Pemphigus Foliaceus
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Questions and Answers

What is the recommended method for diagnosing pemphigus foliaceus?

  • Skin shaving and cleaning
  • Trimming hair and biopsy (correct)
  • Removal of crust
  • Punch biopsy

    • What is the suggested treatment for pemphigus foliaceus in cats?

  • High-dose immunosuppressive therapy
  • Prednisolone combined with azathioprine (correct)
  • Removal of suspect drugs
  • Dexamethasone pulse therapy

    • Which of the following is NOT a possible direct complication of pemphigus foliaceus?

  • Demodicosis (correct)
  • Weight loss
  • Lethargy
  • Anorexia

    • Why is the distribution of lesions important in autoimmune diseases like pemphigus foliaceus?

    <p>To differentiate it from pyoderma</p> Signup and view all the answers

    What should be done before starting immunosuppressive therapy for pemphigus foliaceus?

    <p>Stop flea and tick preventatives</p> Signup and view all the answers

    What is the recommended approach for achieving remission in pemphigus foliaceus?

    <p>Monitor bloods routinely</p> Signup and view all the answers

    When is dexamethasone pulse therapy typically used in pemphigus foliaceus?

    <p>In refractory cases</p> Signup and view all the answers

    Can immunosuppressive drugs be used at anti-inflammatory doses for pemphigus foliaceus?

    <p>Yes, it is the recommended approach</p> Signup and view all the answers

    What is the suggested approach for tapering immunosuppressive drugs in pemphigus foliaceus?

    <p>Maintain a constant dose</p> Signup and view all the answers

    What are the clinical signs of pemphigus foliaceus in cats?

    <p>Pustules, erosion, crusting on ear pinnae, face, and/or nail bed. Mild scaling on pads. Lesions on nasal planum, oral cavity, and mucocutaneous junctions. Nail loss is rare.</p> Signup and view all the answers

    What complications can occur in pemphigus foliaceus?

    <p>Fever, weight loss, lethargy, anorexia. Concurrent dermatophytosis, demodicosis, and secondary pyoderma may also be present.</p> Signup and view all the answers

    What is the suggested method for diagnosing pemphigus foliaceus?

    <p>Cytology and histology - direct impression smear from moist crust or pustule. Punch biopsy is also available. Skin should not be shaved or cleaned. Crust should not be removed.</p> Signup and view all the answers

    What is the recommended treatment for pemphigus foliaceus?

    <p>Stop flea tick preventatives. Then stop other suspect drugs. Treat secondary infections when starting immunosuppressive therapy. Prednisolone or glucocorticoids combined with azathioprine (not in cats).</p> Signup and view all the answers

    When is dexamethasone pulse therapy used in pemphigus foliaceus?

    <p>For refractory cases.</p> Signup and view all the answers

    Which species of animal shows a marked breed predisposition for pemphigus foliaceus?

    <p>Dog</p> Signup and view all the answers

    What is the median age range for pemphigus foliaceus in dogs?

    <p>6-16 years</p> Signup and view all the answers

    Is there a sex predisposition for pemphigus foliaceus in cats?

    <p>No</p> Signup and view all the answers

    Which species shows a rare predisposition for pemphigus foliaceus?

    <p>Horse</p> Signup and view all the answers

    What are the predominant signs of pemphigus foliaceus in general?

    <p>Crusts</p> Signup and view all the answers

    Which species shows a common theme of initial lesions on the face?

    <p>Dog</p> Signup and view all the answers

    What percentage of pemphigus foliaceus cases have lesions only affecting the face and head?

    <p>16%</p> Signup and view all the answers

    Which species shows a common theme of bilateral and symmetrical lesions in pemphigus foliaceus?

    <p>Cat</p> Signup and view all the answers

    Which species shows a common theme of large pustules with erythematous, irregular borders in pemphigus foliaceus?

    <p>Dog</p> Signup and view all the answers

    Which species shows a common theme of hairs protruding from the pustules in pemphigus foliaceus?

    <p>Dog</p> Signup and view all the answers

    Which of the following regions is most commonly affected by pemphigus foliaceus in animals?

    <p>Trunk</p> Signup and view all the answers

    What is the target antigen in pemphigus foliaceus?

    <p>Desmoglein-1</p> Signup and view all the answers

    Which of the following is a common differential diagnosis for pemphigus foliaceus?

    <p>Superficial pyoderma</p> Signup and view all the answers

    What is the recommended treatment for pemphigus foliaceus in horses and goats?

    <p>Prednisolone</p> Signup and view all the answers

    What is the survival rate at 1 year for dogs with pemphigus foliaceus?

    <p>71%</p> Signup and view all the answers

    What is the most common treatment for cats with pemphigus foliaceus?

    <p>Prednisone</p> Signup and view all the answers

    What is the most common reason for euthanasia in dogs with pemphigus foliaceus?

    <p>Treatment side effects</p> Signup and view all the answers

    What is the most common histopathological finding in animals with pemphigus foliaceus?

    <p>Acantholytic keratinocytes</p> Signup and view all the answers

    What is the recommended treatment for pemphigus foliaceus in horses and goats in combination with prednisolone or dexamethasone?

    <p>Gold salts</p> Signup and view all the answers

    Is equine pemphigus foliaceus easier to treat in young horses?

    <p>Not substantiated</p> Signup and view all the answers

    What are the common themes in the clinical signs of pemphigus foliaceus across different domestic animal species?

    <p>Superficial pustules develop rapidly into erosions and crusts which predominate.</p> Signup and view all the answers

    What is the common age range for pemphigus foliaceus in dogs?

    <p>1-16 years (median 6 years)</p> Signup and view all the answers

    Is there a sex predisposition for pemphigus foliaceus in dogs?

    <p>No</p> Signup and view all the answers

    What is the common age range for pemphigus foliaceus in cats?

    <p>1–17 years (median 6 years)</p> Signup and view all the answers

    Is there a sex predisposition for pemphigus foliaceus in cats?

    <p>No</p> Signup and view all the answers

    Which species shows a common theme of acute onset with urticaria in pemphigus foliaceus?

    <p>Goat</p> Signup and view all the answers

    What are the predominant signs of pemphigus foliaceus in general?

    <p>Crusts</p> Signup and view all the answers

    What are the initial lesions of pemphigus foliaceus in animals?

    <p>Initial lesions: erosions and yellowish crusts on the face, ears and feet.</p> Signup and view all the answers

    What regions of the body are commonly affected by pemphigus foliaceus in animals?

    <p>Other regions affected include the footpads (33%) and can be the sole sign. Mucosal lesions are very rare.</p> Signup and view all the answers

    What are the clinical signs of pemphigus foliaceus in horses with systemic signs?

    <p>Ventral and limb edema is seen in many horses with PF and systemic signs, such as depression and lethargy are reported in up to 50% of cases.</p> Signup and view all the answers

    What is the most common differential diagnosis for pemphigus foliaceus in animals?

    <p>Superficial pyoderma is a common differential diagnosis for pemphigus foliaceus in animals.</p> Signup and view all the answers

    What are the histopathological findings in animals with pemphigus foliaceus?

    <p>In dogs, cats, horses and goats with PF, histological examination of lesional skin reveals similar findings. Lesions affect the surface epithelium and the lumen of follicular infundibulum. Pustules are large and span multiple follicular units.</p> Signup and view all the answers

    What is the treatment option for pemphigus foliaceus in dogs and cats?

    <p>Immunosuppressive steroids (2-4 mg/kg prednisolone in divided doses) for 10-14 days, with the addition of azathioprine or chlorambucil if a poor response at 10 days.</p> Signup and view all the answers

    What is the survival rate at 1 year for dogs with pemphigus foliaceus?

    <p>Study 1: 31 dogs. 71% survival at 1 year (13% euthanized due to poor response or relapse).</p> Signup and view all the answers

    What is the recommended treatment for pemphigus foliaceus in horses and goats?

    <p>Pemphigus foliaceus can be treated successfully in horses and goats with either prednisolone or dexamethasone alone or in combination with aurothioglucose (gold salts).</p> Signup and view all the answers

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