Peer-reviewed veterinary case report
Dog developed widespread thickened skin from cyclosporine treatment
By Martini, F et al.·Published in Schweizer Archiv fur Tierheilkunde·2023·Clinic for Small Animal Internal Medicine·View original on PubMed →
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Original publication title: Cyclosporine induced generalized hyperkeratosis in a dog.
- Species:
- dog
Plain-English summary
A 5-year-old female French bulldog developed severe skin problems, including thick, scaly plaques, after being treated long-term with cyclosporine, a medication used to suppress her immune system for a brain condition. Tests ruled out a viral infection, and a skin biopsy showed inflammation and abnormal skin growths. The vet stopped the cyclosporine and switched her to a different medication, mycophenolate mofetil, while also giving her antibiotics for three weeks. After four months, her skin healed completely, and she has remained healthy for two years since then.
People also search for: dog skin problems after cyclosporine · French bulldog skin treatment · mycophenolate mofetil for dogs · dog thick skin plaques treatment
Abstract
Cyclosporine is a potent immunosuppressive agent used in veterinary medicine to treat a variety of inflammatory or immune mediated conditions. Many adverse effects are associated with this medication, however most of them rarely occur. A 5-year-old, female intact French bulldog was presented with multiple, multifocally distributed, severe hyperkeratotic and papillomatous/verrucous plaques. The dog was on long-term immunosuppressive treatment with cyclosporine for meningoencephalitis of unknown origin (MUO). It had an history of atopic dermatitis and calcinosis cutis. A papillomavirus infection was excluded by polymerase chain reaction (PCR), and histopathologic analysis revealed a chronic lymphoplasmacytic non-specific dermatitis, perifolliculitis and periadnexitis and focal folliculitis with papillomatous epidermal hyperplasia and orthokeratotic hyperkeratosis. The diagnosis of "cyclosporine-induced epidermal hyperplasia with secondary pyoderma" was made. Cyclosporine was discontinued and as an alternative mycophenolate mofetil was started to control the MUO. An antimicrobial treatment was prescribed for three weeks. After four months, the skin lesions had healed completely. To date after 2 years, the dog is still in remission. The occurrence of hyperplastic lesions associated with cyclosporine therapy have already been described in previous reports. Most of them resemble those of psoriasiform lichenoid dermatitis, although papilloma virus may be detected in some instances. The dog of the present case showed some peculiarities in the histopathological findings, and a papillomavirus involvement was ruled out with PCR. Like observed in a previous report, there was no correlation between cyclosporine blood level and the severity of dermatological changes. A discontinuation of cyclosporine resulted in complete healing in 4 months. This case highlights the importance of regular monitoring and follow-ups in patients on immunosuppressive therapy. Even rare side effects should always be considered in these cases.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36562746/