Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus
A 6-year-old, intact male miniature Pinscher dog had erosive lesions on perilabial, peripenial and perianal mucocutaneous areas, which were exacerbated by ulcerations, crusts, with pain while defecating and urinating. The lesions were symmetrical, and no systemic signs were observed. Histopathologic...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-04-01
|
| Series: | Veterinary Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2306-7381/8/5/72 |
| _version_ | 1797536503329456128 |
|---|---|
| author | Jae-Eun Hyun Yeong-Hun Kang Cheol-Yong Hwang |
| author_facet | Jae-Eun Hyun Yeong-Hun Kang Cheol-Yong Hwang |
| author_sort | Jae-Eun Hyun |
| collection | DOAJ |
| description | A 6-year-old, intact male miniature Pinscher dog had erosive lesions on perilabial, peripenial and perianal mucocutaneous areas, which were exacerbated by ulcerations, crusts, with pain while defecating and urinating. The lesions were symmetrical, and no systemic signs were observed. Histopathological evaluation showed parakeratotic hyperkeratosis, ulceration and cell-rich lymphoplasmacytic interface dermatitis with basal keratinocyte apoptosis. Immunohistochemistry revealed strong reaction in the dermoepidermal junction against goat-canine IgG and mild-to-moderate reaction against goat-canine IgA, IgM and C3. Based on these findings, the dog was diagnosed with mucocutaneous lupus erythematosus (MCLE). Oral prednisolone 1 mg/kg twice daily, mycophenolate mofetil (MMF) 18.3 mg/kg twice daily and 0.1% tacrolimus ointment were prescribed as initial treatment. The lesions showed remarkable improvement within 4 weeks, but the dog exhibited polyuria, polydipsia and hepatomegaly with high dosage of prednisolone. Hence, the dosage of prednisolone was gradually tapered for 9 weeks and discontinued, but MMF and tacrolimus were continued. No new lesion or associated side effect was observed while reducing the MMF dose to 10 mg/kg twice daily and with continuous use of tacrolimus ointment after steroid discontinuation. In conclusion, this case report emphasizes the usefulness of MMF and tacrolimus as steroid-sparing agents in the treatment of dogs with MCLE. To the best of our knowledge, this is the first case report of MCLE that was successfully managed long-term with MMF and tacrolimus. |
| first_indexed | 2024-03-10T12:01:38Z |
| format | Article |
| id | doaj.art-2fa8b5f749ea4be894a1bf0a7634d1f0 |
| institution | Directory Open Access Journal |
| issn | 2306-7381 |
| language | English |
| last_indexed | 2024-03-10T12:01:38Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Veterinary Sciences |
| spelling | doaj.art-2fa8b5f749ea4be894a1bf0a7634d1f02023-11-21T16:55:31ZengMDPI AGVeterinary Sciences2306-73812021-04-01857210.3390/vetsci8050072Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and TacrolimusJae-Eun Hyun0Yeong-Hun Kang1Cheol-Yong Hwang2Department of Veterinary Internal Medicine, Konkuk Veterinary Medical Teaching Hospital, Konkuk University, Seoul 05029, KoreaLaboratory of Veterinary Dermatology and the Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, KoreaLaboratory of Veterinary Dermatology and the Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, KoreaA 6-year-old, intact male miniature Pinscher dog had erosive lesions on perilabial, peripenial and perianal mucocutaneous areas, which were exacerbated by ulcerations, crusts, with pain while defecating and urinating. The lesions were symmetrical, and no systemic signs were observed. Histopathological evaluation showed parakeratotic hyperkeratosis, ulceration and cell-rich lymphoplasmacytic interface dermatitis with basal keratinocyte apoptosis. Immunohistochemistry revealed strong reaction in the dermoepidermal junction against goat-canine IgG and mild-to-moderate reaction against goat-canine IgA, IgM and C3. Based on these findings, the dog was diagnosed with mucocutaneous lupus erythematosus (MCLE). Oral prednisolone 1 mg/kg twice daily, mycophenolate mofetil (MMF) 18.3 mg/kg twice daily and 0.1% tacrolimus ointment were prescribed as initial treatment. The lesions showed remarkable improvement within 4 weeks, but the dog exhibited polyuria, polydipsia and hepatomegaly with high dosage of prednisolone. Hence, the dosage of prednisolone was gradually tapered for 9 weeks and discontinued, but MMF and tacrolimus were continued. No new lesion or associated side effect was observed while reducing the MMF dose to 10 mg/kg twice daily and with continuous use of tacrolimus ointment after steroid discontinuation. In conclusion, this case report emphasizes the usefulness of MMF and tacrolimus as steroid-sparing agents in the treatment of dogs with MCLE. To the best of our knowledge, this is the first case report of MCLE that was successfully managed long-term with MMF and tacrolimus.https://www.mdpi.com/2306-7381/8/5/72mucocutaneous lupus erythematosusdogmycophenolate mofetilprednisolonetacrolimus |
| spellingShingle | Jae-Eun Hyun Yeong-Hun Kang Cheol-Yong Hwang Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus Veterinary Sciences mucocutaneous lupus erythematosus dog mycophenolate mofetil prednisolone tacrolimus |
| title | Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus |
| title_full | Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus |
| title_fullStr | Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus |
| title_full_unstemmed | Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus |
| title_short | Successful Treatment of Mucocutaneous Lupus Erythematosus in a Dog with Prednisolone, Mycophenolate Mofetil and Tacrolimus |
| title_sort | successful treatment of mucocutaneous lupus erythematosus in a dog with prednisolone mycophenolate mofetil and tacrolimus |
| topic | mucocutaneous lupus erythematosus dog mycophenolate mofetil prednisolone tacrolimus |
| url | https://www.mdpi.com/2306-7381/8/5/72 |
| work_keys_str_mv | AT jaeeunhyun successfultreatmentofmucocutaneouslupuserythematosusinadogwithprednisolonemycophenolatemofetilandtacrolimus AT yeonghunkang successfultreatmentofmucocutaneouslupuserythematosusinadogwithprednisolonemycophenolatemofetilandtacrolimus AT cheolyonghwang successfultreatmentofmucocutaneouslupuserythematosusinadogwithprednisolonemycophenolatemofetilandtacrolimus |