41 Uveodermatological syndrome
Uveodermatological syndrome is a rare condition characterized by ocular and cutaneous signs in dogs. The ocular signs include uveitis, glaucoma, conjunctivitis, blepharospasm and photophobia. The cutaneous signs include depigmentation of the skin and hair, crusting, erythema and ulceration, usually at the mucocutaneous sites. The condition is similar to Vogt–Koyanagi–Harada syndrome described in people. Vogt–Koyanagi–Harada syndrome is progressive, starting with a meningoencephalitis phase, followed by an ophthalmic–auditory phase, which progresses to a convalescent stage, where the ocular signs subside, but the cutaneous changes occur and remain. During the early phase of the disease the clinical signs include fever, malaise, headaches, nausea and vomiting. The ocular signs and deafness are followed by poliosis, alopecia and leucoderma during the convalescent stage. In contrast, in dogs, ocular signs are usually acute and precede the cutaneous signs. Ophthalmic assessment is essential in dogs, even when there are no obvious ocular signs. This chapter describes a case where the cutaneous signs preceded ocular signs, and where early recognition and treatment for ocular disease allowed early intervention.
Ocular signs are the usual reason for presentation of these cases. The owner may present the dog because it has ocular discharge, conjunctivitis, oedema, photophobia or blindness. Depigmentation of skin and hair may be evident, and may be accompanied by erythema, ulceration and alopecia. The relevant history in this case was:
This is a condition where physical examination should include a detailed ophthalmic examination. Ocular signs include conjunctivitis, blepharospasm, anterior and posterior uveitis, retinal haemorrhage and/or detachment. The main cutaneous sign is depigmentation of the nasal planum, eyelids, scrotum, vulva and paw pads. Crusting, ulceration, erythema and alopecia are likely to be present in advanced cases. Oral ulceration may also be observed in chronic, untreated cases.