JPC SYSTEMIC PATHOLOGY

INTEGUMENTRY SYSTEM

September 2016

I-M28

Signalment (JPC 2602974):  Dog.

HISTORY:  Tissue from the nose of a dog with proteinuria.

HISTOPATHOLOGIC DESCRIPTION:  Planum nasale:  Diffusely within the superficial dermis, surrounding blood vessels and adnexa, multifocally obscuring the dermal-epidermal junction (interface dermatitis) and forming a lichenoid band, there is a dense infiltrate of predominantly plasma cells, lymphocytes, fewer macrophages, and rare neutrophils.  Inflammatory cells often transmigrate the epidermis frequently forming variably sized intracorneal pustules, with rare intraepidermal pustules. Multifocally, there are several erosions and ulcers characterized by partial to complete loss of the epithelium with replacement by a serocellular crust composed of serum and necrotic cellular debris.  Diffusely the epidermis and superficial follicular epithelium are spongiotic and hyperplastic with acanthosis, anastomosing rete ridges, and moderate parakeratotic hyperkeratosis.  There is occasional hydropic degeneration and apoptosis (Civatte bodies) within the stratum basale, and basal keratinocytes are often disorganized or jumbled.  Within the superficial dermis, scattered macrophages contain melanin (pigmentary incontinence).  There is mild, diffuse apocrine gland ectasia and lymphatics are ectatic (edema).

Lymph node:  Diffusely the medullary sinuses are expanded by increased numbers of histiocytes that often contain phagocytized erythrocytes and hemosiderin, and extravasated erythrocytes (draining hemorrhage).  There are moderate numbers of plasma cells within the medullary cords.

MORPHOLOGIC DIAGNOSIS:  1. Planum nasale:  Dermatitis, interface, lymphoplasmacytic, diffuse, severe, with scattered basal cell apoptosis, moderate epidermal and follicular hyperplasia and parakeratotic hyperkeratosis, breed not specified, canine. 

2. Lymph node: Draining hemorrhage, diffuse, mild.

ETIOLOGIC DIAGNOSIS:  Immune-mediated dermatosis

CONDITION:  Systemic lupus erythematosus (SLE)

GENERAL DISCUSSION: 

PATHOGENESIS:

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS:

TYPICAL LIGHT MICROSCOPIC FINDINGS: 

ADDITIONAL DIAGNOSTIC TESTS: 

DIFFERENTIAL DIAGNOSIS:  

For histologic lesions:

COMPARATIVE PATHOLOGY:

REFERENCES:

  1. Banovic F, Olivry R, Linder KE. Ciclosporin therapy for canine generalized discoid lupus erythematosus refractory to doxycycline and niacinamide.  Vet Dermatol. 2014;25(5):483-e79.
  2. Gerhauser I, Strothmann-Luerssen A, Baumgartner W. A case of interface perianal dermatitis in a dog: Is this an unusual manifestation of lupus erythematosus? Vet Pathol. 2006;43:761-764.
  3. Gross TL, Ihrke PJ, Walder EJ, Affolter VK. Diseases of the epidermis. In: Skin Diseases of the Dog and Cat. 2nd ed. Ames, IA: Blackwell Publishing Company; 2005:505.
  4. Hargis AM, Ginn PE. The integument. In: Zachery JF, McGavin MD, eds. Pathologic Basis of Veterinary Disease. 5th Philadelphia, PA: Elsevier Saunders Company; 2012: 1055-1056.
  5. Marks SL, Henry CJ. CVT update: Diagnosis and treatment of systemic lupus erythematosus. In: Kirk’s Current Veterinary Therapy XIII. Philadelphia, PA: WB Saunders Co; 2000: 514-516.
  6. Mauldin EA, Peters-Kennedy J. Integumentary system. In: Maxie MG, ed. Jubb, Kennedy, and Palmer’s Pathology of Domestic Animals. Vol 1. 6th ed. Philadelphia, PA: Elsevier; 2015: 604-607.
  7. Olivry T, Dunston SM. Usefulness of collagen IV immunostaining for diagnosis of canine epidermolysis bullosa acquisita. Vet Pathol.  2010;47(3):565-568.
  8. Olivry T, Linder KE. Bilaterally symmetrical alopecia with reticulated hyperpigmentation: A manifestation of cutaneous lupus erythematosus in a dog with systemic lupus erythematosus. Vet Pathol 2013;50(4);682-685.
  9. Olivry T, Rossi MA, Banovic F, Linder KE. Mucocutaneous lupus erythematosus in dogs (21 cases).  Vet Dermatol.2015;26(4):256-e55.
  10. Rottman JB, Willis CR. Mouse models of systemic lupus erythematosus reveal a complex pathogenesis. Vet Pathol. 2010;47:664-676.
  11. Salas EN, Kotschwar JL. Pathology in practice: Exfoliative cutaneous lupus erythematosus in a German shorthair pointer.  J Am Vet Med Assoc. 2014;245(3):291-293.
  12. Smee NM, Harkin KR, Wilkerson MJ. Measurement of serum antinuclear antibody titer in dogs with and without systemic lupus erythematous: 120 cases (1997-2005). J Am Vet Med Assoc. 2007;224:1180-1183.
  13. Smith BE, Tompkins MB, Breitschwerdt EB. Antinuclear antibodies can be detected in dog sera reactive to Bartonella vinsonni berkhoffii, Ehrlichia canis, or Leishmania infantum antigens. J Vet Intern Med. 2004;18:47-51.
  14. Snyder PW. Diseases of immunity. In: McGavin MD, Zachary JF, eds. Pathologic Basis of Veterinary Disease. 5th ed. St. Louis, MO: Mosby Elsevier; 2012: 275-278.
  15. Weiss DJ. Bone marrow necrosis in dogs: 34 cases (1996-2004). J Am Vet Med Assoc. 2005;227:263-267.


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