AUTO-IMMUNE BLEPHARITIS


Primary dermal autoimmune disease may affect multiple areas including the facial, nasal & periocular regions, mucocutaneous junctions and/or external pinnae, manifesting as papular erosions, ulceration, dermatitis and/or depigmentation. The classification of these diseases is complex, encompassing the pemphigus (auto-antibody-mediated acantholysis) diseases, lupus (immune-cellular dysfunction) diseases, vasculitis-related diseases and uveodermatological syndrome (also described as “Vogt-Koyanagi-Harada-like” or “VKH-like” disease). Of the pemphigus diseases, pemphigus foliaceous (PF) is more commonly encountered, notably affecting the Akita, Chow Chow & Labrador Retriver. Of the lupus diseases, discoid lupus erythematosis (DLE), also described as “cutaneous lupus erythematosis”, is more commonly encountered, notably affecting the Akita, Chow Chow, Siberian Husky, German Shepherd, Australian herding and Collie-breeds. Uveodermatological syndrome typically involves not only dermal tissues (manifesting as nasal, periocular and mucocutaneous ulceration and/or depigmentation) but also the uveal tract where it may result in uveitis, retinal detachment, hyphema and/or glaucoma. Breeds commonly affected by uveodermatological syndrome the Akita, Chow Chow & Siberian Husky (*see also uveodermatological associated uveitis & uveodermatological associated chorioretinitis). The diagnosis of autoimmune blepharitis is made based on clinical findings in conjunction with the interpretation of representative dermal biopsies, ideally taken form the interface of affected/non-affected tissue. In all cases, treatment comprises long-term immune-modulation.