33 Erythema multiforme
CASE HISTORY
The history in this case was as follows:
• One week after a recent stay in a boarding kennel, symptoms of lethargy, a serous ocular discharge and sneezing became apparent. Appetite remained unaffected.
• One week after the onset of these respiratory symptoms, skin lesions developed consisting of pinnal erythema and subsequently erosive, ulcerative and crusting lesions over the buccal mucosa, ventral trunk and feet.
• The dog had received annual routine vaccinations; the last vaccination had been 3 months previously when anthelmintic treatment had also been administered.
• At the time of examination, treatment consisted of oral clindamycin. Since the onset of skin lesions, the dog had also received treatment with ampicillin, carprofen and chlorpheniramine.
• One other dog in the household, the dam, was unaffected. There was no evidence of zoonosis and no history of travel abroad. There had been no recent changes to the house environment.
CLINICAL EXAMINATION
Clinical examination in this case revealed:
• Vesicles and bullae, erosions and ulcers over the oral mucosae involving both the hard and soft palates (Figs 33.1 and 33.2)
• Occasional epidermal collarettes and shallow crusting erosions over the glabrous abdominal skin and flank folds (Fig. 33.3)
• Erosions and crusting were evident over all the ungual folds and there were erosions and ulcers over the footpads and footpad margins on all four feet (Fig. 33.4).
Figure 33.2 Macular erythema and erosions over the buccal mucosa. A bullous lesion is evident (arrowed).
