Download Cutaneous or Discoid Lupus Erythematosus

Cutaneous or Discoid Lupus
Erythematosus
Emily Rothstein, DVM, DACVD
BASIC INFORMATION
Description
Cutaneous lupus erythematosus is an ulcerative skin disease that
involves the hairless, “button” part of the nose of dogs and cats. In
severe cases, the skin around the nose, lips, and parts of the mouth
may be affected.
Causes
Discoid lupus is likely caused by a combination of genetic factors and the effects of sunlight on the skin, which may induce a
destructive immune response. The condition occurs most often in
the collie, Shetland sheepdog, German shepherd dog, and Siberian
husky. The immune system attacks the bottom layer of the skin
(epidermis) with secondary erosions and ulcerations.
Clinical Signs
Early lesions include redness and loss of pigment of the skin and nose.
As lesions worsen, the cobblestone architecture of the tip of the nose
is lost. Later, skin may become quite raw, and scabs can be seen.
Diagnostic Tests
The clinical appearance can suggest the diagnosis, but a biopsy
is needed to absolutely determine the presence of this condition, since several other diseases create a similar appearance.
Specialized examination of the biopsy specimens may be needed
to determine the presence of an autoimmune reaction in which
the immune system is attacking the skin cells. Other laboratory
tests may be recommended prior to starting therapy to determine
whether it is safe to start certain medications.
TREATMENT AND FOLLOW-UP
Treatment Options
Avoiding exposure to the sun and using sunscreens are important
measures to protect the skin from ultraviolet light. Topical therapy
(applied directly to the skin) with steroids or immune-modulating
drugs may be successful in mild cases. Systemic therapy with
oral vitamin E, steroids, and other immune-suppressive drugs is
indicated if topical therapy is ineffective and for severe cases.
Numerous drug options are available for this disease, and some of
them have potential side effects that require careful monitoring.
Follow-up Care
After treatment has been started, recheck visits are usually scheduled about every 2-4 weeks to evaluate the response to therapy.
Once clinical remission has been achieved, the visits are often continued at 1-month intervals as the drug dosages are being tapered,
and then every 6 months during maintenance therapy. If systemic
therapy is used, laboratory tests are periodically needed to monitor
for side effects from the medications and to make sure no secondary infections are starting.
Prognosis
This disease can usually be successfully controlled, but a cure
is not expected. Prolonged treatment and monitoring are typically required, with periodic adjustment of medications and their
dosages.
If you have other questions or concerns about this, or other health topics, please call
McFarland Animal Hospital
608-838-3400
Copyright © 2011 by Saunders, an imprint of Elsevier Inc. All rights reserved.