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Dermatology > Autoimmune Skin Diseases & Immunosuppressive Therapies > Flashcards

Autoimmune Skin Diseases & Immunosuppressive Therapies Flashcards

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Dermatology Board Prep flashcards
1
Q

What is pemphigus complex and what are the different kinds?

A

Autoimmune skin disease where antibodies attack desmogleins

Type 2 sensitivity, acantholysis

Types- foliaceous, erythematosis, vegetans, vulgaris

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2
Q

What is pemphigus foliaceous?

A

Most common type of pemphigus
Show-chow, collie, akita
Antibodies target antigens in the upper part of the epidermis

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3
Q

What is the primary lesion for pemphigus foliaceous?

A

Pustule

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4
Q

What are the clinical signs of pemphigus foliaceous in cats?

A

“Stripper’s disease”

Lesions around nipples, nails, face

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5
Q

What does histopathology of PF show?

A

Subcorneal pustules with acantholytic cells

Need to biopsy lesions when off steroid therapy

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6
Q

What are important things to rule out with PF?

A

Pyoderma

Demodex

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7
Q

What is the therapy for P. Foliaceous, erythematosus (severe), vulgairs?

A

High doses of corticosteroids
azathioprine
chlorambucil
gold

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8
Q

What is pemphugus erythematosus?

A

Cross over between pemphigus and lupus
Milder than PF
Breeds- collie, GSD
Antibodies in intercellular spaces of dermis and BM

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9
Q

What are the clinical signs of pemphigus erythematosus?

A

Pustular dermatitis on face and ears
Nasal depigmentation
Aggravated by UV
No systemic signs

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10
Q

What is pemphigus vulgaris?

A

Acantholysis of lower epidermis
Rare in vet med but common in humans

Occurs in mouth! (Way to differentiate from PF)

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11
Q

What is the primary lesion for p. Vulgaris?

A

Bulla

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12
Q

What are the clinical signs of P. Vulgaris?

A

Animals are very ill- lethargy, anorexia, fever, secondary bacterial infections

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13
Q

What will histopathology for p. Vulgaris show?

A

Suprabasilar clefting and acantholysis

Prognosis is poor without therapy

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14
Q

What is pemphigus vegetans?

A

Milder form of PF, rare

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15
Q

What is discoid lupus erythematosus?

A 
Benign form of lupus
No systemic signs
Aggravated by UV -> Ab in BM -> Type II hypersentivity
Breeds- collie, GSD
ANA- negative
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16
Q

What are the clinical signs of discoid lupus erythematosus?

A

Depigmentation, erosions, ulcerations on nose

17
Q

What is the therapy for discoid lupus erythematosus?

A

Topical steroids, sunscreens, Vit E

18
Q

What is systemic lupus erythematosus?

A

Multisystemic disease in which Ab are produced against different antigens (RBCs, platelets, Nuclear)

ANA- positive

19
Q

What are the clinical signs of systemic lupus erythematosus?

A 
Seborrhea
Vasculitis (pinnae, footpads)
Nasal depigmentation
Mucocutaneous bullous disease
Panniculitis
20
Q

What is the therapy for systemic lupus erythematosus?

A

Immunosuppressive drugs )high doses of steroids, azathioprine, chlorambucil)
Gold is contraindicated

21
Q

What is bollus pemphigoid?

A 
Ab attack BM
Old animals (collie, doberman)
22
Q

What is the primary lesion for bollus pemphigoid?

A

Bulla

23
Q

What is erythema multiforme?

A

Immune-mediated syndrome secondary to drugs or infections characterized by peripheral erythema with central clearing

Animals are not usually systemically ill

24
Q

What is toxic epidermal necrolysis?

A

Severe, cutaneous eruptions causing full thickness necrosis and sloughing

Animals are systemically ill

Steroids contraindicated

25
Q

What is mycosis fungoides?

A

T cell Lymphoma that causes depigmentation and ulceration of MM and nose

26
Q

What is necrolytic migratory erythma?

A

Metabolic defect that causes skin necrosis

Cutaneous lesions (erythema , ulcerations of pinnae, muzzle, footpads, genitalia) may precede the onset of systemic illness

Associated with liver disease, glucagonoma, DM, cushings

Poor prognosis

27
Q

How do you diagnose necrolytic migratory erythema?

A

Red-white-blue!
Histpathology-
Red: Hyperkeratotic parakeratosis

White: Edema in middle epidermis

Blue: Hyperplasia of basal cell layer

28
Q

What is the main life-threatening side effect of steroids?

A

GI ulcers

29
Q

What does azathioprine do?

A

Suppressed cell-mediated and humoral immunity

Some dogs have gene mutations that increase risk of side effects (need to give every other day)

DO NOT USE IN CATS

30
Q

What does chlorambucil do?

A

Cytotoxic (B cells) alkylating agent

Safe for cats

31
Q

What do gold salts do?

A

Suppress Ab synthesis

Inhibit phagocytosis and PG synthesis

32
Q

What does cyclophosphamide do?

A

Alkylating agent that interferes with DNA replication- lymphocytes are sensitive

33
Q

What does tetracycline do?

A

Inhibits PMN chemotaxis and complement/PG synthesis

34
Q

What does Niacinamide do?

A

Inhibits mast cell degranulation

35
Q

What does cyclosporine do?

A

Decrease glucocorticoid needs by suppressing T cell proliferation and activation

P450 metabolism

36
Q

What is an important side effect of cyclosporine?

A

Papillomatous dermatitis

37
Q

What does dapsone do?

A

Used in conjunction with glucocorticoids

Decreases complement, Ab production, PNM chemotaxis

Dermatology (8 decks)

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