Metabolic epidermal necrosis in two dogs with different underlying diseases

Abstract

Two dogs with metabolic epidermal necrosis had hyperkeratosis of the footpads accompanied by erythematous, erosive and crusting lesions affecting the muzzle, external genitalia, perineum and periocular regions. Histopathological examination of skin biopsies revealed a superficial hydropic dermatitis with marked parakeratosis. Both dogs had high plasma activities of alkaline phosphatase and alanine aminotransferase and high concentrations of glucose, and also a marked hypoaminoacidaemia. Despite these similarities, the cutaneous eruptions were associated with different underlying diseases. One dog had a pancreatic carcinoma which had metastasised widely; the primary tumour and the metastases showed glucagon immunoreactivity on immunocytochemical staining, and the dog's plasma glucagon concentration was markedly greater than that of control dogs. The other dog had diffuse hepatic disease; its plasma glucagon concentration was similar to that of control samples and cirrhosis was identified post mortem. Metabolic epidermal necrosis in dogs is a distinct cutaneous reaction pattern which may be associated with different underlying systemic diseases; however, the pathogenesis of the skin lesions remains unclear.

Superficial Necrolytic Dermatitis in 11 Dogs with a History of Phenobarbital Administration (1995–2002)

“…The marked reduction in serum amino acid concentrations in 1 dog of the present study and in other dogs with SND 1,4,11,12 likely is a result of excessive utilization of amino acids in hepatocytes.…”

“…4,5,[14][15][16][17][18][19][20] Glucagon stimulates gluconeogenesis and increases amino acid catabolism and can contribute to low plasma amino acid concentrations and glucose intolerance reported in dogs with glucagonomas. 4,5,14,16,17 However, the majority of dogs with SND have no identifiable glucagonoma or defect in hepatic glucagon degradation. Plasma glucagon concentrations measured in SND dogs with no evidence of glucagonoma have either been normal or mildly increased.…”

“…Plasma glucagon concentrations measured in SND dogs with no evidence of glucagonoma have either been normal or mildly increased. 4,16,17 Sporadic cases of infectious, inflammatory, and neoplastic conditions associated with SND in dogs also have been described. 8,9,21,22 Case reports of 2 dogs with SND that have a history of either primidone or phenobarbital (PB) administration have been published.…”

Necrolytic migratory erythema in a dog

“…Hyperkeratosis and fissures on paw-pads, exudativeulcerative dermatitis, bullas and vesicular lesions (3,10), hyperpigmentation are mostly seen in dogs in NME (2). Lesions are observed on paw-pads; mucocutaneous junctions and the regions exposed to pressure and friction (3).…”

Síndrome do gucagonoma em cão

“…1,2 Dermatose similar tem sido observada em cães, gatos e rinocerontes negros. Em cães, essa afecção tem acometido principalmente animais adultos ou idosos, sem predisposição racial e sexual, sendo mais propriamente denominada necrose epidérmica metabólica (NEM), 3 dada a ausência do caráter migratório das lesões, que é evidenciado em humanos. Na espécie canina, a NEM tem sido associada sobretudo a graves doenças do parênquima hepático (hepatopatias crônicas, cirrose e neoplasias hepáticas) sendo raramente decorrente de neoplasias pancreáticas, produtoras ou não de glucagon, e de enteropatias do intestino delgado.…”