Faecal Occult Blood Test

Case of the Month (Emma Scurrell January 2012)

Uveodermatological syndrome in an Akita 

The following are H&E sections of depigmented and erythematous skin from the dorsal muzzle of a 2-year-old male Akita which is concurrently suffering from bilateral uveitis. 



 Fig 1. This is a low power view of the skin which shows focal ulceration and a band-like cellular infiltrate (black arrows) at the epidermal-dermal junction, typical of lichenoid dermatitis (H&E, x20). 


Fig 2. The cellular infiltrate at higher magnification reveals a macrophage-rich infiltrate interspersed with scattered neutrophils. Some of the macrophages contain fine dust-like melanin pigment within their cytoplasm (red arrows).  

 

 






Final Diagnosis

Granulomatous lichenoid dermatitis  

Discussion

The histopathological lesion of a granulomatous lichenoid (band-like) dermatitis associated with the accumulation of fine dust-like melanin pigment within macrophages together with the breed and clinical is indicative of uveodermatological syndrome, also known as Vogt-Koyanagi-Harada-like syndrome (VKH).

This is an autoimmune disease and the proposed mechanism is a cell-mediated hypersensitivity reaction against melanin and related proteins. In dogs, the uveal tract and skin are typically affected resulting in a granulomatous panuveitis and dermatitis. Ocular signs often preceed the cutaneous lesions and prompt recognition and treatment of this disease is important to prevent permanent blindness. The disease can affect multiple breeds, however Akitas, Samoyeds, Siberian Huskies, Alaskan Malamutes and Chow Chows are particularly predisposed. Cutaneous lesions (which resemble those of other auto-immune diseases) include symmetrical facial depigmentation, erythema and crusting. Lesions particularly affect the periorbital skin, dorsal muzzle, nasal planum and lips although the scrotum, vulva and pawpads can also be affected. Biopsies should be taken from regions of depigmentation, erythema and crusting – clearly ulcerated and infected areas are best avoided.

Previous Monthly Cases

Hypertensive Retinopathy January 2010
FIP in a cat - uncommon presentation February 2010
Phaeohyphomycosis    March 2010 
Scleral Rupture April 2010
Canine and feline epulides May 2010
Erythema multiforme in a labrador retreiver June 2010
Keloidal fibrosarcoma in a labrador retreiver July 2010
Cutaneous epitheliotropic lymphoma  August 2010 
Benign cutaneous histiocytoma  September 2010 
Iridociliary adenoma October 2010
Proliferative thrombovascular necrosis of the pinnae November 2010
Signet-ring cell carcinoma in the stomach of a dog December 2010
Cutaneous infiltrative lipoma in a labrador January 2011

Tonsillar squamous cell carcinoma February 2011
Canine orbital meningioma March 2011
"Lung-digit" syndrome in a cat April 2011
Hepatic amyloidosis in a cat May 2011
Haemophagocytic histiocytic sarcoma June 2011
Alternaria spp. infection in an immunocompromised dog July 2011
Ocular manifestation of lymphoma in a cat  August 2011
Kerion dermatophytosis in a Cocker spaniel September 2011
Subcuticular coenurus in a rabbit  October 2011
Optic nerve glioma in a dog November 2011
Malignant transformation of a viral papilloma in a dog  December 2011



CytoPath Ltd | PO Box 24 | Ledbury | Herefordshire | HR8 2YD |
tel: 01531 63 00 63 | fax: 01531 63 00 33 | email: customer.enquiries@cytopath.co.uk | web: www.cytopath.co.uk

2009 Cytopath Limited / / all rights reserved / / design and development by mightyweb.co.uk

Faecal Occult Blood Test