Die Haut als Zielscheibe – Erythema multiforme bei Hund und Katze

Zusammenfassung

Dieser Übersichtsartikel stellt das komplexe Krankheitsbild Erythema multiforme bei Hund und Katze dar. Es werden Ätiologie, Pathogenese, klinische Symptomatik, Diagnostik und Therapie erläutert. Erythema multiforme ist eine seltene, immunmediierte Hauterkrankung mit einem akut auftretenden spezifischen Reaktionsmuster der Haut und Schleimhaut auf unterschiedliche zugrundeliegende Mechanismen. Als auslösende Faktoren wurden Medikamente, Futtermittelbestandteile und Neoplasien, aber auch virale oder bakterielle Infektionen sowie Impfreaktionen identifiziert. In über 20% der Fälle lässt sich das auslösende Agens jedoch nicht eindeutig feststellen. Der Deutsche Schäferhund sowie der Pembroke Welsh Corgi scheinen prädisponierte Hunderassen zu sein. Häufig werden bei Hunden erythematöse Makulae, geringgradig erhabene und sich peripher ausbreitende Papeln sowie ringförmige bis bogenförmige erythematöse Muster beschrieben. Quaddeln, Plaques, Vesikel und Bullae, die sich zu Ulzerationen entwickeln, treten ebenfalls zeitweise auf. Häufig betroffene Körperregionen beim Hund sind Ventrum, mukokutane Übergänge, Maulhöhle, Pinnae und Pfotenballen. Histopathologische Befunde umfassen meist Einzelzellnekrosen in mehreren Schichten der Epidermis mit lymphozytärer Satellitose und einer zellarmen Grenzzonendermatitis. Eine Elimination der ursächlichen Faktoren und gleichzeitige symptomatische Therapie werden empfohlen. Die Prognose des Erythema multiforme variiert von vorsichtig bis günstig, je nach zugrundeliegender Ursache, Ausprägungsform und Ansprechen auf die Behandlung.

Summary

This review article will describe the complex nature of erythema multiforme in dogs and cats. The disease pattern will be illustrated in terms of etiology, pathogenesis, clinical signs, diagnostics and therapy. Erythema multiforme is a rare, immune-mediated skin disorder with an acute specific reaction pattern of skin and mucous membranes against different underlying causes. Reported triggering factors include drugs, food ingredients and neoplasias, but viral or bacterial infections and vaccine reactions were also identified. In over 20% of the cases the cause cannot be identified. The German Shepherd dog and Pembroke Welsh Corgi seem to be predisposed. Erythematous macules, slightly elevated and peripherally spreading papules as well as circular to arciform patterns were described frequently in the dog. Wheals, plaques, vesicles and bullae that develop into ulcers, are also seen. Frequently affected areas in the dog are the ventrum, mucocutaneous junctions, mouth, pinnae and foot pads. Histopathological findings include single cell necrosis in all layers of the epidermis with lymphocytic satellitosis and a cell-poor interface dermatitis. Elimination of the causative factors and concurrent symptomatic therapy are recommended. The prognosis varies from guarded to fair, depending on the underlying cause, presenting clinical signs and response to therapy.

Schlüsselwörter

Medikamentenhypersensitivität - Keratinozyten - Apoptose - Grenzzonen dermatitis - Zielscheibenläsionen

Keywords

Drug hypersensitivity - keratinocytes - apoptosis - interface dermatitis - target lesions

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