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Long-term results of immunosuppressive therapy in canine pemphigus foliaceus
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Pemphigus foliaceus is one of the most common autoimmune diseases in dogs, leading to autoantibodies to desmoglein I and finally to pustule and crust formation. Immunosuppressive therapy is mandatory in this disease - but does it always have to be given for the rest of the life? An interesting, rarely discussed question!
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Limited information is available on the long-term outcome of treatment of pemphigus foliaceus in dogs.
The purpose of this study is to report that a prolonged remission can occur after discontinuation of immunosuppressive regimens in some animals with this disease.
Six dogs were diagnosed with pemphigus foliaceus based on suggestive clinical signs and histopathology. These patients were treated either with immunosuppressive doses of oral glucocorticoids or with a combination of oral glucocorticoids and azathioprine.
After clinical signs underwent complete remission, which occurred 1.5-5 months after immunosuppression was initiated, the drugs were tapered progressively and eventually withdrawn.
The total duration of immunosuppressive therapy varied between 3 and 22 months. Skin lesions of pemphigus foliaceus did not recur for 1.5-6 years after treatment was stopped.
These observations suggest that, in some dogs with pemphigus foliaceus, immunosuppression can lead to long-term remission of skin lesions, and that discontinuation of treatment is not necessarily followed by a recurrence of clinical signs.
Source: Olivry T, Bergvall KE, Atlee BA (2004): Prolonged remission after immunosuppressive therapy in six dogs with pemphigus foliaceus. In: Vet Dermatol. 2004 Aug;15(4):245-52.
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