Autoimmune and immune-mediated skin disease

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Autoimmune and immune-mediated diseases of the skin are uncommon or rare disorders. The severity can vary from mild localized disease to life-threatening conditions. Many diseases are seen more commonly in certain breeds, suggesting an hereditary predisposition. Diagnosis of such disorders is not always easy and usually relies on biopsy for histopathology. Management should never be instituted until a specific diagnosis has been reached and treatment is often difficult. The chapter focuses on Autoimmune diseases; Immune-mediated diseases; and Treatment.

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26.1 Symmetrical crusting on the haired skin and nasal planum of a dog with pemphigus foliaceus. Multifocal crusts on the convex pinna of a dog with drug-induced pemphigus foliaceus. (Courtesy of P Forsythe)
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26.2 Cytology of an intact pustule from a case of pemphigus foliaceus. Note the non-degenerate neutrophils and free-floating acantholytic keratinocytes. (Diff-Quik stain; original magnification x1000)
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26.3 Histology of pemphigus foliaceus. Note the intact subcorneal pustule. (Haematoxylin and eosin stain; original magnification x400)
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26.4 Mucous membrane pemphigoid. Note the ulceration, crusting, cicatricial alopecia and loss of pigment.
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26.5 Epidermolysis bullosa acquisita in a young Great Dane. Sloughing of the footpads is visible.
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26.7 Vesicular cutaneous lupus erythematosus in a Rough Collie. Note the polycyclic, serpigenous ulcerations on the ventral abdomen. (Reproduced from with permission from the publishers)
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26.9 Ischaemic damage to the extremities of a cat with idiopathic vasculitis.
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26.10 Vascular infarct of the convex pinna caused by post-vaccination ischaemia.
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26.11 Petechiae on the lateral flank associated with Rocky Mountain spotted fever ().
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26.12 Diascopy: with extravasation the lesions fail to blanche with pressure.
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26.13 Multifocal erosions associated with erythema multiforme.

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