepdog, Scottish Terrier, Chinese Shar Pei, Spitz, Shetland Sheep Dog, Weimeraner, and West Highland White Terrier. An increased risk of developing pemphigus foliaceus was noted in the Akita (OR = 37.8), English Springer Spaniel (OR = 20.7), Chow Chow (OR = 12.3), Chinese Shar Pei (OR = 7.9), and Collie (OR = 3.9). Pemphigus foliaceus had a higher average density of acantholytic cells (226 +/- 22.9) than superficial folliculitis (11.8 +/- 4.6), and acantholytic cells were 183 times more likely to be present in pemphigus foliaceus. The presence of rafts of acantholytic cells occurred in pemphigus foliaceus (23/50) more often than superficial folliculitis (1/47). Recornification and reformation of pustules were, respectively, 13.4 and 3.6 times more likely to occur in pemphigus foliaceus.(ABSTRACT TRUNCATED AT 250 WORDS)

Immune-mediated skin disease in the dog and cat

Immune-mediated skin disease was recorded in 24 dogs and 11 cats by the Department of Pathology and Microbiology, University of Bristol, over the period 1973-1992. The clinical and histopathological features, together with the age, breed and sex, are given for each case. Skin biopsies from the 24 dogs in this series, together with tissue from 25 control dogs, were immunostained for IgG, IgM and C3 by direct immunoperoxidase methodology. The same technique, with species-specific antisera for IgG and IgM, was applied to skin biopsies from 10 affected cats. The correlation between clinical features, histopathology and immunohistochemistry is discussed.

Eosinophils: a review

The eosinophil was discovered by Jones in 1846 (Dessein and David, 1982) but its proclivity to stain with aniline dyes was first described by Paul Ehrlich in 1879 (Hirsch and Hirsch, 1980). Recognized and named for this quality, eosinophils possess an abundance of highly basic proteins within their granules which confer their affinity for acidic dyes (Gleich and Loegering, 1984). Eosinophils are traditionally viewed as killer-effector cells in parasitic infestations and as modulators of Type I hypersensitivity reactions (Butterworth and David, 1981; Kay, 1985). The eosinophils' reserve of cationic proteins and enzymes which imparts their profound parasiticidal effects (Butterworth and David, 1981) contrasts with this leukocyte's purported regulatory function in inflammation (Kay, 1985; Fechter et al., 1986). The opposing functions possessed by this leukocyte exemplify the enigma of the eosinophil. Recent evidence suggests that although the eosinophil does posses some regulatory capabilities, its presence is, in fact, a harbinger of tissue destruction (Gleich and Adolphoson, 1986, Wardlaw and Kay, 1987; Spry, 1988). Nor does the presence of the eosinophil automatically infer IgE mediated hypersensitivity, as evidenced by studies examining the interaction of the eosinophil with the cellular arm of the immune system (Basten and Beeson, 1970; Ruscetti et al., 1976; Beeson and Bass, 1977; Raghavachar et al., 1987; Ohnishi et al., 1988). The purpose of this review is to provide a brief overview of the structure and biology of the mammalian eosinophil and to emphasize the fact that eosinophils fulfil a paradoxical role as effectors of tissue damage and as benign modulators of inflammation.

Immunoperoxidase staining for the detection of autoantibodies in canine autoimmune skin disease; comparison to immunofluorescence results

Skin sections from 22 dogs with autoimmune skin disease were stained with anti-canine IgG, IgM and IgA using an immunobridge immunoperoxidase method. Eight cases of lupus erythematosus, three cases of pemphigus vulgaris, and 11 cases of pemphigus foliaceus were included. Results of previously performed, direct immunofluorescence tests for the detection of canine immunoglobulin on skin were available on 17/22 cases. The immunoperoxidase method yielded an overall positive result in 59% (5/8 lupus erythematosus, 2/3 pemphigus vulgaris and 6/11 pemphigus foliaceus) versus an overall positive result of 47% for direct immunofluorescence (3/5 lupus erythematosus, 2/2 pemphigus vulgaris and 2/10 pemphigus foliaceus). The immunobridge immunoperoxidase method compared favorably to direct immunofluorescence testing of canine skin for autoantibody in cases of lupus erythematosis and pemphigus vulgaris, and was superior in cases of pemphigus foliaceus. This method should prove useful as an aid in the diagnosis of canine autoimmune skin disease.

Subcorneal pustular dermatosis in dogs and in human beings: comparative aspects

Subcorneal pustular dermatosis is a rare disorder in dogs and in human beings. A retrospective study of 13 cases of canine subcorneal pustular dermatosis indicates that many of the clinicopathologic features of this disease are similar in both species. In both the condition is characterized by a variably pruritic, sterile, pustular eruption that is resistant to antibiotics and glucocorticoids. The therapeutic response to dapsone is not uniformly successful in either species, and the disorder tends to be chronic and recurrent.

Ultrastructure of junctional epidermolysis bullosa in Belgian foals

Ultrastructural examination of a mechanobullous disease of probable hereditary nature in Belgian foals, confirmed light microscopic findings that separation of the dermo-epidermal junction occurred through the lamina lucida of the basement membrane, leaving the intact lamina densa adherent to the dermis and the plasmalemma of the basal epithelial cells intact. The location of the cleft and the presence of small hemidesmosomes in adjacent intact skin are additional characteristics which make this condition similar to junctional epidermolysis bullosa of man.

Pathologic changes in otitis externa

Otitic lesions must be evaluated in the context of the whole animal. Accurate historical and clinical assessments are important aids to the pathologist attempting to reach an accurate diagnosis. Primary lesions of the pinna, with or without involvement of the external ear canal, may be an extension of a more generalized dermatologic problem or may specifically involve the ear because of its unique gross and histologic characteristics.

Sterile eosinophilic pustulosis in dog and man: comparative aspects

Sterile eosinophilic pustulosis is a rare dermatosis of dogs and humans. The clinicopathologic aspects of the disorder are similar in both species. In both the disease is characterized by a moderately generalized, pruritic, sterile, follicular and nonfollicular papulopustular dermatitis. Blood and tissue eosinophilia are usually present. Response to systemic glucocorticoids is better in dogs, probably because of the larger doses that can be used. The disorder is chronic and recurrent in both species.

Long-term cultivation of canine keratinocytes

The growth characteristics and morphology of canine keratinocytes grown in vitro were studied. Keratinocytes from canine oral mucosa, ear skin, and ventral abdominal skin were grown in culture either as explants or as dispase/trypsin-derived suspensions in the absence of a feeder cell layer. Cholera toxin and epidermal growth factor were essential to the successful long-term growth and propagation of the cells during multiple passages. Keratinocytes from all tissue sources, either as primary cultures or subcultivated for up to 10 passages, had growth characteristic and morphology similar to that reported in other species. The use of cultured canine keratinocytes should provide a suitable model for comparative in vitro studies of the pathogenesis of dermatologic diseases.

Immunodiagnosis of autoimmune skin disease in the dog, cat and horse

Skin biopsies from 47 dogs, 6 cats and 5 horses with suspected autoimmune skin disease were submitted for immunofluorescence from 1978 to 1985. These cases were predominantly Western Australian in origin, although a number were also referred from Queensland and Victoria. In 5 dogs, 2 cats and 2 horses immunoglobulin binding to intercellular cement substance and/or basement membrane was demonstrated by direct immunofluorescence. Antinuclear antibody was also demonstrated in several of these cases. Immunofluorescence was used in combination with histopathological examination to confirm the clinical diagnosis of autoimmune disease in 19/47 dogs, 4/6 cats and 2/5 horses. There was no age, breed or sex predisposition amongst the 19 positive dogs, however there was a higher incidence of antinuclear antibody (54%) than the normal canine population (10%) and other autoantibodies (rheumatoid factor) were sometimes present. Abnormalities in serum protein electrophoresis and serum complement C4 levels were also recorded in this group.

Pathology of an ulcerative dermatitis in Belgian Landrace sows

Chronic ulcers of the skin were observed in three Belgian Landrace sows. Lesions were located on ears, limbs, and in the mammary region and were resistant to treatment that included corticosteroid therapy. Major histologic changes were located at the dermo-epidermal junction. Ulcers were deep, and the adjacent epidermis had marked hyperkeratosis, acanthosis, and intracellular edema. Dermatitis was prominent, essentially located in the superficial dermis. By electron microscopy, basal lamina appeared disrupted. Dermo-epidermal separation occurred beneath the basal lamina. Collagen was morphologically normal. Desmosomes, hemidesmosomes, and anchorage fibers were present in areas adjacent to lesions. Ulcerative dermatitis of sows is morphologically similar to pemphigus, pemphigoid, systemic lupus erythematosus, epidermolysis bullosa simplex, erythema multiforme, toxic epidermal necrolysis, and drug eruption. However, significant differences exist between ulcerative dermatitis and these conditions.

The longevity of immunoglobulin preservation in canine skin utilizing Michel's fixative

Skin biopsy specimens from 7 dogs with immune-mediated skin diseases diagnosed by routine histology and 5 dogs with other skin diseases were placed in Michel's transport medium for 4 to 9 years. Direct immunofluorescence yielded positive results in tissue samples from 3 dogs with pemphigus foliaceus and 2 dogs with discoid lupus erythematosus. Direct immunofluorescence was not seen in tissue samples from 1 dog with pemphigus foliaceus and 5 dogs with non immune-mediated skin diseases. Direct immunofluorescence was seen in skin biopsy specimens maintained in Michel's medium for 4 to 8 years.

Pemphigus and pemphigoid in dog and man: comparative aspects

A review of canine pemphigus vulgaris, pemphigus vegetans, pemphigus foliaceus, pemphigus erythematosus, and bullous pemphigoid shows them to share many clinicopathologic similarities with their human counterparts. Because of their numerous analogies in clinical presentations, histopathologic and immunopathologic findings, and therapeutic results, canine and human pemphigus and pemphigoid may represent a valuable area for comparative dermatologic research.