Pemphigus foliaceus: ritka bőrbetegség egy fiatal lipicai ménben : Esetismertetés

Abstract

ÖSSZEFOGLALÁS A szerzők egy fiatal lipicai mén esetén keresztül szeretnék bemutatni egy ritka bőrbetegség, a pemphigus foliaceus kóroktanát, klinikai tüneteit, a kórjelzés lehetőségeit, kórlefolyását és kezelését. Kezdetben jellegtelen tüneteket tapasztaltak a tulajdonosok, majd a beérkezést követően néhány nap elteltével kezdődött meg a bőr leválása. Bőrbiopsziából végzett kórszövettani vizsgálat segítségével történt a diagnózis felállítása. A kezelés során a ló állapota hullámzó volt, majd végül akut respirációs distressz szindróma tüneteiben elhullott az állat. A kórbonctani vizsgálat során elhúzódó, Streptococcus baktériumtörzs okozta septicaemiát és annak következményeit állapították meg. SUMMARY Background: Pemphigus foliaceus is a rare condition, but it is the most common autoimmune skin disease in horses, and it has also been recognised in dogs, cats, goats and lamas. The cause is the formation of autoantibodies, which destroy the connection between keratinocytes. These antibodies are produced against desmoglein proteins located on the surface of keratinocytes. This process is called acantholysis. The formation of blisters occurs in the epidermis layer of the skin, which is relatively short-lived due to the thin epidermis layer. It is still unclear what predisposing factors play a role in the development of the disease, but there are several hypotheses for example, age, breed, and the use of antibiotics. Objectives: The aim of this study was to describe the pathophysiology, clinical signs, differential diagnosis and treatment options of pemphigus foliaceus. Materials and Methods: We performed physical examination, complete blood count, serum biochemistry, skin biopsy and histopathology, coagulation tests, abdominocentesis, gastroscopy, bacterial culture from the skin, and a tracheal wash sample. Results and Discussion: This 3-year-old colt was presented to the clinic with a history of 3-4 days of mild colic and sweating of the neck. A few days later, peeling, inflammation, and dermal discharge appeared. After diagnosing the disease, we started a glucocorticoid treatment, which resulted in improvement of the skin lesions, but caused some side effects. Corneal ulceration and pneumonia caused by secondary bacterial infection, and penile prolapse appeared. The corneal ulcer and the pneumonia improved, the penile prolapse was completely solved due to the therapy. On the last few days, a low-grade fever was seen, and on the last night, his respiratory function began to deteriorate, which led to the death of the animal. Post-mortem examination revealed prolonged septicaemia caused by a Streptococcal strain and its consequences.