Erythema Multiforme Major in a Dog Treated with Intravenous Human Immunoglobulin and Immunosuppressive Therapy

2020 ◽  
Vol 56 (2) ◽  
pp. 133-138
Author(s):  
Sara J. Ramos ◽  
Victoria M. Beale ◽  
Ingeborg M. Langohr ◽  
Michelle C. Woodward
Keyword(s):  
Erythema Multiforme ◽  
Clinical Signs ◽  
Skin Lesions ◽  
Human Immunoglobulin ◽  
Initial Examination ◽  
Immunosuppressive Medications ◽  
Erythema Multiforme Major ◽  
History Of ◽  
Major Treatment ◽  
Dermatologic Disease

ABSTRACT An ∼12 yr old castrated mixed-breed dog was evaluated for a 7 wk progressive history of intermittent hyporexia, lethargy, and erosive dermatitis. Initial examination revealed disseminated papules and macules coalescing to irregularly shaped and serpiginous plaques with widespread erosion progressing to ulceration. Skin histopathology revealed transepidermal keratinocyte apoptosis with lymphocyte satellitosis and lymphocytic and histiocytic interface infiltrate. Histopathology combined with clinical signs and history were compatible with the diagnosis of erythema multiforme major. Treatment was initiated with multidrug immunosuppression. Following 36 hr with no improvement, intravenous human immunoglobulin (0.45 mg/kg IV) was administered resulting in notable improvement in the dog’s attitude and appetite within 2 hr and the dog’s skin lesions within 48 hr. Following discharge, the dog improved daily with near complete resolution of dermatologic disease achieved 1 mo postdischarge. All immunosuppressive medications were ultimately discontinued 5 mo following presentation. This is the first report of a dog with erythema multiforme major that has been successfully treated with a combination of intravenous immunoglobulin and immunosuppression.

scholarly journals  Erythema multiforme minor in a dog following inappropriate intranasal Bordetella bronchiseptica vaccination: a case report

2011 ◽  
Vol 56 (No. 11) ◽  
pp. 568-572 ◽  
Author(s):  
MH Kang ◽  
HM Park
Keyword(s):  
Case Report ◽  
Erythema Multiforme ◽  
Clinical Signs ◽  
Skin Lesions ◽  
Bordetella Bronchiseptica ◽  
Hydropic Degeneration ◽  
First Case ◽  
History Of ◽  
One Year

A one-year-old, intact female, Yorkshire terrier dog was presented with a six-month history of multifocal, polycyclic erythematous lesions with epidermal collarette formation at the axillae, the trunk and ventral abdomen. The dog had a history of an inappropriate vaccine administration one day prior to the onset of clinical signs. The histopathology of the lesions revealed apoptosis of keratinocytes in the overlying epidermis, hydropic degeneration and lymphocytic exocytosis. The clinical signs and histopathology of the lesions were compatible with erythema multiforme. The skin lesions resolved after treatment with prednisolone combined with azathioprine for one month. No recurrence of clinical signs occurred during the follow-up period (four months). This is the first case report of erythema multiforme associated with an accidental subcutaneous injection of a Bordetella bronchiseptica vaccine.  

Hyperadrenocorticism in 10 Dogs with Skin Lesions as the Only Presenting Clinical Signs

2011 ◽  
Vol 47 (6) ◽  
pp. 419-427 ◽  
Author(s):  
Gila Zur ◽  
Stephen D. White
Keyword(s):  
Skin Disease ◽  
Severe Disease ◽  
Clinical Signs ◽  
Skin Lesions ◽  
Screening Tests ◽  
Skin Infections ◽  
Initial Examination ◽  
Thin Skin ◽  
Lost To Follow Up

Ten dogs that had skin lesions as the only presenting signs of hyperadrenocorticism (HAC) and as the owners’ primary complaint are described. Dogs were included if the initial examination was for skin disease, there were no signs of systemic illness on initial presentation and there was a confirmed diagnosis of HAC by specific screening tests. Dogs were excluded if they had a severe disease that might interfere with screening tests for HAC or if the screening tests were not diagnostic. There were five males and five females; six dogs were intact. Nine dogs were diagnosed at ≥7 years. Eight dogs weighed ≤10 kg. Alopecia was present in nine dogs. Eight dogs had bacterial pyoderma, five had hyperpigmentation, and four had thin skin. One dog had unresolved dermatophytosis. Skin lesions resolved after treatment in eight dogs. One dog was not treated and one was lost to follow-up. This study showed that skin lesions may be the only clinical signs of HAC. The presence of the more common clinical signs of HAC, such as a non-pruritic, truncal alopecia and/or thin skin, without any systemic signs of HAC and/or the presence of poorly responsive skin infections warrant screening for this disease.

Surgical Treatment of Suspected Meningioangiomatosis in the Thoracolumbar Spinal Cord

2020 ◽  
Vol 56 (4) ◽  
Author(s):  
Marie C. Dantio ◽  
Amanda J. Dennis ◽  
Robert L. Bergman
Keyword(s):  
Computed Tomography ◽  
Hind Limb ◽  
Clinical Signs ◽  
Initial Examination ◽  
Limb Ataxia ◽  
Vascular Proliferation ◽  
History Of ◽  
Pelvic Limb ◽  
Long Term Prognosis

ABSTRACT A 5 yr old male neutered Labrador retriever was evaluated for an 8 wk history of a slowly progressive abnormal hind limb gait that did not respond to treatment with nonsteroidal anti-inflammatories. Initial examination findings were mild pelvic limb ataxia and moderate right pelvic limb lameness. A computed tomography with a myelogram was performed and showed a suspected intramedullary spinal mass. MRI was conducted and supported the computed tomography with myelogram findings of a possible intradural spinal mass at L1. A left-sided hemilaminectomy followed by a durotomy at L1 was performed and a firm, tan mass was removed. The histopathologic findings indicated a vascular proliferation most suggestive of a rare proliferative disorder of leptomeningeal blood vessels termed meningioangiomatosis. Although the dog’s signs initially worsened after surgery and he was nonambulatory with marked paraparesis, he regained ambulation within 3–4 wk after the operation. Eighteen months after surgery, he was ambulatory with mild hind limb ataxia with no progression of signs. This case suggests that surgical resection of lesions of suspected meningioangiomatosis can result in improvement of clinical signs with a good long-term prognosis.

scholarly journals STEROID INDUCED PSYCHOSIS IN A CASE OF ERYTHEMA MULTIFORME MAJOR.

2021 ◽  
pp. 9-10
Author(s):  
Nirali Muchhala ◽  
Nishikant Thorat
Keyword(s):  
Erythema Multiforme ◽  
Outpatient Department ◽  
Course Of Illness ◽  
Holistic Management ◽  
Psychiatric Disturbances ◽  
Erythema Multiforme Major ◽  
Detailed Evaluation ◽  
History Of ◽  
Long Term Prognosis

Corticosteroids have been documented to cause psychiatric disturbances to various degree. We report a case of psychosis in a case of erythema multiforme major treated with steroids that presented to psychiatric outpatient department requiring medical management. A 32 years old female was brought to psychiatry outpatient department following behavioural disturbances. Patient had a history of recently suffering from Erythema Multiforme major following a dose of injectable ceftriaxone. After being treated with injectable and oral dose of corticosteroids she developed behavioural disturbances. On detailed evaluation patient was diagnosed to be suffering from Substance/medication-induced psychotic disorder as per DSM-5. She was started on treatment with Tab. Olanzapine (5mg) HS and Tab. Clonazepam (0.5 mg) HS with which her symptoms improved and remitted completely within few weeks. Corticosteroid induced psychosis can be managed with tapering of steroid dosages and / or addition of psychotropic medication. This case emphasizes on the need of liaison-based approach for a holistic management in such cases.Further research is essential to establish the course of illness and long-term prognosis in these patients

scholarly journals Clinical Pattern and Treatment of Erythema Multiforme among a Sample of Sudanese Subjects

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Erythema Multiforme ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Skin Lesions ◽  
Treatment Results ◽  
Erythema Multiforme Major ◽  
Oral Mucosal Lesions ◽  
Associated Symptoms ◽  
Causative Agents ◽  
Etiological Agents

Background: Erythema multiforme is a rare hypersensitivity reaction, caused by different etiological agents affect the skin and mucus membranes. Material and Methods: A retrospective chart review of 110 patients was conducted. Data were collected on the types of erythema multiforme, associated symptoms, etiological agents and treatment. Results: Over 110 patients with erythema multiforme 54 (49.1%) were males and 56 (50.9%) were females. Mean age of the patients was 35 years old. Recurrent episodes of the disease were detected in 17.3% of the patients. Fever was found to be the most common associated symptom. Oral mucosal lesions were presented more than the skin lesions. Incisional biopsy was carried out by 15.5% of the patients. The three most common causative agents were antibiotics, bacterial infection and antimalarial drugs. Steroids was the treatment of choice in most of the cases (33.6%) followed by antibiotics (27.2%). Conclusion: Erythema multiforme major was the most common form of the disease.

scholarly journals Scrotal hemangiosarcoma in a Large White boar

2022 ◽  
Vol 52 (4) ◽  
Author(s):  
Renato Luiz Silveira ◽  
Ana Claudia de Menezes Cruz ◽  
Phillipe Bauer de Araújo Doria ◽  
Joao Marcelo Silva Silveira ◽  
Carlos Otávio de Paula Vasconcelos ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Skin Lesions ◽  
Neoplastic Cells ◽  
Large White ◽  
Existing Problems ◽  
Eosinophilic Cytoplasm ◽  
History Of ◽  
Degree Of Malignancy ◽  
Production Animals ◽  
Immunohistochemical Diagnosis

ABSTRACT: Tumors are rarely diagnosed in swine specie because of the short lifespan of production animals. Normally, these tumors do not present any clinical signs and are often detected at the time of slaughter. A 2-year-old Large White boar, used in the reproductive management of a farm and without a history of pre-existing problems, was examined for skin lesions on the scrotum. Samples were collected from skin segments containing lesions for histopathological and immunohistochemical diagnosis. Microscopically, the nodes in the scrotum pouch consisted of poorly demarcated, highly cellular, expansile, and multifocally invasive neoplasms, composed of immature endotheliocytes organized into neovascular formations. The tumor cells were pleomorphic, slightly oval to spindle-shaped, with eosinophilic cytoplasm and hyperchromatic nuclei with one to three nucleoli. All the nodules analyzed were compatible with hemangiosarcoma. After immunohistochemical evaluation, for the quantification of tissue angiogenesis the neoplastic cells immunoexpressed the CD31 monoclonal antibodies and factor VIII, through the identification of proteins expressed on the surface of endothelial cells. The Ki67 cell proliferation marker was positive in approximately 10% of the neoplastic cells, demonstrating a high degree of malignancy. Hemangiosarcoma in swine species has already been identified in several organs and tissues; however, to date, no study has demonstrated the diagnosis of this condition on the skin of the scrotum, as reported in this study. Therefore, it is expected that this report will contribute to the knowledge of the frequency of neoplasms in swine species.

scholarly journals Stevens-Johnson Syndrome

KYAMC Journal ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. 31-35
Author(s):  
Arpan Kumar Basak ◽  
Joya Debnath
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Erythema Multiforme ◽  
Primary Care Physicians ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Unknown Etiology ◽  
Initial Report ◽  
Johnson Syndrome ◽  
Erythema Multiforme Major ◽  
Mucous Membranes

Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and mucous membranes. While minor presentations may occur, significant involvement of oral, nasal, eye, vaginal, urethral, gastrointestinal, and lower respiratory mucous membranes may develop in the course of the illness. GI and respiratory involvement may progress to necrosis. Stevens-Johnson syndrome is a serious systemic disorder with the potential for severe morbidity and even death. The syndrome was first described in 1922, when the American pediatricians Albert Mason Stevens and Frank Chambliss Johnson reported the cases of 2 boys aged 7 and 8 years with "an extraordinary, generalized eruption with continued fever, inflamed buccal mucosa, and severe purulent conjunctivitis". Both cases had been misdiagnosed by primary care physicians as hemorrhagic measles. Erythema multiforme (EM), originally described by Von Hebra in 1866, was part of the differential diagnosis in both cases but was excluded because of the 'character of skin lesions, the lack of subjective symptoms, the prolonged high fever, and the terminal heavy crusting". Despite the presence of leucopenia in both cases, Stevens and Johnson in their initial report suspected an infectious disease of unknown etiology as the cause. In 1950, Thomas divided EM into 2 catagories: erythema multiforme minor (Von Hebra) and Erythema multiforme major (EMM). Since 1983, erythema multiforme major and Stevens-Johnson syndrome had been considered synonymous. In the 1990s, however, Bastuji and Roujeau each proposed that Erythema multiforme major and Stevens-Johnson syndrome are 2 distinct disorders. Several investigators propose that Stevens-Johnson syndrome and Toxic epidermal necrolysis (TEN) represent the same disease at different levels of severity. Although several classification schemes have been reported, the simplest breaks the disease down as follows: * Stevens-Johnson syndrome-A "minor form of TEN", with less than 10% body surface area (BSA) detachment. * Overlapping Stevens-Johnson syndrome/Toxic epidermal necrolysis (SJS/TEN)-Detachment of 10-30% BSA. * Toxic epidermal necrolysis-Detachment of more than 30%BSA.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 31-35

Herpes Simplex Virus in Childhood Erythema Multiforme

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 32-34
Author(s):  
William L. Weston ◽  
Sylvia L. Brice ◽  
Joy D. Jester ◽  
Scott Stockert ◽  
J. Clark Huff ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Erythema Multiforme ◽  
Inflammatory Diseases ◽  
Pediatric Population ◽  
Skin Lesions ◽  
Herpes Infection ◽  
Clinical Criteria ◽  
History Of ◽  
Simplex Virus

Although an association between herpes simplex virus (HSV) infection and erythema multiforme (EM) minor has been documented in adults, this has not been reported in the pediatric population. This study assessed the potential role of HSV infection in the pathogenesis of EM minor in children. Erythema multiforme skin lesions from 20 children, aged 1 to 16 years, were examined for the presence of HSV by using the polymerase chain reaction. The children included all fit strict clinical criteria for EM minor. Ten had a clinical history of an antecedent herpes infection ("herpes-associated EM"), and 10 did not ("idiopathic EM"). Herpes simplex virus DNA was detected in skin lesions of 8 of 10 children with herpes-associated EM and in 8 of 10 with idiopathic EM. Control skin biopsies from children with other bullous inflammatory diseases were negative. In addition, no HSV could be detected in a biopsy of normal uninvolved skin of a child in whom HSV was present in lesional skin. In situ hybridization on selected biopsies by means of an HSV-specific riboprobe confirmed the presence of HSV and localized it to the epidermis. It is concluded that HSV is a significant precipitating factor for EM minor in children, as it is in adults, and that clinicians should maintain a high index of suspicion of HSV even in the absence of a known history of herpes infection.

Intraocular tuberculosis, a challenge in diagnosis and treatment

2020 ◽  
Vol 3 ◽  
pp. 4
Author(s):  
Martina Larroude ◽  
Gustavo Ariel Budmann
Keyword(s):  
Developing Countries ◽  
Clinical Signs ◽  
Steady Increase ◽  
Ocular Tuberculosis ◽  
Industrial Countries ◽  
Choroidal Granuloma ◽  
History Of ◽  
And Migration ◽  
Ocular Tb

Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition and has variable manifestations. The incidence of TB is still high in developing countries, and a steady increase in new cases has been observed in industrial countries as a result of the growing number of immunodeficient patients and migration from developing countries. Choroidal granuloma is a rare and atypical location of TB. We present a case of a presumptive choroidal granuloma. This case exposes that diagnosis can be remarkably challenging when there is no history of pulmonary TB. The recognition of clinical signs of ocular TB is extremely important since it provides a clinical pathway toward tailored investigations and decision making for initiating anti-TB therapy and to ensure a close follow-up to detect the development of any complication.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

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