Eosinophilic folliculitis and furunculosis

52 Eosinophilic folliculitis and furunculosis




INITIAL PRESENTATION


Sudden onset of nodules with ulceration, crusting and bleeding on the nose of a collie cross.



INTRODUCTION


Canine eosinophilic furunculosis is an uncommon condition with an acute onset. It is usually confined to the nose and the muzzle, although it can occur on the pinna and the trunk. The severity of the lesions varies and many dogs will exhibit signs of pruritus. In most cases, it is thought to result from an acute hypersensitivity reaction to arthropod antigens. The condition is similar to mosquito-bite hypersensitivity in cats.




CASE PRESENTING SIGNS


A 4-year-old, neutered female collie cross was presented with a sudden onset of pruritus, nodules, ulceration and crusting on the nose.



CASE HISTORY


Most dogs are presented with a history of a sudden onset of symptoms. Only when questioned is the owner likely to report a possible recent exposure to insects.


In this case the owner reported that:


• The dog had yelped during a walk on the previous day.

• The next day the dog was constantly rubbing its muzzle and haemorrhagic papules and plaques had appeared on the bridge of its nose.

• There was no previous history of dermatological disease.

• The dog’s appetite and demeanour were unaffected.

• The dog was presented in December, when insect activity in the UK is assumed to be absent; however, this was in a year when mild autumn conditions extended into December.


CLINICAL EXAMINATION


A physical examination revealed enlarged submandibular lymph nodes, but all other parameters were within normal limits. Multiple nodules, some with an ulcerated surface and some with a haemorrhagic crust, were present on the bridge of the nose (Fig. 52.1). The dog resented examination of this site. None of the other sites were affected in this case.


image

Figure 52.1 Large nodules with haemorrhagic crusts and oozing on the bridge of the nose.




DIFFERENTIAL DIAGNOSES


The most likely differential diagnoses based on the history were:


• Canine eosinophilic furunculosis of the face

• Bacterial folliculitis and furunculosis

• Sterile pyogranulomatous dermatitis

• Tick-bite hypersensitivity

• Contact irritant or allergic dermatitis.

An adverse drug reaction can also have a sudden onset, but the dog in this case had not been medicated for over 12 months. Other less likely diagnoses include:


• Dermatophyte kerions

• Pemphigus complex

• Neoplasia.

However, the onset in these conditions is slow and the lesions progressively worsen. Furthermore, they usually involve multiple sites, so they can easily be ruled out during the case work-up.

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Eosinophilic folliculitis and furunculosis
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