Diagnosis of pemphigus.
Diagnosis requires clinical presentation and histopathology that are consistent with pemphigus and either a positive direct immunofluorescence (DIF) microscopy result or serologic detection of autoantibodies against epithelial cell surface antigens..
How is pemphigus diagnosed? The diagnosis of pemphigus requires a skin biopsy.
Your veterinarian will use a biopsy punch to remove a small, circular plug of skin from a skin lesion..
Cytology from cases of pemphigus foliaceous classically shows acantholytic keratinocytes associated with intact neutrophils and occasional eosinophils (1,4).
Intracellular and extracellular bacteria may be seen if there is a secondary bacterial infection (4)..
“Pemphigus” refers to a group of autoimmune blistering diseases of the skin and mucous membranes that are characterized clinically by blisters and erosions, histologically by acantholysis (loss of cell-cell adhesion) at particular levels of the epidermis, and immunopathologically by autoantibodies against specific .
Histology of pemphigus vulgaris
The blister cavity may contain inflammatory cells including eosinophils and rounded acantholytic cells with intensely eosinophilic cytoplasm and a perinuclear halo.
The floor of the blister may be lined with intact keratinocytes, the “tombstone pattern” (figures 1, 2)..
There are multiple types of pemphigus, and these different types often vary in their clinical appearance.
The three most common types of pemphigus are pemphigus foliaceus, pemphigus vulgaris, and pemphigus erythematosus.
Pemphigus Foliaceus – Pemphigus foliaceus is the most common autoimmune skin disease in dogs and cats.
Possible exogenous causes of pemphigus include:
Pemphigus foliaceus, the most common autoimmune dermatosis in dogs, presents with primary large, superficial pustules.
Pustules may be punctate or span multiple follicles, and contents may appear translucent to yellow ( Figure 1).
Because they are thin-roofed, pustules tend to rapidly rupture and form crusts with underlying erosions.
Pemphigus foliaceus (PF) is the most common autoimmune skin disease in dogs and cats.
It is also the most common variant of pemphigus diseases,1,2 which are characterized by autoantibodies that target keratinocyte desmosomal proteins, leading to loss of cell-to-cell adhesion (acantholysis).
