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Canine Discoid
Lupus
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Nasal Solar Dermatitis (Collie Nose)
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Side View
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Collie Nose is a discoloration of the nose pigment diagnosed as Discoid
Lupus Erythematosus. Originally thought to be an allergic reaction to
sunlight, the condition is only aggravated by prolonged sun exposure.
Though not painful, the lighter colored areas are very sensitive to
sunlight
and can be sunburned. The dog should be kept out of bright sunlight as
much as possible or the affected area should be protected with a sun
screen
lotion. Though it is known as Collie nose it is not indigenous to the
Collie
breed as it also appears in the Shetland Sheepdog and any mixed breed
farm
shepherd type dogs. One Disease know as DM (Dermatomyositis) in it's
early
stages, has been mistaken for Collie Nose.
reprinted with kind permission from Becky
Vaughan-Curran
Garwood Kennels, Garwood Web Design, CKC member, AWCA member
www.garwoodkennels.com
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Discoid lupus
Michael Richards, DVM
Discoid lupus is an immune
mediated skin disease that is probably related to systemic lupus
erythematosus (SLE) but instead of affecting the whole body as SLE
does, it primarily affects the nose and face. As far as I know, there
is no known cause of this problem but it does seem more frequent in
dogs of the German shepherd, collie, Brittany spaniel. Shetland
sheepdog, Siberian husky and German shorthaired pointer breeds.
The disease normally starts
as loss of pigment around the nose. There may be scabby
sores or just scaling of the nasal tissue. The surface of the nose may
change from its typical cobblestoned appearance to a smooth surface.
As this disease progresses it can cause deep sores on the borders of
the nose where it meets normal skin and the sores start to progress up
the bridge of the nose. Some dogs seem to be really bothered by this
condition and others show little reaction to the sores.
Ultraviolet light seems to make the sores worse, so the disease may
appear to be seasonal. It is more common in areas in which exposure to
ultraviolet light is increased, such as high altitudes. If the
depigmentation leads to sunburn, squamous cell carcinoma becomes more
likely than in other dogs. Topical sunscreens can be very beneficial,
although it is hard to get dogs to leave them on. Keeping the dog in
during the peak sunlight hours is probably the most effective way to
prevent excessive exposure to UV light.
Treatment depends on the
severity of the disease. In many cases, topical treatment will be all
that is necessary, using a corticosteroid ointment (Panalog, Synalar
and others). It is usually necessary to use a fairly potent
corticosteroid. Vitamin E supplementation is sometimes beneficial
but can take several months to show much effect. Severe cases require
treatment with corticosteroids. It is possible that other
immunosuppressive
therapy such as gold salts or azathioprine (Immuran) could be
beneficial
but this is rarely necessary to consider. In people, this condition is
often responsive to antimalarial medications but I do not know if this
is safe or effective therapy for dogs.
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Question: Dear Dr. Richards,
I have had a biopsy done on my German Shepherd
and found out that she does in fact have Discoid Lupus. My
question now relates to treatment. The clinic I took her to
told me that the pathologist said that my dog's case is very mild
and in the very beginning stages so they suggested I go for the lowest
type of treatment. I went by the clinic the other day and what
they are telling me to give her is 4 capsules of Tetracycline 250 mg.
each day (2 capsules 2 times a day) and also Vitamin E, Vitamin B and
some fish oil capsules also twice a day. I have no problem with
the vitamin supplements but I am concerned about giving her so many
antibiotics for the rest of her life. I am not much for
medications even for
myself and I don't feel comfortable giving my dog so many pills each
day.
My question, therefore, is...Is it absolutely necessary for her to take
the Tetracycline or are there other options. Can I just give her
the vitamins and not the Tetracycline? I would appreciate any advice or
referral you can give me.
Thank you, Sheryl
Answer: Sheryl-
It helps a lot when thinking of the use of tetracyline to think of it
as an immune modulator with minimal side effects rather than an
antibiotic. The effects it has on the immune system are probably why
tetracycline can be helpful in cases of discoid lupus rather than its
antibiotic effect. When compared to other drugs with immune system
effects it is very unlikely to cause problems, except for causing
vomiting in some patients.
Another medication sometimes used for discoid lupus is niacinamide. At
the present time I think it is usually used at the same time as
tetracycline, with both medications dosed at about 250mg (small dog)
or 500mg (large dog) three times a day. It is also relatively
unlikely to cause serious side effects, when compared to
medications such as corticocsteroids but it also causes vomiting in a
fair number of dogs.
Discoid lupus can often be treated with topical medications. A
sunblocker can be helpful. You have to use a waterproof one and it
should have an SPF of 30 or greater. Some dogs do better with
oral supplementation of Vitamin E, usually 400 to 800 IU per day.
Keeping affected dogs indoors helps a lot, too.
Topical application of a potent corticosteroid, like
fluocinolone acetonide or betamethasone dipropionate applied twice
daily will often control the symptoms of discoid lupus and is
preferable
to using oral or injectable
corticosteroids.
It would really surprise me if the vitamins and fatty acid
supplementation would work alone but it might, if you also use
sunblock and try to avoid exposure to the sun, too. Topical
corticosteroids work for many dogs and the combination of these things
and tetracycline and niacinamide works for most dogs.
Mike Richards, DVM
7/14/2000
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Discoid Lupus Erythematosus
Also called:
· DLE
· Discoid Lupus
· Collie Nose
What is Discoid Lupus Erythematosus?
Discoid Lupus Erythematosus (DLE) is a skin condition
of dogs. It typically causes a loss of color in the hairless,
moist part of the nose. A normally black nose may fade to gray or
pink. The discoloration can be accompanied by ulcers and
bleeding. The skin around the nose may also look abnormal, and
rarely, the disease affects other parts of the skin. It does not
affect other organs.
What causes Discoid Lupus Erythematosus?
The skin lesions in DLE arise when the animal’s immune system targets
the skin. The immune system normally
clears
infections and any substances that are “foreign” to the body, while
ignoring, or tolerating, substances that are normally found
there. In DLE, we believe that the immune system considers some
of the normal components of the skin as foreign. It uses the
mechanisms normally launched at foreign invaders to try to “clear”
these skin components. The resulting inflammation and skin damage
lead to the visible changes seen on the surface.
Unfortunately, we do not know all the factors that contribute to this
error. We do know that some breeds of dogs seem more prone to
developing the disease. In many dogs, sunlight exacerbates the
disease. Once DLE has developed, it tends to be a lifelong
condition due to the long-lasting “memory” of the immune
system.
How is Discoid Lupus Erythematosus diagnosed?
The diagnosis is based on skin biopsies. Due to
the location of the skin lesions, general anesthesia or sedation
may be required to collect the biopsies.
How is Discoid Lupus Erythematosus treated?
Treatment consists of oral medications, topical therapy, or a
combination of both. Oral medications are usually
prescribed, as
dogs tend to resist the application of medications to the nose, and can
also quite easily remove them. Since DLE can be exacerbated by
sun exposure, a sunscreen (not containing zinc oxide) should be applied
to the nose when the dog goes outside. It is best to keep your
dog indoors during the peak daylight hours.
The treatment for DLE may need to be continued for life, but serious
side-effects from the treatments are uncommon. Routine rechecks
are recommended to enable the dose of medications to
be kept as low as possible.
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The above information is simply
informational. It's intent is not to replace the advice of a
veterinarian nor to assist
you in making a diagnosis of your pet. Please consult with your own
veterinarian for confirmation of any diagnosis. Your pets life may
depend on it.
