Ulcerative Dermatosis of The Shetland Sheepdog and Rough Collie Dog May Represent A Novel Vesicular Variant of Cutaneous Lupus Erythe
Ulcerative Dermatosis of The Shetland Sheepdog and Rough Collie Dog May Represent A Novel Vesicular Variant of Cutaneous Lupus Erythe
Ulcerative Dermatosis of The Shetland Sheepdog and Rough Collie Dog May Represent A Novel Vesicular Variant of Cutaneous Lupus Erythe
Abstract A syndrome of ulcerative dermatitis (UDSSC) previously has been described as unique to the
Shetland sheepdog and rough collie dog. The pathogenesis of this disease is poorly understood and it has been
suggested that it may be a variant of canine dermatomyositis (DM) which is also seen in these breeds.
Information on the clinical presentation and previous medical history was collected from ve Shetland
sheepdogs and three rough collie dogs previously diagnosed with UDSSC. Characteristic features of the
disease were adult onset in the summer months with annular, polycyclic and serpiginous ulcerations
distributed over sparsely haired areas of the body. Skin biopsies taken from active lesions were compared in a
blinded fashion with histological sections from seven Shetland sheepdogs and one rough collie with DM.
Dermatomyositis was characterized histologically as a cell poor interface dermatitis associated with follicular
atrophy. In contrast, the lesional pattern of UDSSC is that of a lymphocyte-rich interface dermatitis and
folliculitis with vesiculation at the dermalepidermal junction. The authors conclude that these represent two
distinct diseases and that UDSSC may be a vesicular form of cutaneous lupus erythematosus seen in the adult
rough collie dog and Shetland sheepdog.
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INTRODUCTION
A syndrome of ulcerative dermatitis has previously
been described as unique to the Shetland sheepdog and
rough collie dog breeds (UDSSC). Dogs clinically
aected with ulcerative skin disease are reported to be
adults and are described as developing a visually
distinctive disease characterized by serpiginous ulcerations and erosions of the groin and axillae which can
progress to involve the mucocutaneous junctions, oral
cavity and footpads.1 The pathogenesis of this disease
is poorly understood and it has been suggested that it
may be a variant of canine derma-tomyositis (DM)
which is an hereditary disease in these dog breeds.2 In
contrast DM is characterized by a cicatricial alopecia
of the face, limbs and extremities preceded by papules,
vesicles and erythema. Some aected animals have a
concurrent myositis.3
Dermatomyositis in man may be of juvenile or
adult onset. Although rare, dermatitis in the absence
of muscle disease has been described. Clinically, it is
characterized by pruritus and a symmetrical macular
erythema involving the pressure points and periorbital areas. Weakness is associated with skeletal muscle
212 DISC
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Vesicular lupus in rough collies and Shelties
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Concurrent
physical ndings
Urinalysis
Laboratory
abnormalities
ANA
Coombs
RF
% indoor
Last vaccination
Case 1
Case 2
Case 3
Case 4
8 years
August
North Carolina
Sheltie
M
Ulceration. Oral,
preputial,
labial commisures,
ventral abdomen
Assymetric testes
eas
WBC, protein
5 years
September
New York
Sheltie
FS
Ulceration
Axillae, groin, ventral
abdomen
Footpad hyperkeratosis
1 years chronic degenerative
polyarthropathy
Granular hyaline casts
in urine.
Protein 1+
4 years
July
Oregon
Sheltie
FS
Ulceration
inguinal, axillae
Concave pinnae
Mucocutaneous junctions.
N/R
6 years
June
Texas (moved from North)
Sheltie
FS
Ulceration ventral abdomen
periorbital, perilabial. Spread
to involve dorsum and
footpads
N/R
Granular casts
N/R
N/R
neg
neg
neg
100%
February/rabies
neg
90%
16 months previously
90%
June after onset disease.
Rabies & DHLPP
Case 5
Case 6
Case 7
Case 8
7 years
February
Virginia
Sheltie
M
Ulceration, vesicles
inguinal, axillae
concave pinnae
Muzzle, oral
5 years
July
North Carolina
rough collie
F
Ulceration, vesicles
Inguinal, axillae
concave pinnae
Mucocutaneous
al, interdigital
weight loss
Myiasis, fever
lyphadenopathy septicaemia
N/R
3 years
August
California
rough collie
FS
Ulceration
Inguinal, axillae,
axillae, inguinal
3 years
July
North Carolina
rough collie
FS
Ulceration
Periocular, mucocutaneous,
N/A
N/R
N/A
N/R
N/R
Lymphopaenia
neutrophilia with left shift
Amorphous casts.
UPC 0.8
N/R
neg
N/R
Fully vaccinated
date unknown
Table 1. continued
Age/month onset
Area USA
Breed/gender
Skin lesions
Concave pinnae
Concurrent
physical ndings
Urinalysis
Lab abnormalities
ANA
Coombs
% indoor
Last vaccination
Developed periocular
swelling on treatment
-unknown cause
Epithelial cells
WBC
Granular casts
neutrophilia with left shift Non-regen. anaemia
Eosinophilia
neutrophilia with toxic
left shift
Mild elevation AP
lymphopaenia
& ALT
hypoproteinaemia
neg
neg
neg 4, 25, 37 8C
0%
0%
3 months prior to onset: After onset disease
DHLPP
Mild elevation AP
N/R
neg
N/R
N/R
0%
N/R
212 DISC
Vesicular lupus in rough collies and Shelties
23
Vesicles at DEJ
9{
1*
4*
1*
0*
1*
2{
10*
0*
9*
8*
11*
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Vesicular lupus in rough collies and Shelties
DLE is not associated with systemic manifestations
and the ANA titre is negative.18 An interface
dermatitis is characteristic of both these diseases, in
DLE the inltrate is more lichenoid in nature.2,9
Many clinicians however, recognize cutaneous diseases with histological features of lupus erythematosus which do not t into the above canine
classication system (personal observation).
Although UDSSC has histological features which
support lupus, we did not nd consistent clinical or
clinicopathological evidence which supported a diagnosis of SLE. The reporting of granular casts in the
urinalysis in four cases, however, should not be
overlooked. This may be indicative of renal tubular
disease and warrants further investigation. Since the
urine sediment analysis was performed at dierent
laboratories and no specic quantitative evaluation
was reported, it is not possible to interpret this
nding further. None of the aected dogs presented
with clinical signs attributable to concurrent myositis,
therefore no additional diagnostic evaluation was
performed. The absence of clinical signs however,
may not rule out subclinical muscle disease because
some dogs with DM muscle abnormalities were only
supported by demonstration of electromyographic
abnormalities.3
The onset of clinical signs in the summer months in
7/8 cases and the distribution of the cutaneous lesions
over thinly-haired areas in these plush-coated breeds
support a role for photoinitiation if not photoaggravation. Additionally, it is interesting to note that
in two cases which were followed for more than 12
months, the disease went into remission over the
winter and ared up again in the early summer.
Furthermore, colonization of the skin by gramnegative bacteria and development of septicaemia in
this severe ulcerating skin disease have life-threatening consequences.
There are no specic clinicopathological features
associated with canine DM. An inammatory leukogram may be present in the early stages and
chronically, a nonregenerative anaemia, hyperglobulinaemia and monocytosis might be seen. Urinalysis is
reportedly unremarkable. Antinuclear antibody titres
and rheumatoid factors are typically negative
although weak positive results may be seen with the
Coombs test.19 The same investigators demonstrated
high concentrations of circulating immune complexes
(CIC) of the IgG class in moderately and severely
aected dogs. The signicance of CIC in this disease
is not known. They may arise as a consequence of
chronic inammatory disease or alternatively can be
central to the disease pathogenesis. If canine DM is
associated with a complement mediated vasculopathy, as is the case in man, then evidence of
microvascular immunoglobulin and complement deposition in lesional tissue must be demonstrated.
These studies are currently being undertaken by the
authors and may further substantiate the distinction
between canine DM and UDSSC.
25
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26
ACKNOWLEDGEMENTS
The authors would like to thank the following
colleagues for providing case information and/or
histological slides.: T. DeManuelle, C. Rees, D.
Gram, M. Rosenbaum, T. L. Gross, R. Dunstan, B.
Sigmon and P. Luther.
REFERENCES
1. Ihrke, P.J., Gross, T.L. Ulcerative dermatosis of
Shetland Sheepdogs and Collies. Kirk's Current
Veterinary Therapy XII (Small Animal Practice).
Bonagura JD, ed. Philadelphia: W.B. Saunders Co.,
1995: 63940.
2. Gross, T.L., Ihrke, P.J., Walder, E.J. Veterinary
Dermatopathology: A macroscopic and microscopic
Evaluation of canine and feline skin disease. St Louis:
Mosby Year Book, 1992: 368.
3. Hargis, A.M., Mundell, A.C. Familial canine
dermatomyositis.
Compendium
of
Continuing
Education for Practising Veterinarians. Small Animal
Practice 1992; 14: 85564.
4. Kovacs, S.O., Kovacs, S.C. Dermatomyositis. Journal
of the American Academy of Dermatology 1998; 39:
899920.
5. Crowson, A.N., Magro, C.M. The role of microvascular injury in the pathogenesis of cutaneous lesions of
dermatomyositis. Human Pathology 1996; 27: 14.
6. Haupt, K.H., Prieur, D.J., Moore, M.P. et al. Familial
canine dermatomyositis: clinical electrodiagnostic and
genetic studies. American Journal of Veterinary
Research 1985; 46: 18619.
7. Schmeitzel, L.P. Dermatomyositis: an immune
mediated disease with a link to canine lupus
erythematosus. Compendium of Continuing Education
for the Practising Veterinarian. Small Animal Practice
1992; 14: 86671.
8. Kunkle, G.A. Canine dermatomyositis: a disease with
an infectious origin. Compendium of Continuing
Education for the Practising Veterinarian. Small
Animal Practice 1992; 14: 86671.
Resume Un syndrome de dermatose ulcerative (UDSSC) a ete rapporte dans la litterature chez les Shetlands
et les Collie. La pathogenie de cette maladie est mal comprise, et il a ete suggere qu'il pourrait s'agir d'une
variante de dermatomyosite canine (DM), qui est egalement rencontree preferentiellement dans ces races. Des
donnees relatives aux symptomes et a l'anamnese ont ete obtenues pour cinq Shetland et trois Collie sourant
d'UDSSC. Les aspects caracteristiques de cette maladie regroupaient l'apparition des lesions a l'age adulte,
pendant les mois d'ete, des lesions ulcerees, annulaires, polycycliques et serpiginees, localisees au niveau des
zones peu velues. Des biopsies cutanees, obtenues au niveau de lesions evolutives, furent comparees a l'aveugle
avec des sections histologiques de sept Shetland et d'un Colley sourant de DM. La dermatomyosite etait
caracterisee sur le plan histologique par une dermatite d'interface pauvre en cellules, associee avec une
atrophie folliculaire. A l'oppose, la modalite de reaction cutanee observee pour les cas d'UDSSC etait
caracterisee par une dermatite lymphocytaire d'interface et des images de folliculite, avec une vesiculation au
niveau de la jonction dermo-epidermique. Les auteurs concluent qu'il s'agit de deux maladies dierentes, et
que l'UDSSC pourrait representer une variante vesiculeuse de lupus erythemateux cutane chez les Collie et les
Shetland adultes. [Olivry, T. und Jackson, H. A. Ulcerative dermatosis of the Shetland sheepdog and rough
collie dog may represent a novel vesicular variant of cutaenous lupus erythematosus. (La dermatose ulcerative
des Shetlands et des Collie pourrait representer une forme vesiculeuse nouvelle de lupus erythemateux cutane.)
Veterinary Dermatology 2001; 12: 1927.]
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Vesicular lupus in rough collies and Shelties
27