Primary cutaneous vasculitis is a rare immune-mediated disease of blood vessels.
The pathology is a result of peripheral ischemia as a result of vasculitis or vasculopathy.
In dogs, this disease is characterized by an ischemic dermatopathy which manifests as purpura, wheals, edema, plaques, alopecia and scarring of the extremities.
Greater than 50% of cases are idiopathic, the remainder induced by such things as endo- and ecto-parasites and vaccine and drug/food reactions.
Vaccines-induced vasculitis is not uncommon in association with rabies vaccine. A case of acute febrile neutrophilic vasculitis in a litter of Shar Pei pups, suggestive of an underlying vaccine reaction has been reported.
Clinical signs of primary cutaneous vasculitis include areas of hypopigmentation or hyperpigmentation associated with areas of erythematous alopecia, ulceration and scaling, often affecting the ears, but also the paw pads, tail tip and nasal planum.
Diagnosis usually requires histopathological assessment of skin biopsies, although ELISA assays are available for detection of D-dimers associated with intravascular thrombosis.
A differential diagnosis of primary immune-mediated vasculitis would include secondary causes of cutaneous vasculitis, including Bartonella spp, Leishmania spp, Demodex spp, Toxoplasma spp, atopy-associated vasculitis, pemphigus, lupus erythematosus and sebaceous adenitis.
Treatment is usually successful with topical tacrolimus, although scarring is permanent.
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